A cross-sectional survey of predictors of infection prevention and control practice among health workers in primary health centers in a southwest state, Nigeria

Year 2025, Volume: 23 Issue: 2, 207 - 218, 09.08.2025

Adetumi Subulade , Adejoke Ogundana , Opeyemi Adesoye

Abstract

Objective: This study aimed to assess the knowledge of health workers and their attitude towards infection prevention and
control (IPC) practice and to determine the associated factors and predictors of IPC practice among the health workers at
primary health centres (PHCs) in a southwest state of Nigeria .
Materials and Methods: This was a facility-based cross-sectional survey among 450 health workers across 60 PHCs in
Ekiti state for a period of 3 months from July to September 2022. The sample size was determined using Leslie Fishers
formula, and multistage sampling technique was used in selecting eligible participants. A self-administered structured
questionnaire was used and data analyzed using SPSS version 27 .
Results: A total of 450 health workers participated in this study with 94% response rate. The respondents in the urban
PHCs were little less likely to have good IPC practice [adjusted odds ratio (AOR)= 0.646, 95% confidence interval (CI)=
0.448-0.931], those with IPC training were about twice more likely (AOR= 1.866, 95% CI= 1.089-3.926), and those with
work experience above five years about thrice more likely to have good IPC practice (AOR= 2.463, 95% CI= 1.197-
5.071). Also, respondents with good knowledge were about ten times more likely (AOR= 10.433, 95% CI= 4.600-14.322),
and those with positive attitude were about four times more likely to have good IPC practice (AOR= 3.630, 95% CI=
2.293-5.747).
Conclusion: Health workers in urban PHCs, those that had been trained and those with more work experience were
predictors of good IPC practice. Periodic training of health workers on IPC should be promoted especially in rural PHCs.

Keywords

Infection prevention and control , Primary health centre , Health workers

Ethical Statement

Ethical approval was obtained from the Ethics and Research Review Committee of Ekiti State University Teaching Hospital, Ado Ekiti with protocol number: EKSUTH/A67/2021/012/011 on 17th December 2021, and permission was obtained from Ekiti State Primary Health Care Development Agency.

Supporting Institution

None

Thanks

I gratefully acknowledge the contributions of Dr. (Mrs) Ajite for her encouragement through the course of this research work.

