Assessment Of Implementation Of Tuberculosis Infection Control Measures Among Health Care Workers At The Greater Accra Regional Hospital

Abstract

Background: Tuberculosis has become a global burden and of public health importance. Health care workers in developing countries are highly susceptible to workplace associated TB infection due to the long hours spent with patients who have undiagnosed or untreated TB cases, poor infection control measures and poor isolation of TB cases in health care facilities. Objective: To assess the implementation of tuberculosis infection control measures among health care workers at the Greater Accra Regional Hospital. Methods: Descriptive cross-sectional study design using both quantitative and qualitative approach was employed in this study. One hundred and thirty seven (137) Health Care Workers (HCWs) and seven (7) Key Informants participated in the study. The HCWs were proportionally selected from each job category using simple random sampling technique. Quantitative data were obtained using semi-structured questionnaires, and triangulated with direct observation and Key Informant Interviews. Descriptive analysis, univariate and multivariate logistic regression were carried out using STATA version 14.0. Qualitative data were transcribed verbatim and analyzed using thematic analysis. Results: More than half, 88 (64.2%) of the HCWs exhibited good knowledge, while a similar proportion 83 (60.6%) also exhibited good practice. Being female (COR= 2.06, 95% CI: 1.00-4.22) and married (AOR= 3.19, 95% CI: 1.11-9.13) were significantly associated with knowledge. Having good knowledge (AOR = 5.83, 95% CI: 2.07-16.43) and being a Doctor (AOR= 7.91, 95% CI: 1.73-36.18) were significantly associated with good practice. Qualitative data showed that HCWs perceived screening of patients as the main promoter of effective implementation of Tuberculosis Infection Control (TBIC), while inadequate Personal Protective Equipment (PPEs), absence of staff screening. small waiting area and improper ventilation were the major inhibitors. Conclusion: The overall level of knowledge and practice was good among HCWs. Knowledge and job category were the main significant predictors of TBIC practice. Sustained TBIC practice was perceived to be largely promoted by availability of screening of suspected TB patients, while inadequate PPEs and absence of staff screening for TB were perceived to be the major inhibitors. Hence, facility management should work closely with the TB Coordinator to ensure periodic staff screening exercise and provision of needed logistics.