Tamir Kassahun, Wasie Belaynew, Azage Muluken
MNCH Case Team, Health Promotion and Disease Prevention Process, Amhara Regional Health Bureau, P.O. Box: 495, Bahir Dar, Ethiopia.
School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
BMC Health Serv Res. 2016 Aug 8;16(a):359. doi: 10.1186/s12913-016-1608-y.
Tuberculosis (TB) remains a major global health problem. The emerging epidemic of multi- and extensively drug-resistant (M/XDR) TB further imperils health workers, patients and public health. Health facilities with inadequate infection control are risky environments for the emergence and transmission of TB. There was no study that presented data on infection control practices of health care workers. This study aimed to assess tuberculosis infection control practices and associated factors among health care workers in West Gojjam Zone, Northwest Ethiopia.
Institution based quantitative cross-sectional study triangulated with qualitative observation and key informant interview was conducted. Six hundred sixty two health care workers were selected by multistage random sampling method. Self-administered structured questionnaire was used to collect quantitative data. Observation checklists and key informant interview guides were used to collect qualitative data. Quantitative data were entered in to Epi Info version 3.5.3 and analyzed using SPSS version 20. Odds ratio with 95 % confidence interval was used to identify factors associated with TB infection control practice of health care workers. Qualitative data were translated, transcribed, analyzed and triangulated with the quantitative findings.
The proportion of proper TB infection control (TBIC) practices was 38 %. Qualitative data showed that administrative, environmental and personal respiratory protection control measures were not practiced well. Knowledge on the presence of TBIC plan [AOR = 4.25, 95 % CI: 2.46 - 7.35], knowledge on the presence of national guideline [AOR = 8.95, 95 % CI: 4.35 - 18.40] and working department of the health care workers were independent predictors of TBIC practices.
The proportion of proper TBIC practices of health care workers was low. TBIC practices were determined by knowing the presence of TBIC plan and national guideline and working department. Hence, supportive supervision and trainings should be given to health care workers who are working other than TB clinics to improve the knowledge of TBIC plan and guidelines. Health centers shall prepare TBIC plans and orient all health care workers.
结核病仍然是一个重大的全球卫生问题。多重耐药和广泛耐药结核病的不断流行进一步危及卫生工作者、患者和公众健康。感染控制措施不完善的医疗机构是结核病出现和传播的危险环境。此前尚无研究提供医护人员感染控制措施的数据。本研究旨在评估埃塞俄比亚西北部西戈贾姆地区医护人员的结核病感染控制措施及相关因素。
采用基于机构的定量横断面研究,并结合定性观察和关键 informant 访谈。通过多阶段随机抽样方法选取了 662 名医护人员。使用自填式结构化问卷收集定量数据。观察清单和关键 informant 访谈指南用于收集定性数据。定量数据录入 Epi Info 3.5.3 版本,并使用 SPSS 20 版本进行分析。采用 95%置信区间的优势比来确定与医护人员结核病感染控制措施相关的因素。定性数据进行翻译、转录、分析,并与定量研究结果进行三角验证。
正确的结核病感染控制(TBIC)措施的比例为 38%。定性数据显示,行政、环境和个人呼吸防护控制措施执行情况不佳。对 TBIC 计划存在的了解[AOR = 4.25,95%CI:2.46 - 7.35]、对国家指南存在的了解[AOR = 8.95,95%CI:4.35 - 18.40]以及医护人员的工作部门是 TBIC 措施的独立预测因素。
医护人员正确的 TBIC 措施比例较低。TBIC 措施取决于对 TBIC 计划和国家指南的了解以及工作部门。因此,应向结核病诊所以外工作的医护人员提供支持性监督和培训,以提高他们对 TBIC 计划和指南的认识。卫生中心应制定 TBIC 计划并对所有医护人员进行培训。