Infection prevention and control in a treatment centre during a Lassa fever outbreak in southeastern Nigeria - January, 2018

Odekunle Bola Odegbemi,Chukwuma David Umeokonkwo,Elsie Ilori,Patrick Nguku,Chinenye Nkem Nwaekpe,William Nwachukwu,Kingsley Ojide,Benedict Azuogu,Joseph Agboeze,Chikwe Ihekweazu,John Oladejo,Muhammad Shakir Balogun

doi:10.31646/gbio.44

Abstract

Introduction: Lassa fever (LF) is a communicable viral haemorrhagic disease. Person-to-person spread occurs by inhalation or direct contact with the bodily fluids of an infected patient. Infection Prevention and Control (IPC) is essential in healthcare facilities for the wellbeing and safety of patients, staff and visitors. Federal Teaching Hospital, Abakaliki is the designated treatment center for LF in Ebonyi State. We assessed IPC practices in this facility during the 2018 outbreak of LF involving healthcare workers. Methods: We conducted a cross-sectional study on 135 healthcare workers selected by systematic sampling. Information on their knowledge and practice of IPC was collected using a pre-tested, semi-structured questionnaire. We classified knowledge into “good”, “fair” and “poor” based on the total correct response. Those that scored ≥75% of the maximum score were classified as good, 50-74% as fair and Results: The mean age of the respondents was 37.6 ± 7.6 years and 75 (55.6%) were females. Fifty-seven (42.5%), 29 (21.6%) and 13 (9.9%) respondents claimed always to have gloves, running water and hand washing soaps, respectively, in their units. The proportion of respondents with good knowledge of IPC measures was 71.8%, while 58.5% and 37.8% had good knowledge of LF epidemiology and LF clinical features, respectively. Being a core health worker (OR: 3.39 95%CI: 1.38-8.32) was significantly associated with good knowledge of LF epidemiology. Being male (OR: 1.55 95%CI: 0.72-3.34) and having spent >15years in the facility (OR: 1.16 95%CI: 0.39 - 3.44) were associated with good knowledge of IPC precautionary measures. However, these associations were not statistically significant. Conclusions: The majority of the staff had good knowledge of IPC. However, knowledge of LF epidemiology was greater among those whose roles were related to management of LF cases. We recommended more awareness on LF, IPC practices and improved supply of IPC commodities.

Highlights

Lassa fever (LF) is a communicable viral haemorrhagic disease
We purposively sampled key units involved in the management of suspected Lassa fever cases and assessed the availability of basic Infection Prevention and Control (IPC) requirements
Knowledge of LF epidemiology was greater among those whose roles were related to management of LF cases

Summary

Introduction

Lassa fever (LF) is a communicable viral haemorrhagic disease. Person-to-person spread occurs by inhalation or direct contact with the bodily fluids of an infected patient. Lassa fever is a communicable acute viral haemorrhagic disease. Person-to-person spread occurs by inhalation or direct contact with blood, vomitus, urine, saliva, feaces, throat secretions or other body fluids from affected Lassa fever patients.[2, 12]. Lassa fever is an epidemic-prone disease with an alert threshold of a single suspected case and an epidemic threshold of a single confirmed case.[3] Outbreaks of the disease have been observed in Nigeria, Liberia, Sierra Leone, Guinea and the Central African Republic, but it is believed that human infections exist in Democratic Republic of the Congo, Mali and Senegal. The infection is endemic in West African countries and causes 300500,000 cases annually with about 5,000 deaths.[4,5]

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Conclusion