Infection Control Protocols Research Articles

Marburg virus disease: lesson learned from the first outbreak encounter in Tanzania

Marburg virus disease: lesson learned from the first outbreak encounter in Tanzania

Effect of a Health Education Intervention on Practices of Hospital Laboratory Staff; A Quasi-Experimental Study

Background: The incidence of Laboratory acquired infections is on the rise despite the existence and continuous upgradation of infection prevention protocols. The objective of this study was to determine the practice of lab staff before and after carrying out an intervention in the form of health education intervention based on WHO protocols for infection prevention. Methods: This is a Quasi-experimental study carried out in three hospitals in Rawalpindi. A total of n=38 technical and non-technical lab staff participated in the study. Laboratory practices were observed by the researchers themselves for a week. Then an education session was conducted for the staff regarding the World Health Organization (WHO) standard protocols for infection control. The post-intervention data were collected after about two weeks of health education sessions. Data were analyzed using SPSS version 22. Paired t-test was applied to compare the mean scores of pre- and post-interventional data. Results: The laboratory staff participated in the study mostly 19(50%) belonging to the age(years) range of 20-27. The percentage of respondents having good practice of infection prevention protocols before intervention was 7.5%, after the intervention this increased to 57.9%. Paired t-test showed that the difference in practice mean score of pre- and post-interventional data was statistically significant (CI=21.55-15.33 p-value=0.001). Conclusion: Pre-intervention data showed that the practice of the staff was not completely in accordance with WHO infection prevention. After delivering the education session on WHO infection prevention protocols, there was a significant improvement in the practices of laboratory staff.

Lung Transplant Recipients and COVID-19: Report of Two Cases.

Although the WHO has declared the end of the pandemic emergency, COVID-19 still poses a threat to immunocompromised patients. The COVID-19 pandemic has spread throughout the world over the last two years, causing a significant number of deaths. After three years, SARS-CoV-2 has lost its initial lethality but has shown a significantly worse prognosis for immunocompromised patients, especially those who have undergone lung transplantation, compared with the general population. This paper presents two compelling case studies that highlight the complex challenges of COVID-19 infection in lung transplant recipients. The first case involves a patient who received a bilateral lung transplant for pulmonary artery hypertension in 2009, followed by a kidney transplant in 2022. Surprisingly, despite an initially favorable clinical course after contracting COVID-19, the patient deteriorated rapidly and died within a few days due to extensive lung involvement. This case highlights the unpredictable nature of COVID-19 and its potentially devastating impact on lung transplant recipients. The second case involves a patient who underwent bilateral lung transplantation five years earlier for chronic obstructive pulmonary disease (COPD). This individual also contracted COVID-19 and had pre-existing complications, including chronic lung allograft rejection (CLAD) and diffuse bronchial stenosis. Following viral infection, the patient's clinical condition deteriorated rapidly, with worsening bronchial stenosis. This case highlights the ability of COVID-19 to exacerbate pre-existing pulmonary complications in transplant recipients. These cases highlight the urgent need for increased vigilance and tailored management strategies when dealing with COVID-19 in lung transplant recipients. The unpredictable and detrimental course of the disease observed in these patients highlights the importance of implementing stringent preventive measures, such as vaccination and strict adherence to infection control protocols, in this vulnerable population. Further research is essential to gain a full understanding of the unique dynamics of COVID-19 in lung transplant recipients and to develop targeted interventions to improve their outcomes.

INSTRUMENT FOR THE ASSESSMENT OF DENTISTS’ ADHERENCE TO INFECTION CONTROL AND PSYCHOLOGICAL ASPECTS IN INFECTIOUS DISEASES

