Abstract
BackgroundTuberculosis (TB) is highly prevalent in sub-Saharan Africa, making the risk of infection transmission high in these countries. Despite high prevalence of TB and expected high probability of nosocomial transmission in Ethiopia, a rapid assessment done in 2008 revealed that most health facilities in Ethiopia do not use tuberculosis infection control (TBIC) practices. Patients and providers are therefore at risk of exposure to TB, especially at high case load facilities. The purpose of this study was to assess TBIC knowledge and practices among health professionals working in hospitals in the Amhara region of Northwest Ethiopia.MethodsAn institution-based hybrid study was implemented form August 2010 to January 2011. The subjects were health professionals who were proportionally selected from each hospital. Subjects self-administered a questionnaire that contained sections on socio-demographics and on TBIC knowledge and practice. Those answering ≥60% of knowledge questions correctly and ≥50% of practice questions correctly were considered to have good knowledge and practice, respectively.ResultsA total of 313 healthcare professionals were enrolled from four healthcare facilities. The response rate was 96%. Only 18.8% received in-service training. Among those who were trained, 74.4%, 95% CI (69.6, 79.3%) were found to have good knowledge and 63.2%, 95% CI (57.9, 68.6%) good practice on TBIC. Training was found to be a predictor of TBIC knowledge, AOR* 3.386 and 95% CI (1.377, 8.330) while knowledge of TBIC was a strong predictor of good TBIC practice, AOR* 10.667 and 95% CI (5.769, 19.721).ConclusionsThough the majority of the respondents had good TBIC knowledge and practice, a considerable proportion of healthcare professionals were not trained on TBIC. Respondents trained on TBIC were found to be more knowledgeable than those not trained. Similarly, respondents with good TBIC knowledge were 10 times more likely to have good TBIC practice compared to those with poor TBIC knowledge. Training was not found to have an effect on TBIC practice.*Adjusted Odds Ratio.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-014-0593-2) contains supplementary material, which is available to authorized users.
Highlights
Tuberculosis (TB) is highly prevalent in sub-Saharan Africa, making the risk of infection transmission high in these countries
The analyses found no significant difference in the proportions of male and female respondents with good tuberculosis infection control (TBIC) practice (64.1% and 62.5%, respectively), odds ratio (OR) 0.935 and 95% CI (0.591, 1.482)
Our findings revealed that only 34.2% of the healthcare professionals felt that a respirator should be worn to prevent TB infection transmission; this is far below what is reported from the United States (65% of those with no TB patient contact and 88% of those with patient contact) [14]
Summary
Tuberculosis (TB) is highly prevalent in sub-Saharan Africa, making the risk of infection transmission high in these countries. Despite high prevalence of TB and expected high probability of nosocomial transmission in Ethiopia, a rapid assessment done in 2008 revealed that most health facilities in Ethiopia do not use tuberculosis infection control (TBIC) practices. Effective TBIC in healthcare settings depends on early identification, isolating infected persons, and “The risk of transmission of M. tuberculosis from individuals with TB to other patients and to health professionals (HPs) has been recognized for many years. This risk is high in health facilities especially in many lowand middle-income countries” [4]. Other reports showed tuberculin skin test conversion and increased risk of TB among health professionals in Turkey [6] and Melbourne [7], demonstrating the importance of appropriate TBIC practice at health care settings
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