Implementation of infection control in health facilities in Arua district, Uganda: a cross-sectional study.

Peter Wasswa,Christine K Nalwadda,Patrick Anguzu,Esther Buregyeya,Sheba N Gitta,Fred Nuwaha

doi:10.1186/s12879-015-0999-4

Abstract

BackgroundAt least 1.4 million people are affected globally by nosocomial infections at any one time, the vast majority of these occurring in low-income countries. Most of these infections can be prevented by adopting inexpensive infection prevention and control measures such as hand washing. We assessed the implementation of infection control in health facilities and determined predictors of hand washing among healthcare workers (HCWs) in Arua district, Uganda.MethodsWe interviewed 202 HCWs that included 186 randomly selected and 16 purposively selected key informants in this cross-sectional study. We also conducted observations in 32 health facilities for compliance with infection control measures and availability of relevant supplies for their implementation. Quantitative data underwent descriptive analysis and multiple logistic regressions at 95 % confidence interval while qualitative data was coded and thematically analysed.ResultsMost respondents (95/186, 51 %) were aware of at least six of the eight major infection control measures assessed. Most facilities (93.8 %, 30/32) lacked infection control committees and adequate supplies or equipment for infection control. Respondents were more likely to wash their hands if they had prior training on infection control (AOR = 2.71, 95 % CI: 1.03–7.16), had obtained at least 11 years of formal education (AOR = 3.30, 95 % CI: 1.44–7.54) and had reported to have acquired a nosocomial infection (AOR = 2.84, 95 % CI: 1.03–7.84).ConclusionsHealthcare workers are more likely to wash their hands if they have ever suffered from a nosocomial infection, received in-service training on infection control, were educated beyond ordinary level, or knew hand washing as one of the infection control measures. The Uganda Ministry of Health should provide regular in-service training in infection control measures and adequate necessary materials.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-0999-4) contains supplementary material, which is available to authorized users.

Highlights

At least 1.4 million people are affected globally by nosocomial infections at any one time, the vast majority of these occurring in low-income countries
A meta-analysis by Aiello and Larson indicated that appropriate hand hygiene practices significantly reduced the risk of nosocomial infections while a case-control study conducted in Brazil singled-out poor hand hygiene in addition to overcrowding and understaffing as risk factors for nosocomial infections [15, 16]
A descriptive exploratory study conducted in Botswana amongst emergency department nurses identified resource constraints such as the lack of the necessary facilities, inadequate equipment and materials, inadequate staffing and the lack of sustainable in-service education as factors that could prevent them from complying with infection control measures [18]

Summary

Introduction

At least 1.4 million people are affected globally by nosocomial infections at any one time, the vast majority of these occurring in low-income countries Most of these infections can be prevented by adopting inexpensive infection prevention and control measures such as hand washing. The World Health Organization (WHO) estimates that over 1.4 million people suffer from nosocomial infections at any one time, with the proportion of these infections being up to 20 times higher in low and middle income countries [1]. These infections are among the leading cause of death and morbidity among hospitalized patients and present a considerable public health burden [2].

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Conclusion