Objective To develop and validate an instrument for the assessment of dentists’ adherence to infection control protocols and the identification of psychological aspects in dental practices against infectious diseases. Study Design Methodological study conducted in the following steps: establishment of conceptual structure and definition of instrument objectives and the population involved; elaboration of items and response scales; instrument structuring; content validity to judge representativeness, clarity, and degree of understanding of the items; semantic validity to verify dentists’ clarity and comprehension of the items. Results The instrument initially consisted of 49 items with five dimensions. In content validation, the instrument was presented to a committee of eight postgraduate experts in the area. Items that presented a Content Validity Coefficient of less than 0.8 were modified, and the instrument was reduced to 46 items. Semantic validity was performed by thirty-two dentists with different qualification levels. After the necessary adjustments, the instrument consisted of 38 questions. Conclusion The instrument entitled "Biosafety Scale and Psychological Aspects related to infectious diseases in Dentistry" was elaborated and validated. However, for its use in the target population, it is necessary to assess the reliability and construct the validity of the instrument. To develop and validate an instrument for the assessment of dentists’ adherence to infection control protocols and the identification of psychological aspects in dental practices against infectious diseases. Methodological study conducted in the following steps: establishment of conceptual structure and definition of instrument objectives and the population involved; elaboration of items and response scales; instrument structuring; content validity to judge representativeness, clarity, and degree of understanding of the items; semantic validity to verify dentists’ clarity and comprehension of the items. The instrument initially consisted of 49 items with five dimensions. In content validation, the instrument was presented to a committee of eight postgraduate experts in the area. Items that presented a Content Validity Coefficient of less than 0.8 were modified, and the instrument was reduced to 46 items. Semantic validity was performed by thirty-two dentists with different qualification levels. After the necessary adjustments, the instrument consisted of 38 questions. The instrument entitled "Biosafety Scale and Psychological Aspects related to infectious diseases in Dentistry" was elaborated and validated. However, for its use in the target population, it is necessary to assess the reliability and construct the validity of the instrument.

The impact of the COVID-19 pandemic on parents seeking dental care for their children

Many changes in routine dental care were implemented to protect dentists and patients during the COVID-19 pandemic. Pediatric dentists face unique challenges in dealing with parental fears and behavioral changes in pediatric patients. Despite the meticulous infection control protocols that dental offices have implemented during the pandemic, they experienced significant reductions in routine recall. The aim of this study is to assess the impact of the SARS-CoV-2 pandemic on parents seeking dental care for their children at the Temple Kornberg School of Dentistry (TUKSoD). Parents who currently have their children treated at the TUKSoD were invited to participate in a questionnaire. One hundred and six parents completed the survey anonymously on paper. The survey focused on parents’ attitude changes towards dental care for their children post-pandemic. Bivariate analysis followed by a Two-way ANOVA test was used to calculate the association between the effect of the COVID-19 pandemic on parents of pediatric patients’ decision to seek dental care versus the age of the child. Our results showed that improved dental protocols increased the likelihood of parents bringing their children to the dentist during the COVID pandemic (p < 0.001). The results help pediatric dentists to build trust among their patients during the pandemic. It will also help policymakers understand the pediatric patients’ parents’ concerns and assess their current safety measures. Ultimately, this study will give practitioners more insight into how to handle outbreaks of new COVID-19 variants that may present in the future.

Antimicrobial Resistance Pattern of Pseudomonas aeruginosa: An 11-Year Experience in a Tertiary Care Hospital in Makkah, Saudi Arabia.

Pseudomonas aeruginosa (P. aeruginosa) is a common causative pathogen in healthcare settings and displays increasing levels of resistance to common antimicrobial drugs. Its capacity to resist has been reported in multiple locations across the world. This study evaluates current levels of antibiotic resistance and seeks to understand antibiotic resistance patterns in the context of the clinical isolates of P. aeruginosa. All clinical isolates were cultured at 37 °C for 24 h in different media: blood sheep agar, McConkey agar, and cystine-lactose-electrolyte-deficient agar (CLED), bacterial identification and antibiotic susceptibility patterns were determined using the Vitek-2 (bioMérieux) automated system. In total, there were 61,029 patient specimens, of which 5534 were identified as non-duplicated P. aeruginosa clinical isolates, most being from males aged over 60 years. The research findings revealed that the maximum antibiotic resistance associated with P. aeruginosa isolates was found in colistin (97%), which was followed by piperacillin/tazobactam (75.8%). The maximum resistance rates in P. aeruginosa isolates were found in relation to cefepime (42.7%,) which was followed by ciprofloxacin (34.3%). The antibiotic resistance rate during the first six years of the research period was notably higher than in the last years, due to the application of infection control protocols and strict policies to control antibiotic prescriptions in all Saudi hospitals.

Prevalence of nosocomial infection Pre- and Post-COVID 19 Pandemic in a Tertiary Care Hospital in Karachi.

