Difficulties in tuberculosis infection control in a general hospital of Vietnam: a knowledge, attitude, and practice survey and screening for latent tuberculosis infection among health professionals

BMC Infect Dis. 2019 Nov 8;19(1):951. doi: 10.1186/s12879-019-4593-z.

Abstract

Background: In Vietnam, a country with a high tuberculosis (TB) burden, health professionals in both TB-specialized and non-TB-specialized general hospitals have a high risk of acquiring TB. The aims of the present study were to clarify the difficulties in TB infection control at non-TB specialized hospitals and whether any associated risks of latent TB infection exist among health professionals in Vietnam.

Methods: We conducted a cross-sectional study in a national tertiary and general hospital of Hanoi, Vietnam. Participants were health professionals, including physicians, nurses, and other health professionals. We assessed difficulties in TB infection control by conducting a knowledge, attitude, and practice (KAP) survey. We also collected data on the results of tuberculin skin tests (TSTs) conducted during health check-ups for hospital staff to determine whether health professionals had latent TB infection or TB disease. KAP scores were compared among health professional groups (physicians vs. nurses vs. other health professionals). Factors influencing knowledge scores were evaluated using multiple regression analysis.

Results: A total 440 health professionals at the study site participated in the KAP survey, and we collected the results of TSTs from a total of 299 health professionals. We observed a high prevalence of latent TB infection (74.2%), especially among participants in the emergency department. Although participants had high KAP scores, some topics were less understood, such as symptoms and risks of TB, proper use of protective equipment such as N95 respirators, and preventing transmission by patients with confirmed or suspected TB. Factors influencing knowledge scores associated with TB were age, a belief that TB is the most important infectious disease, being a medical professional, having previously attended workshops or seminars, and knowing that Vietnam has a high burden of TB.

Conclusion: In a non-TB specialized hospital of Vietnam, we observed a risk of TB infection among health professionals and difficulties in properly controlling TB infection. Early awareness regarding patients with suspected TB, to apply proper measures and prevent transmission, and education regarding obtaining updated knowledge through scientific information are crucial to enhancing TB infection control in general hospitals of Vietnam.

Keywords: General hospital; KAP; Latent tuberculosis infection; N95 respirator; TB infection control; Tuberculin skin test; Tuberculosis.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Personnel*
  • Hospitals, General*
  • Humans
  • Infection Control*
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control
  • Latent Tuberculosis / diagnosis*
  • Latent Tuberculosis / epidemiology*
  • Latent Tuberculosis / prevention & control
  • Male
  • Mass Screening*
  • Mycobacterium tuberculosis / immunology
  • Prevalence
  • Respiratory Protective Devices
  • Surveys and Questionnaires*
  • Tuberculin Test
  • Vietnam