Infection Control & Hospital Epidemiology

Original Article

Infection Control Knowledge, Attitudes, and Practices among Healthcare Workers at Mulago Hospital, Kampala, Uganda

Ajay K. Sethia1 c1, Charles W. Achera2, Bruce Kirengaa3, Scott Meada4, Curtis J. Donskeya5 and Achilles Katambaa3 c2

a1 Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

a2 University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

a3 Department of Medicine, Makerere University School of Medicine, Kampala, Uganda

a4 Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

a5 Case Western Reserve University, Cleveland, Ohio

Abstract

Objective. Effective implementation of infection control programs and adherence to standard precautions are challenging in resource-limited settings. The objective of this study was to describe infection control knowledge, attitudes, and practices among healthcare workers (HCWs) in Uganda.

Design. We conducted a survey of hospital employees who had direct contact with patients or their immediate environment. We also performed an environmental assessment of resource availability and utilization within hospital wards.

Setting. Surgical, medicine, and obstetrics wards at a national referral hospital in Kampala, Uganda.

Participants. One hundred eighty-three randomly selected HCWs.

Results. Almost all HCWs knew to wash their hands, although nursing and support staff were less likely to perceive that HCWs' hands can be a vector of disease transmission. Hand washing was valued more as a means of self-protection than as a means to prevent patient-to-patient transmission, consistent with the prevailing belief that infection control was important for occupational safety. Sinks were not readily accessible, and soap at sinks was uncommon throughout the medicine and obstetrics wards but more commonly available in the surgery wards. Alcohol gel was rarely available.

Conclusions. Changing infection control practices in developing countries will require a multifaceted approach that addresses resource availability, occupational safety, and local understanding and attitudes about infection control.

(Received October 06 2011)

(Accepted April 05 2012)

Correspondence

c1 Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, 610 Walnut Street, 601 WARF, Madison, WI 53726 (aksethi@wisc.edu)

c2 Makerere University School of Medicine, P.O. Box 21696, Kampala, Uganda (akatamba@yahoo.com)