Objective: To evaluate the role of the COVID-19 pandemic in the prevalence of nosocomial infections in patients admitted to the Ziauddin University Hospital, Clifton Campus, Karachi. Study Design: Retrospective Cross-sectional study. Setting: Ziauddin University Hospital, Clifton Campus, Karachi. Period: Pre-COVID: Feb 1, 2019 – Jan 31, 2019 Post-COVID: May 1 2020- Apr 30, 2021. Material & Methods: Clinicians retrospectively reviewed all Infectious Disease Department medical records for a list of all patients who developed a NI after 48 hours of admission to the hospital. The diagnosis of NI had been formulated by clinicians on the basis of clinical, radiological and microbiological findings. Results: We found an increase in certain types of NIs, and stability in the infection rate for many other organisms, which may be due to improved infection control practices during COVID. This information will lead to a better understanding of infection control practices in the future, and will better guide clinical decision making. Conclusion: The strict and proper implementation of infection control protocols during the COVID-19 outbreak has reduced the rate of NIs. It has been evident that NIs can be minimized by creating a positive attitude, improving awareness and staff hygiene practices and behaviours, and the provision of facilities to comply with the of infection control protocols’ standards.

Molecular Detection of Carbapenem Resistance in Clinical Isolates of Klebsiella pneumoniae in Tertiary Care Hospital

Antibiotic resistance has become a serious global threat, mainly due to misuse, overuse of antibiotics and non-compliance with infection control protocol. Superbugs are multidrug-resistant (MDR) and extended drug-resistant (XDR) bacteria, mainly Klebsiella pneumoniae and Escherichia coli from the Enterobacteriaceae family, which cause opportunistic infections and raise death rates and hospital expenditures. The present study was conducted at a tertiary care teaching hospital to study the epidemiology and molecular detection of carbapenem-resistant K. pneumoniae isolated from various clinical specimens. 240 K. pneumoniae isolates were collected from January 2020 to December 2021 at the Bacteriology laboratory, Index Medical College and Hospital, Indore. All isolates were analyzed for carbapenem resistance by the conventional disc diffusion method. All carbapenem-resistant isolates were tested for carbapenemase production using the phenotypic double-disk synergy test (DDST) and modified Hodge test (MHT) as per 2020 CLSI guidelines. All isolates were negative by phenotypic methods, further confirmed by conventional PCR to detect the gene responsible for carbapenemase production. 240 isolates of K. pneumoniae were included during the study periods. Out of 240 isolates, 102 isolates were found resistant to carbapenem drugs. All 102 isolates were confirmed carbapenemase and MBL producers by MHT and DDST tests. Among 102, 60 isolates were found to be MBL producers negative by MHT and DDST tests. Sixty phenotypic negative carbapenem-resistant isolates were tested by conventional PCR. One or more carbapenemase genes were detected in 61.0% of isolates. The blaKPC was detected in 13/60 (21%) isolates, followed by blaNDM 10/60 (16%) isolates, followed by blaVIM in 6/60(10%), blaOXA-48 in 5/60 (8%) and blaIMP in 3/60(5%) isolates. K. pneumoniae produces carbapenemase, which enhances resistance to the carbapenem class of antibiotics. The simultaneous detection of these resistance genes expressed by Klebsiella pneumoniae might be managed by early detection and adhering to antibiotic policies that limit the use of antibiotics.

Referrals for Recurrent Acute Otitis Media With and Without Spontaneous Tympanic Membrane Perforation Through COVID-19: A Cross-Sectional Comparative Study.