References

• 1. Sydnor ERMM, Perl TM. Hospital epidemiology and infection control in acute-care settings. Clin Microbiol Rev. 2011;24(1):141-173.
• 2. Allegranzi B, Nejad SB, Combescure C et al. Burden of endemic health-care-associated infection in developing countries: Systematic review and meta-analysis. Lancet. 2011;377(9761):228–241.
• 3. Bedoya G, Dolinger A, Rogo K, et al. Observations of infection prevention and control practices in primary health care, Kenya. Bull World Health Organ. 2017;95(7):503- 516.
• 4. World Health Organisation. Prevention of hospital-acquired infections A Practical Guide 2nd edition. WHO. 2002;(12):72.
• 5. Yallew WW, Kumie A, Yehuala FM. Risk factors for hospital-acquired infections in teaching hospitals of Amhara regional state, Ethiopia: A matched-case control study. PLoS One. 2017;12(7):e0181145.
• 6. Dostogir Harun G. Knowledge, attitude and practice towards infection control measures among nurses in selected hospital in Bangladesh. Infect Dis Heal. 2018;23:S2.
• 7. Chen YC, Sheng WH, Wang JT, et al. Effectiveness and limitations of hand hygiene promotion on decreasing Healthcare-Associated infections. PLoS One. 2011;6(11):e27163
• 8. Storr J, Twyman A, Zingg W, et al. Core components for effective infection prevention and control programmes: New WHO evidence-based recommendations. Antimicrob Resist Infect Control. 2017;6(1):6.
• 9. Webb A, Angus D, Finfer S, Gattinoni L, Singer M, Care C. Definition , epidemiology , and general management of nosocomial infection. Oxford Medicine Online. 2016;1-9.
• 10. CT B nduye, Tc U. Assessment of Infection Prevention and Control Implementation in Primary and Secondary Health Care Facilities in Rivers State. J Community Heal Prim Heal Care. 2021;33(2):100-114.
• 11. World Health Organization. Strengthening Infection Prevention and Control in Primary Care, a collection of existing standards, measurement and implementation resources. [Internet]. 2021. Available from: https://www. who.int/publications-detail-redirect/9789240035249
• 12. Padoveze M, RM Figueiredo. The role of primary care in the prevention and control of healthcare associated infections. SciELO Bras. 2014;48(6):1132-1138.
• 13. Houghton C, Meskell P, Delaney H, et al. Barriers and facilitators to healthcare workers’ adherence with infection prevention and control (IPC) guidelines for respiratory infectious diseases: A rapid qualitative evidence synthesis. Cochrane Database of Systematic Reviews. Cochrane Database Syst Rev. 2020;4:1-55.
• 14. World Health Organization. Infection prevention and control in primary care [Internet]. Nursing in Practice. 2021. Available from: https://www.nursinginpractice.com/ article/infection-prevention-and-control-primary-care
• 15. Aregbeshola BS, Khan SM. Primary health care in Nigeria: 24 years after Olikoye Ransome-Kuti’s leadership.Frontiers in Public Health. 2017;5:48.
• 16. World Health Organization. Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level [Internet]. World Health Organization. 2016 [cited 2021 Sep 3]. 91 p. Available from: https://apps.who.int/iris/bitstream/hand le/10665/251730/9789241549929-eng.pdf
• 17. World Health Organisation. Rational use of personal protective equipment for coronavirus disease ( COVID-19 ) and considerations during severe shortages. 2020.
• 18. Iliyasu G, Dayyab FM, Habib ZG, et al. Knowledge and practices of infection control among healthcare workers in a Tertiary Referral Center in North-Western Nigeria. Ann Afr Med. 2016;15(1):34-40.
• 19. Magill SS, Edwards JR, Bamberg W,et al. Multistate Point- Prevalence Survey of Health Care–Associated Infections. N Engl J Med. 2014;370(13):1198-1208.
• 20. Hagel S, Ludewig K, Pletz MW, et al. Effectiveness of a hospital-wide infection control programme on the incidence of healthcare-associated infections and associated severe sepsis and septic shock: a prospective interventional study. Clin Microbiol Infect. 2019;25(4):462-468.
• 21. AlJohani A, Karuppiah K, Al Mutairi A, Al Mutair A. Narrative review of infection control knowledge and attitude among healthcare workersJournal of Epidemiology and Global Health. Springer; 2021;11:20-25.
