Self-reported adherence of healthcare workers to infection prevention and control practices during the early waves of the COVID-19 pandemic in Egypt
DOI:
https://doi.org/10.3396/ijic.v19.22791Keywords:
Infection prevention and control, COVID-19, healthcare workers, self-reported adherence, EgyptAbstract
Introduction: Considering the absence of effective treatment, the World Health Organization had recommended stringent infection prevention and control (IPC) measures against coronavirus disease 2019 (COVID-19) to reduce its transmission. The non-adherence of healthcare workers (HCWs) to these measures had been reported as a major cause of infection.
Aim: To assess the level of self-reported adherence of HCWs to IPC measures during their social life and work time.
Methods: This cross-sectional study included 559 HCWs (411 females and 148 males) working at 39 hospitals across different Egyptian governorates. A predesigned structured questionnaire about COVID-19 IPC measures was completed by trained interviewers.
Results: Washing hands before eating (98.2%), using soap for hand wash (97.9%), washing hands after returning home (96.6%), and wearing a face mask when going outside in public places (83.7%) were the commonest daily-life practices among the 559 studied HCWs, while the least common was social distancing (46.0%). Less than half of the studied HCWs were adherent to the proper duration of handwashing (P < 0.01). Only 5.9% of the studied HCWs usually wore full personal protective equipment (PPE) at work (P = 0.051). The highest percentages of HCWs working at outpatient clinics and laboratories (98.1% each) ‘sometimes’ used PPE (P = 0.017). There was a significant difference in self-reported adherence to wearing face masks at hospitals according to specialties (P < 0.01). HCWs working at intensive care units (ICUs) recorded the highest attendance rates at IPC training (53.8%, P = 0.012). A relatively higher percentage of HCWs at COVID-19 isolation hospitals wore PPE (15.7%) versus 2.2–4.7% in other hospitals (P = 0.015).
Conclusion: The majority of HCWs sometimes complied with wearing PPE (93.6%). HCWs were more adherent to wearing masks at hospitals (94.6%) compared to community settings (42.9%). Older age and female gender were significantly associated with self-reported adherence to some IPC measures. Hand hygiene training session emphasizing the proper duration of hand wash is mandatory.
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References
Piper K. Here’s how Covid-19 ranks among the worst plagues in history. 2021. Available from: https://www.vox.com/future-perfect/21539483/covid-19-black-death-plagues-in-history [cited 8 September 2021].
Nguyen LH, Drew DA, Graham MS, Guo CG, Ma W, Mehta RS, et al. Risk of COVID-19 among frontline healthcare workers and the general community: a prospective cohort study. Lancet Public Health 2020; 5: E475–83. doi: 10.1101/2020.04.29.20084111
World Health Organization. Health workers: A global profile. 2020. Available from: https://apps.who.int/iris/bitstream/handle/10665/250368/9789241511131-eng.pdf [cited 30 September 2021].
World Health Organization. The impact of COVID-19 on health and care workers: a closer look at deaths. World Health Organization; 2021. Available from: https://apps.who.int/iris/handle/10665/345300. License: CC BY-NC-SA 3.0 IGO [cited 15 October 2021].
World Health Organization. Infection prevention and control during health care when coronavirus disease (COVID-19) is suspected or confirmed. 2021. Available from: https://apps.who.int/iris/rest/bitstreams/1356030/retrieve [cited 15 October 2021].
World Health Organization. Risk assessment and management of exposure of healthcare workers in the context of COVID-19. 2020. Available from: https://apps.who.int/iris/handle/10665/331496 [cited 30 August 2021].
Ehrlich H, McKenney M, Elkbuli A. Protecting our healthcare workers during the COVID-19 pandemic. Am J Emerg Med 2020; 38: 1527–8. doi: 10.1016/j.ajem.2020.04.024
Mohammed G, Hassan A, Abo Elmagd N, Gamal N, Mohammed Saleh Z, Khalil S. COVID-19: Knowledge, perception and infection control practice of health care workers (A suggested ward-based educational package). Assiut Sci Nur J 2020; 8(22): 175–87. doi: 10.21608/asnj.2020.39657.1035
Galal YS, Abuelhamd WA, Hamid TAA, Elsayed NR. Coronavirus disease 2019: Knowledge, attitude, practice, and perceived barriers among health care workers at Cairo University Children Hospital, Egypt. Maced J Med Sci 2021; 9(E): 80–8. Available from: https://oamjms.eu/index.php/mjms/article/view/5703
El-Ghitany EM, Farghaly AG, Farag S, Hashish MH, Charl F, Omran EA. Prevalence of severe acute respiratory syndrome coronavirus 2 spike antibodies in some healthcare settings in Egypt. J Egypt Public Health Assoc 2022; 97(1): 11. doi: 10.1186/s42506-022-00106-4
World Health Organization. Roadmap to improve and ensure good indoor ventilation in the context of COVID-19. 2021. Available from: https://www.who.int/publications/i/item/9789240021280 [cited 8 September 2021].