To the Editors: Most children experience at least one episode of acute otitis media (AOM) and approximately one-third of them suffer from recurrent episodes (rAOM) with or without spontaneous tympanic membrane perforation (STMP).1 Data on the epidemiology of rAOM and STMP during the COVID-19 pandemic are scarce. The aim of this report is to evaluate the number and characteristics of children presenting with rAOM with and without STMP before and during the pandemic. This study was conducted at the otitis media pediatric outpatient clinic of the Ospedale Maggiore Policlinico, Milan (Italy), from 2019 to 2022. All consecutive children referring to the outpatient clinic for a first-time visit for rAOM2 were eligible and the following information was extracted: sex, age (≤2 and >2 years), date of first visit and history of STMP. Data were obtained from patient’s online medical records. Four periods were considered for the analysis: the year preceding the pandemic (2019), the 2 years with the strictest measures to limit the spread of COVID-19 (2020 and 2021) and the year in which these measures were progressively relaxed (2022). The Fisher exact test or the χ2 test were used for the analysis, as appropriate. A P value <0.05 was assumed as significant. The study was approved by the Ethical Committee of the Ca’ Granda Ospedale Maggiore, Milan (Comitato Etico Area2). A total of 786 children (53% >2 years of age and 45% females) were included (Table 1). A decreasing trend in the number of children with rAOM was observed in the first 3 years of the study. Furthermore, the percentage of children <2 years of age increased in 2021 and 2022. Similar data were observed for children with rAOM without STMP. No age difference (P = 0.319) was found for children with rAOM and STMP. TABLE 1. - Total Number of Patients and Number of First-Time Visits for rAOM With and Without STMP All 2019 2020 2021 2022 P Value rAOM N 786 300 141 108 237 Male 437 165 71 54 147 0.072 Age ≤2 yr 367 (47%) 120 (40%) 61 (43%) 59 (55%) 127 (53%) 0.004 >2 yr 419 (53%) 180 (60%) 80 (57%) 49 (45%) 110 (47%) rAOM without STMP N 441 143 59 72 167 Male 248 79 30 36 103 0.273 Age ≤2 yr 190 (43%) 44 (31%) 21 (36%) 41 (57%) 84 (50%) 0.0002 >2 yr 251 (57%) 99 (69%) 38 (64%) 31 (43%) 83 (50%) rAOM with STMP N 344 157 81 36 70 Male 189 87 41 18 43 0.544 Age ≤2 yr 177 (51%) 77 (40%) 39 (48%) 18 (51%) 43 (62%) 0.319 >2 yr 167 (49%) 80 (60%) 42 (52%) 18 (49%) 27 (38%) rAOM indicates recurrent acute otitis media; STMP, spontaneous tympanic membrane perforation P values <0.05 are in bold. The changes in rAOM frequency during the study period is consistent with prior research indicating a reduction in AOM cases.3,4 However, the main finding of this investigation pertains to a notable shift in the age distribution of children affected by rAOM. This age bracket presumably comprises children born during the peak of the stringent control measures. As such, the infection control protocols might have limited their exposure to pathogens, creating a cohort of immunologically naive children more susceptible to rAOM once the restrictions were lifted. Contrary to initial expectations, a significant rise in rAOM with STMP cases in 2022 and the decrease in the age of affected children were not observed. Recent data point out a change in antibiotic prescription in children after 2020.5 The early and widespread use of broad-spectrum antibiotics for respiratory infections and AOM may have decreased the incidence of common complications such as STMP. The main limitation of this study relies on its retrospective, monocentric design. In conclusion, this investigation reveals a rise in rAOM cases in 2022 with a noticeable increase in the younger age groups. These data underscore the possible medium to long-term repercussions of infection control measures.

Effect of COVID-19 pneumonia infection control protocols on nosocomial infection incidence in trauma patients

PurposeNosocomial infection is a major threat to the health care system and patient welfare. After the pandemic, new protocols were established in hospitals and communities to protect against the transmission of COVID-19, which may have changed the incidence of nosocomial transmission. This study was conducted to compare the incidence of nosocomial infection before and after the COVID-19 pandemic. MethodsThis was a retrospective cohort study performed on trauma patients who were admitted, from May 22, 2018 to November 22, 2021, to the largest level-1 trauma center in Shiraz, Iran (Shahid Rajaei Trauma Hospital). All the trauma patients over 15 years old admitted during the study time were included in this study. Individuals who were declared dead upon arrival were excluded. Patients were evaluated in 2 periods: before the pandemic (May 22, 2018 – February 19, 2020) and after the pandemic (February 19, 2020 – November 22, 2021). Patients were assessed based on demographic information (age, gender, length of hospital stay, and patient outcome), the occurrence of hospital infection, and the type of infection. The analysis was done using SPSS version 25. ResultsOverall, 60,561 patients were admitted, with a mean age of 40 years. Nosocomial infection was diagnosed in 4.00% (n = 2423) of all admitted patients. The incidence rate of post-COVID-19 hospital-acquired infections decreased by 16.28% (p < 0.001) when compared to before the pandemic; in contrast, surgical site infection (p < 0.001) and urinary tract infection (p = 0.043) were responsible for this change, while hospital-acquired pneumonia (p = 0.568) and bloodstream infection (p = 0.156) were not significantly different. Overall mortality was 1.79%, while 28.52% of all patients with nosocomial infections died. During the pandemic, there was a 25.78% increase (p < 0.001) in the overall incidence rate of mortality, which was also observed among patients with nosocomial infections (17.84%). ConclusionThe incidence of nosocomial infection has decreased during the pandemic, possibly due to the use of more personal protective equipment and modified protocols after the outbreak. This also explains the difference in the change in incidence rates of nosocomial infection subtypes.

