Prevalence and correlates of knowledge and practices regarding infection prevention and control, and triage in primary healthcare settings: A cross-sectional study in Bangladesh

Animesh Talukder; Antara Roy; Muhammed Nazmul Islam; Mohiuddin Ahsanul Kabir Chowdhury; Malabika Sarker; Morseda Chowdhury; Imran Ahmed Chowdhury; Mehadi Hasan; A H M Mahbub Latif

doi:10.1016/j.infpip.2022.100258

Prevalence and correlates of knowledge and practices regarding infection prevention and control, and triage in primary healthcare settings: A cross-sectional study in Bangladesh

Infect Prev Pract. 2022 Nov 18;5(1):100258. doi: 10.1016/j.infpip.2022.100258. eCollection 2023 Mar.

Affiliations

¹ BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.
² Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.
³ Health, Nutrition, and Population Program, BRAC, Dhaka, Bangladesh.
⁴ Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh.

Abstract

Background: Despite the high prevalence of healthcare-acquired infection in resource-limited settings, healthcare workers' (HCWs') knowledge and practices of infection prevention and control (IPC) and triage are not well-researched. We examined thisin Bangladesh's primary healthcare facilities (HCFs) during the COVID-19 pandemic.

Methods: We surveyed 312 HCWs in 94 community clinics (CCs) and 90 family welfare centres (FWCs) in six districts from February to April 2021. We assessed HCWs' self-reported knowledge and observed practices in four domains: personal hygiene, medical instrument processing, waste management, and triage. We constructed a weighted composite knowledge score and estimated the association between knowledge and background characteristics using a generalised linear mixed effects model. Practices were described through univariate analysis.

Findings: On a scale of 100, the mean composite knowledge score was 38.3 (SD: 13.3) overall and 44.0 (SD: 13.1) and 33.8 (SD: 11.6) for FWCs and CCs, respectively. The HCWs of FWCs were more aged, experienced, and educated than those of CCs. Knowledge score was the highest in personal hygiene and the lowest in medical waste segregation. Knowledge was significantly associated with HCWs' designation and education. Concerning practices, not more than one-third of the HCWs or HCFs, on average, followed the recommended protocols, except for wearing face masks while on duty (87.1%) and referring potential COVID-19 patients to higher-level facilities (68.3%).

Conclusions: HCWs' capacity in instrument processing, waste management, and triage needs to be improved through formal education and training initiatives. Our study can contribute to the under-researched IPC and triage domains in resource-limited settings.

Keywords: Bangladesh; COVID-19; Infection prevention and control; Knowledge; Practices; Triage.