Bandyopadhyay S, Baticulon RE, Kadhum M, Alser M, Ojuka DK, Badereddin Y, et al. Infection and mortality of healthcare workers worldwide from COVID-19: a systematic review. BMJ Glob Health 2020; 5(12): e003097. doi: 10.1136/bmjgh-2020-003097
Daily News. 30% of COVID-19 related deaths among healthcare workers were women: Planning Minister. 2021. Available from: https://dailynewsegypt.com/2021/03/21/30-of-covid-19-related-deaths-among-healthcare-workers-were-women-planning-minister/ [cited 30 August 2021].
Elgibaly O, Daef E, Elghazally SA, Hassan HM, ElsaidTash RM, Bahgat SM, et al. Knowledge, perception, and confidence of healthcare workers about COVID-19 preventive measures during the first wave of the pandemic: a cross-sectional study from Egypt. Germs 2021; 11(2): 179–88. doi: 10.18683/germs.2021.1255
World Health Organization. Infection prevention and control guidance for long-term care facilities in the context of COVID-19: Interim guidance. License: CC BY-NC-SA 3.0 IGO. World Health Organization; 2020. Available from: https://apps.who.int/iris/handle/10665/331508 [cited 30 August 2021].
Deif I. Guide to COVID-19 vaccination in Egypt: What we need to know. 2021. Available from: https://english.ahram.org.eg/News/402519.aspx [cited 23 August 2021].
Sridhar MR, Boopathi S, Lodha R, Kabra SK. Standard precautions and post-exposure prophylaxis for prevention of infection. Indian J Paediatr 2004; 71: 617–25. doi: 10.1007/BF02724121
Abdel-Salam W. Ministry of Health launches the ‘Egypt’s Health’ application for inquiries and advice about Corona. Youm7; 2020. Available from: https://www.youm7.com/story/2020/4/14/ [cited 30 September 2021].
El-Sheikh S. Daily news Egypt: what has happened in Egypt since discovering 1st COVID-19 case? Egypt has taken several measures on economic, medical, social, educational levels. 2020. Available from: https://wwww.dailynewssegypt.com/2020/03/24/what-has-happened-in-egypt-since-discovering-1st-covid-19-case [cited 30 August 2021].
Centers for Disease Control and Prevention. Clean hands count for safe healthcare. 2020. Available from: https://www.cdc.gov/patientsafety/features/clean-hands-count.html [cited 30 August 2021]
Albeladi FI, Alluli MM, Daghriri KA, Almalki YH, Wafi MY, Otaif FA, et al. Level of self-reported adherence to COVID-19 preventive measures among health care workers in Saudi Arabia. Cureus 2021; 13(6): e15969. doi: 10.7759/cureus.15969
Engdaw GT, Gebrehiwot M, Andualem Z. Hand hygiene compliance and associated factors among health care providers in Central Gondar zone public primary hospitals, Northwest Ethiopia. Antimicrob Resist Infect Control 2019; 8: 190. doi: 10.1186/s13756-019-0634-z
Papagiannis D, Malli F, Raptis DG, Papathanasiou IV, Fradelos EC, Daniil Z, et al. Assessment of knowledge, attitudes, and practices towards new coronavirus (SARS-CoV-2) of health care professionals in Greece before the outbreak period. Int J Environ Res Public Health 2020; 17(14): 4925. doi: 10.3390/ijerph17144925
Almohammed OA, Aldwihi LA, Alragas AM, Almoteer AI, Gopalakrishnan S, Alqahtani NM. Knowledge, attitude, and practices associated with COVID-19 among healthcare workers in hospitals: A cross-sectional study in Saudi Arabia. Front Public Health 2021; 9: 643053. doi: 10.3389/fpubh.2021.643053
Al Mutairi SM, Alotaibi A, Kofi M, Alsuraimi A, Bawazir A. To what extent the hand hygiene among health care workers become the core of best practice in the COVID-19 era? Int Arch Nurs Health Care 2020; 6: 144. doi: 10.23937/2469-5823/1510144
World Health Organization. Mask use in the context of COVID-19: Interim guidance. World Health Organization; 2020. Available from: https://apps.who.int/iris/handle/10665/337199. License: CC BY-NC-SA 3.0 IGO [cited 30 September 2021].