Knowledge, Attitude and Risks Associated in Treatment among Dental Practitioners of Ghaziabad Regarding COVID-19 Pandemic

INTRODUCTION: COVID 19 was first reported in Wuhan China, in December 2019 and it soon spread to the entire globe involving millions of people. It was declared as a global pandemic on 11th March 2020 by WHO. The symptoms ranged from mild to deadly and often included fever, cough, breathing difficulty, loss of taste, loss of smell. Severe cases resulted in pneumonia, dyspnea, shock, multi-organ failure and death. Transmission is chiefly through droplets thus pose a significant risk among dental professionals. AIM: to assess the knowledge about Covid-19 among dental practitioners in Ghaziabad and the preventive measures used for the treatment of the patients. MATERIALS AND METHOD: An online survey was carried out among the dental practitioners of Ghaziabad from November 2020 to January 2021. A snowball sample of 250 dentists was selected and a predesigned questionnaire was mailed to them. Response was recorded via a second email sent by them. RESULTS: The study showed that majority of dentists 95% had good knowledge about Covid and the primary source of information was World Health Organization through television, radio and social media. About 85% were fearful of the being infected by suspected patients, and transmitting the disease to their homes and 61% were afraid of the impact it will have on dentists livelihood. It was witnessed that dentists having more than 10 years experience had a positive attitude towards the virus. Infection control protocols seemed insufficient and needed improvement and assistance. CONCLUSION: the study concluded that though the knowledge was good, the practice scores were poor. Our findings have important implications in need for a special training program for dentists to deal which such pandemics.

The Effects of an Advanced Air Purification Technology on Environmental and Clinical Outcomes in a Long-Term Care Facility.

Long-term care facilities (LTCFs) are constantly working to reduce sources of infectious pathogens to improve resident care. LTCF residents are particularly susceptible to health care-associated infections (HAIs), many of which originate from the air. An advanced air purification technology (AAPT) was designed to comprehensively remediate volatile organic compounds (VOCs) and all airborne pathogens including all airborne bacteria, fungi, and viruses. The AAPT contains a unique combination of proprietary filter media, high-dose ultraviolet germicidal irradiation, and high-efficiency particulate air (HEPA) filtration. The AAPT was installed in an LTCF's heating, ventilation, and air-conditioning ductwork and 2 floors were studied: the study floor with comprehensive AAPT remediation and HEPA filtration and the control floor with only HEPA filtration. VOC loading and airborne and surface pathogen loading were measured in 5 locations on both floors. Clinical metrics such as HAI rates were also studied. There was a statistically significant 98.83% reduction in airborne pathogens, which are responsible for illness and infection, an 89.88% reduction in VOCs, and a 39.6% reduction in HAIs. Surface pathogen loading was reduced in all locations except 1 resident room where the detected pathogens were linked to direct touch. The removal of airborne and surface pathogens by the AAPT led to a dramatic reduction in HAIs. The comprehensive removal of airborne contaminants has a direct positive impact on resident wellness and quality of life. It is critical that LTCFs incorporate aggressive airborne purification methods with their current infection control protocols.

Factors of Compliance of Dental Patients in Primary Health Care Services during the Pandemic.

The compliance of dentists with good hygiene practices during the COVID-19 pandemic was essential to minimize the transmission of SARS-CoV-2 strains, and the pandemic has significantly interrupted the provision of oral health care to many individuals. We aimed to examine, in a cross-sectional study, factors affecting dental patients' compliance in primary dental health settings during the pandemic period. The present study was conducted on 300 dental patients visiting four private dental offices in the city of Larissa in Central Greece during the period October-December 2021. The patients in the study sample were of an average age of 45.79 years with a standard deviation of 15.54 years, and 58% of the sample were females. A significant proportion of the participants, 22%, reported that they would be influenced if they knew that the dentist had been ill with COVID-19 despite being fully recovered. A total of 88% of the participants reported that they would feel safe if they knew their dentist was vaccinated against COVID-19. Regarding the information received by dentists, 88% of the participants agreed that the dentist's role is important in dealing with the COVID-19 pandemic, and 89% of them agreed that the information they received from the dentist about the COVID-19 pandemic was sufficient. One-third of the total sample reported that COVID-19 negatively impacted keeping dental appointments, and 43% of the sample kept scheduled appointments. A total of 98% reported that the dentist followed all health protocols against COVID-19 and that their office was equipped to follow health protocols. In the present study, we observe that dentists had adequate knowledge of, attitudes towards, and practices of infection control protocols against COVID-19 during the second wave, according to patients' perceptions.

