Determinants influencing prevention and control of Health-care associated Tuberculosis infection.
Transmission of tuberculosis (TB) in health care settings to both patients and health care workers (HCWs) has been reported from virtually every country of the world, regardless of local TB incidence. This study set out with a general objective of establishing the determinants influencing prevention and control of Tuberculosis infection among health care workers in health facilities in Lira District in Northern Uganda. Specifically, the study set out to establish the level of knowledge of health care workers pertaining to prevention and control of TB infection when managing TB patients in health facilities in Lira District; examine the practices of the health care workers in regard to TB infection prevention and control when managing TB patients in health facilities in Lira District; and to determine the health facility factors influencing prevention and control of TB infection in health facilities in Lira District. This was with a view to provide data about the level of knowledge and practices currently being used by HCWs. This may be useful in awareness creation to avoid further spread of TB. The study adopted a cross-sectional research design in which HCWs within HC IIIs, IVs, and the Regional Referral Hospital of Lira district participated in providing data for the study. The sample of 138 health care workers who were conveniently sampled were used to provide information through completion of structured questionnaires, face to face interviews on the determinants influencing prevention and control of health-care associated TB infection in Lira District. The study found out that the level of knowledge of the health care workers about prevention and control of TB infection was relatively high. However, it was found out that their knowledge was low in regard to the National guidelines for prevention and control of TB infection. The study further found out that most health workers utilize the practices that prevent and control TB infection although there were several factors health facility factors that influence utilization of the practices thereby negatively influencing the prevention and control of TB infection. The study concluded that health care workers in health facilities in Lira District have a high level of knowledge pertaining to prevention and control of TB infection. That the health -care workers have low level of knowledge with respect to the national TB prevention guidelines and policy. The health care workers in health facilities in Lira District use the recommended practices although these are hindered by the health facility factors such as shortage of gloves, N95 respirators, curtains and patient beds. The study recommended among others that the Ministry of Health and that of Local Government should provide adequate facilities to ensure standards of management of TB patients. These should include some equipment like gloves, N95 respirators, curtains and patient beds. The study further recommended that the health department in local governments should ensure continuous training of health care workers particularly with respect to national TB guidelines and the policy relating to TB patients in health facilities. Health care administrators should ensure proper design of safety cabinets, patient isolation and nose covering that have been found not strictly observed by health care workers.