Chughtai AA, Seale H, Dung TC, Hayen A, Rahman B, Raina MacIntyre C. Compliance with the use of medical and cloth masks among healthcare workers in Vietnam. Ann Occup Hyg 2016; 60(5): 619–30. doi: 10.1093/annhyg/mew008
World Health Organization. COVID-19: Occupational health and safety for health workers: interim guidance. 2021. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-HCW_advice-2021-1 [cited 30 September 2021].
Azene ZN, Merid MW, Muluneh AG, Geberu DM, Kassa GM, Yenit MK, et al. Correction: Self-reported adherence towards COVID-19 mitigation measures and its associated factors among Gondar City residents: A community-based cross-sectional study in Northwest Ethiopia. PLoS One 2021; 16(8): e0256954. doi: 10.1371/journal.pone.0256954
Al-Mohrej OA, Al-Shirian SD, Al-Otaibi SK, Tamim HM, Masuadi EM, Fakhoury HM. Is the Saudi public aware of Middle East respiratory syndrome? J Infect Public Health 2016; 9: 259–66. doi: 10.1016/j.jiph.2015.10.003
Nivette A, Ribeaud D, Murray AL, Steinhoff A, Bechtiger L, Hepp U, et al. Non-compliance with COVID-19-related public health measures among young adults: Insights from a longitudinal cohort study. Soc Sci Med 2021; 268: 113370. doi: 10.1016/j.socscimed.2020.113370
Solomou I, Constantinidou F. Prevalence and predictors of anxiety and depression symptoms during the COVID-19 pandemic and compliance with precautionary measures: Age and sex matter. Int J Env Res Publ Health 2020; 17(14): 4924. doi: 10.3390/ijerph17144924
van Rooij B, de Bruijn AL, Reinders Folmer C, Kooistra E, Kuiper ME, Brownlee M, et al. Compliance with COVID-19 mitigation measures in the United States (April 22, 2020). Amsterdam Law School Research Paper No. 2020-21, General Subseries Research Paper No. 2020-03, UC Irvine School of Law Research Paper No. 2020-33. Available from SSRN: https://ssrn.com/abstract=3582626.
Al-Hanawi MK, Angawi K, Alshareef N, Qattan AMN, Helmy HZ, Abudawood Y, et al. Knowledge, attitude and practice toward COVID-19 among the public in the Kingdom of Saudi Arabia: A cross-sectional study. Front Public Health 2020; 8: 217. doi: 10.3389/fpubh.2020.00217
Centers for Disease Control and Prevention. Strategies for optimizing the supply of isolation gowns. 2021. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/isolation-gowns.html [cited 20 October 2021].
Wilder-Smith A, Freedman DO. Isolation, quarantine, social distancing and community containment: pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak. J Travel Med 2020; 27(2): taaa020. doi: 10.1093/jtm/taaa020
Shah SU, Xiu Ling Loo E, En Chua C, Sen Kew G, Demutska A, Quek S, et al. Association between well-being and compliance with COVID-19 preventive measures by healthcare professionals: A cross-sectional study. PLoS One 2021; 16(6): e0252835. doi: 10.1371/journal.pone.0252835
United Nations International Children’s Emergency Fund. UNICEF provides essential medical supplies to healthcare workers during COVID-19 pandemic and secures support to vulnerable children. 2020. Available from: https://www.unicef.org/egypt/press-releases/unicef-provides-essential-medical-supplies-healthcare-workers-during-covid-19 [cited 30 August 2021].
Neuwirth MM, Mattner F, Otchwemah R. Self-reported adherence to personal protective equipment use among healthcare workers caring for confirmed COVID-19 and alleged non-COVID-19 patients. Antimicrob Resist Infect Control 2020; 9(1): 199. doi: 10.1186/s13756-020-00864-w
Sundaram RO, Parkinson RW. Universal precaution compliance by orthopaedic trauma team members in a major trauma resuscitation scenario. Ann R Coll Surg Engl 2007; 89(3): 262–7. doi: 10.1308/003588407X168370
Ragusa R, Marranzano M, Lombardo A, Quattrocchi R, Bellia MA, Lupo L. Has the COVID 19 virus changed self-reported adherence to hand washing among healthcare workers? Behav Sci 2021; 11(4): 53. doi: 10.3390/bs11040053
McGaw CD, Tennant I, Harding HE, Cawich SO, Crandon W, Walters CA. Healthcare workers’ attitudes to and compliance with infection control guidelines in the operating department at the university hospital of the West Indies, Jamaica. Int J Infect Control 2012; 8(3): 1–9. doi: 10.3396/ijic.v8i3.10411
Elbqry M, Elmansy F, Elsayed A, Mansour B, Tantawy A, Bahi El Din M, et al. Effect of COVID-19 stressors on healthcare workers’ performance and attitude at Suez Canal university hospitals. Middle East Curr Psychiatry 2021; 28(1): 4. doi: 10.1186/s43045-021-00084-x
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