High-level disinfection, sterilization, and hand hygiene: What do accreditation surveyors want to see?

Health care organizations accredited by the Joint Commission should follow a standardized approach to the development of infection prevention and control-related processes, policies, and protocols. This approach should start with applicable regulatory requirements and may incorporate evidence-based guidelines and consensus documents chosen by the Health care organizations. Surveyors follow this approach when assessing compliance.

Knowledge and Practice of Dental Students and Dentists Regarding Infection Control Protocols in Isfahan, Iran

Knowledge and Practice of Dental Students and Dentists Regarding Infection Control Protocols in Isfahan, Iran

Assessment of knowledge, accessibility, and adherence to the use of personal protective equipment and standard preventive practices among healthcare workers during the COVID-19 pandemic.

Healthcare workers are at risk of acquiring infectious agents while providing services to patients. Thus, the need for evaluating and closely monitoring healthcare worker knowledge, perception, and adherence levels is critical. This study evaluates the knowledge, accessibility, and adherence regarding personal protective equipment (PPE) and preventive protocols among healthcare workers during the COVID-19 pandemic. A web-based cross-sectional survey was conducted from March to September 2021. The study participants were 187 healthcare workers who replied to a 31-item questionnaire using an online tool. A total of 187 participants responded to the questionnaire. Most of the participants 102 (54.5%) were in the age group of 25-34 years. Of the 187 participants, 98 (52.4%) were medical doctors, and 92 (49.2%) had correct knowledge regarding donning and doffing of PPE. The vast majority (93.7%) had access to essential PPE. The average adherence level was 82.1%. Accessibility (p = 0.003) and adherence (p < 0.01) were found to be significantly high in older age participants. The study showed most of the healthcare workers had appropriate knowledge and, they also adhered to the proper use of PPE and infection control protocols. However, few of them identified with poor knowledge about COVID-19, inappropriate doffing of PPE, non-adherence to the protocol, and unacceptable practices. We recommend the provision of adequate training that will lead to minimizing the risk of exposure to and transmission of COVID-19 among healthcare providers.

Bringing Hepatitis Care Closer to the Dentists

Introduction: Among the various cadres of health-care professionals, dentists are placed in a high-risk group of acquiring hepatitis B infection, as an occupational hazard. In a dental setting, hepatitis B virus (HBV) transmission may occur directly (blood/saliva/nasopharyngeal secretions of infected patient and needlestick injury) or indirectly (through contaminated equipment). The risk of acquiring occupational HBV infection can be prevented by implicating certain policies such as vaccination, strict compliance with standard precautions, adherence to standard infection prevention and control protocols, and use of personal protective equipment and immediate postexposure prophylaxis in case of accidental exposure to infected blood or body fluids. Objective: The objective of this study was to assess the risk of HBV infection in dental professionals based on their knowledge, attitude, and practice (KAP) and vaccination status score. Materials and Methods: A cross-sectional study was conducted using a self-administered, structured questionnaire with 26 including both open- and close-ended statements such as demography, department, duration of clinical exposure, KAP statements, and vaccination status. A minimum of 80% and 90% score is set to evaluate KAP response and vaccination status, respectively. Data were subjected to statistical analysis using SPSS version 26, an IBM tool. Results: The response rate was 100% (n = 92, male = 48, and female = 44). Among the participants, 78% scored &gt;80% in KAP, the overall mean was 84.17 ± 6.08. Forty-eight percentage of participants scored &gt;90% in vaccination status (overall mean: 79.45 ± 21.965). There was an overall good internal consistency (Cronbach’s alpha value &gt; 0.8). In this study, 48% of the study population were found to be safe, whereas 52% are found at risk. Conclusion: The overall awareness regarding HBV was found to be at a fairly satisfactory level. Further, detailed research with a large study population aiming to determine both KAP and immunity status is required to determine the risk to dentists.

