Prevalence and correlates of knowledge and practices regarding infection prevention and control, and triage in primary healthcare settings: A cross-sectional study in Bangladesh

Abstract

Background: Despite the high prevalence of healthcare-acquired infection in resource- limited settings, healthcare workers’ (HCWs’) knowledge and practices of infection pre- vention and control (IPC) and triage are not well-researched. We examined thisin Ban- gladesh’s primary healthcare facilities (HCFs) during the COVID-19 pandemic.

Methods: We surveyed 312 HCWs in 94 community clinics (CCs) and 90 family welfare

centres (FWCs) in six districts from February to April 2021. We assessed HCWs’ self- reported knowledge and observed practices in four domains: personal hygiene, medical

instrument processing, waste management, and triage. We constructed a weighted composite knowledge score and estimated the association between knowledge and background characteristics using a generalised linear mixed effects model. Practices were described through univariate analysis. Findings: On a scale of 100, the mean composite knowledge score was 38.3 (SD: 13.3) overall and 44.0 (SD: 13.1) and 33.8 (SD: 11.6) for FWCs and CCs, respectively. The HCWs of FWCs were more aged, experienced, and educated than those of CCs. Knowledge score was the highest in personal hygiene and the lowest in medical waste segregation. Knowledge was significantly associated with HCWs’ designation and education. Concerning

practices, not more than one-third of the HCWs or HCFs, on average, followed the rec- ommended protocols, except for wearing face masks while on duty (87.1%) and referring

potential COVID-19 patients to higher-level facilities (68.3%). Conclusions: HCWs’ capacity in instrument processing, waste management, and triage needs to be improved through formal education and training initiatives. Our study can contribute to the under-researched IPC and triage domains in resource-limited settings.