• 22. World Health Organisation. Critical preparedness, readiness and response actions for COVID-19: WHO/2019-nCoV/ Community_Actions/2020.3. Vol. 2, WHO Global site. 2020.
• 23. Adebimpe W, Folayan W, Shittu A, Adebimpe M, Ibirongbe D. Infection prevention and control practices among health-care workers in tuberculosis clinics in Ondo State, Nigeria. Libyan J Med Sci. 2019;3(2):51.
• 24. Okonkwo PI, Okafor KC, Garbal JH, Kwaghal BS, Boluwatito B. Hospital Acquired Infections (HAIs) Prevention Practices Among Medical Students in a Teaching Hospital in Jos, Plateau State, Nigeria. Eur J Med Heal Sci. 2024;6(2):14-20.
• 25. Ochie CN, Aniwada EC, Uchegbu EK, Asogwa TC, Onwasoigwe CN. Infection prevention and control: knowledge, determinants and compliance among primary healthcare workers in enugu metropolis, south-east nigeria. Infect Prev Pract. 2022;4(2):100214.
• 26. Akinruwa TE, Awolusi OD, Ibojo BO. Determinants of Small and Medium Enterprises ( SMEs ) Performance in Ekiti State , Nigeria : A Business Survey Approach. Eur J Humanit Soc Sci. 2013;27(1):1397-1413.
• 27. World Health Organisation. Minimum Requirements for Infection Prevention and Control Programmes, Geneva [Internet]. 2019. Available from: https://www.who.int/ infection-prevention/publications/MinReq-Manual_2019. pdf?ua=1
• 28. Tobin K, Ekaete A, Asogun D, Odia I, Grace E. Knowledge and practice of infection control among health workers in a tertiary hospital in Edo state , Nigeria. Niger Direct Res J Heal Pharmacol. 2013;1(2):20-27.
• 29. Okwor TJ, Gatua J, Umeokonkwo CD, et al. An assessment of infection prevention and control preparedness of healthcare facilities in Nigeria in the early phase of the COVID-19 pandemic ( February – May 2020 ). J Infect Prev. 2022;23(3):101-107.
• 30. Al Abri ZGH, Al Zeedi MASA, Al Lawati AA. Risk Factors Associated with COVID-19 Infected Healthcare Workers in Muscat Governorate, Oman. J Prim Care Community Heal. 2021;12.
• 31. Bannor PA, Otu RA, Akyeampong E, et al. Infection Prevention and Control in Healthcare Facilities During the Covid-19 Pandemic in Ghana. Int J Infect Prev. 2021;1(2):29-47.
• 32. Pauline Mbachu CN, Azubuike CMC, Mbachu II, et al. COVID-19 infection: Knowledge, attitude, practices, and impact among healthcare workers in a South-Eastern Nigerian state. J Infect Dev Ctries. 2020;14(9):943-952.
• 33. Ogoina D, Pondei K, Adetunji B, Chima G, Isichei C, Gidado S. Knowledge, attitude and practice of standard precautions of infection control by hospital workers in two tertiary hospitals in Nigeria. J Infect Prev. 2015;16(1):16- 22.
• 34. Geberemariyam BS, Donka GM, Wordofa B. Assessment of knowledge and practices of healthcare workers towards infection prevention and associated factors in healthcare facilities of West Arsi District, Southeast Ethiopia: A facility-based cross-sectional study. Arch Public Heal. 2018;76(1).
• 35. Fashafsheh I, Ayed MA, Faeda M, Mrs E, Lubna H. Knowledge and Practice of Nursing Staff towards Infection Control Measures in the Palestinian Hospitals. J Educ Pract. 2016;6(33):99-105.
• 36. Kapata N, Ihekweazu C, Ntoumi F, et al. Is Africa prepared for tackling the COVID-19 (SARS-CoV-2) epidemic. Lessons from past outbreaks, ongoing pan-African public health efforts, and implications for the future. International Journal of Infectious Diseases. 2020;93:233-236.
• 37. Shehadeh Khraisat F, Hanafiah Juni M, Abd Rahman A, Md Said S. Needlestick and Sharp Injuries among Healthcare Workers in Hospitals: A Mini-Systematic Review. Int J Clin Med Res Int J Clin Med Res. 2014;1(4):151-160.
• 38. Olayanju O, Bamidele O, Edem F, et al. SARS-CoV-2 Seropositivity in Asymptomatic Frontline Health Workers in Ibadan, Nigeria. Am J Trop Med Hyg. 2021;104(1):91- 94.
• 39. National Population Commission Abuja. Nigeria Demographic and Health Survey. Nigeria Demographic and Health Survey. 2018.
• 40. Barker AK, Brown K, Siraj D, Ahsan M, Sengupta S, Safdar N. Barriers and facilitators to infection control at a hospital in northern India: A qualitative study. Antimicrob Resist Infect Control. 2017;6(1).
• 41. Gadzama GB, Bawa SB, Ajinoma Z, Saidu MM, Umar AS. Injection safety practices in a main referral hospital in northeastern Nigeria. Niger J Clin Pract. 2014;17(2):134- 139.