Clinical Placement Amidst the Covid-19 Pandemic: An Exploration of Nursing Students' Emotional Experiences and Response Strategies

The nursing education and clinical placement programs, along with healthcare systems globally, have been substantially affected by the Covid-19 pandemic. This study explores the emotional experiences and response strategies of nursing students during clinical placement amidst the Covid-19 pandemic in Indonesia. Fourteen nursing students in their final year participated in the study. The study identified two main themes and associated subthemes: emotional responses (including fear, anxiety, uncertainty, and confidence) and coping strategies (including maintaining physical health, adhering to safety protocols, maintaining a positive outlook, nurturing spiritual well-being, and building self-confidence). The emotional responses highlight the challenges faced by nursing students during clinical placement, particularly fear and anxiety about contracting the virus, uncertainty, and confusion. However, some students also felt confident in their ability to navigate the challenges of clinical placement and had a sense of duty and purpose in serving their patients during the pandemic. Coping strategies employed by nursing students included maintaining physical health, adhering to safety protocols, maintaining a positive outlook, nurturing spiritual well-being, and building self-confidence. The study underscores the importance of recognizing and addressing the emotional impact of the pandemic on nursing students and the need for effective support mechanisms to help them cope with the challenges of clinical practice. Educational programs that promote mental health and well-being and practical training on infection control and safety protocols can help nursing students cope with the challenges of clinical placement during pandemics.

Cross Infection Control Awareness During 5th Wave of Covid 19 Pandemic, Omicron Variant Amongst the Dental Health Care Professionals of Government Sector University in Karachi, Pakistan

Objective: The objective of this study is to evaluate the awareness of cross-infection control measures followed by DHCPs during the 5th wave of Covid-19 pandemic, Omicron variant in a government sector university of Karachi, Pakistan. Method: A Cross-sectional study was conducted from June till September 2022 at Sindh Institute of Oral Health Science during the 5th wave of Covid 19 pandemic, Omicron variant. Data was collected from 153 DHCPs from government sector university using a self-administered questionnaire, comprising of 20 closed ended question to assess the awareness and practice of cross infection protocols by DHCPs. Results: 98.7% of the participants were vaccinated against Covid 19. 96% of the participants used surgical gowns, face shields, and face masks as part of PPE during examining patients and while performing procedure. After treatment 99.3% of participants washed hands with hand wash, soap or used antiseptic solution. 77.1% of participants asked for Covid 19 test report and 68.6% of participants asked for proof of vaccination against covid 19 before treating patients. 96.1% of participants recommended disinfection of dental unit after every patient. 98% of participants changed glove after every patient. 88.2% of the participants said they would carry all elective and emergency procedures. Conclusion: The results of this study show that DHCPs practicing at government sector university have adequate knowledge regarding prevention of cross infection protocols and their importance to limit spread of infections. But their practice of prevention of cross infection during Covid 19 pandemic is not ideal as percentage of DHCPs requiring proof of vaccination or negative reports for Covid 19 were rather low and the percentage of DHCPs willing to carry elective procedures along with emergency ones was rather high. Keywords: Covid 19 pandemic, Omicron virus, cross infection control protocols, omicron

Availability of Infection Control Protocol and Facilities, Practice Level and Barrier Perception Among Healthcare Workers in Secondary Healthcare Facilities, Southern Cross River State, Nigeria

The practice of infection prevention and control is key to prevention of healthcare acquired infections and protection of healthcare workers, patients and public health. There are however several challenges militating against the use of standard precautions among healthcare workers. This study was aimed at assessing availability of infection prevention and control (IPC) protocol and facilities, practice level and barrier perception among healthcare workers in secondary healthcare facilities, Southern Cross River State, Nigeria. The study adopted a cross-sectional descriptive design using quantitative methods to elicit information from 336 healthcare workers. A structured questionnaire was administered to respondents in this study an observational checklist was also used. The data generated was analyzed using SPSS version 25. The study comprised of 87.5% females and 12.5% males. Existence of IPC protocols in the facilities was assessed and over half of the respondents (53%) agreed to the availability of IPC protocols in their healthcare facilities. The study identified lack of: knowledge, time, equipment/materials and resources as factors perceived by healthcare workers as influencing their practice of IPC. Among all the factors, only lack of equipment/materials was found to be a significant perceived barrier to practice of IPC (t= 0.269, 0.012). The level of IPC practice was however found to be higher among those who perceived these factors as barriers. It is concluded that lack of time, knowledge, materials/equipment and resources are probable factors influencing practice of infection prevention and control in the secondary healthcare facilities. Healthcare facility management should make adequate provision of requirements for infection control in addition to training of staff and regular monitoring of compliance among health workers to protect public health.