Factors associated with good TB infection control practices among primary healthcare workers in the Free State Province, South Africa.
Despite the availability of TB infection control guidelines, and good levels of healthcare worker knowledge about infection control, often these measures are not well implemented. This study sought to determine the factors associated with healthcare workers' good TB infection control practices in primary health care facilities in the Free State Province, South Africa.



A cross-sectional self-administered survey among nurses (n = 202) and facility-based community healthcare workers (n = 34) as well as facility observations were undertaken at all 41 primary health care facilities in a selected district of the Free State Province.



The majority of respondents were female (n = 200; 87.7 %) and the average age was 44.19 years (standard deviation ±10.82). Good levels of knowledge were recorded, with 42.8 % (n = 101) having an average score (i.e. 65-79 %) and 31.8 % (n = 75) a good score (i.e. ≥ 80 %). Most respondents (n = 189; 80.4 %) had positive attitudes towards TB infection control practices (i.e. ≥ 80 %). While good TB infection control practices were reported by 72.9 % (n = 161) of the respondents (i.e. ≥75 %), observations revealed this to not necessarily be the case. For every unit increase in attitudes, good practices increased 1.090 times (CI:1.016-1.169). Respondents with high levels of knowledge (≥80 %) were 4.029 (CI: 1.550-10.469) times more likely to have good practices when compared to respondents with poor levels of knowledge (<65 %). The study did not find TB/HIV-related training to be a predictor of good practices.



Positive attitudes and good levels of knowledge regarding TB infection control were the main factors associated with good infection control practices. Although many respondents reported good infection control practices - which was somewhat countered by the observations - there are areas that require attention, particularly those related to administrative controls and the use of personal protective equipment.
Centre for Health Systems Research & Development, University of the Free State, Nelson Mandela Road, Bloemfontein, 9300, South Africa. engelmc@ufs.ac.za.
Michelle
0000-0002-3970-0552
M
Engelbrecht
Centre for Health Systems Research & Development, University of the Free State, Nelson Mandela Road, Bloemfontein, 9300, South Africa.|Health and Demographic Research Unit, Department of Sociology, Ghent University, Korte Meer 5, Ghent, 9000, Belgium.|Department of Political Science, Stellenbosch University, Corner Merriman and Ryneveld Street, Stellenbosch, 7602, South Africa.
André
A
Janse van Rensburg
Centre for Health Systems Research & Development, University of the Free State, Nelson Mandela Road, Bloemfontein, 9300, South Africa.
Gladys
G
Kigozi
Centre for Health Systems Research & Development, University of the Free State, Nelson Mandela Road, Bloemfontein, 9300, South Africa.
Hcj Dingie
HD
van Rensburg
D000328:Adult; D003428:Cross Infection / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017053:Infection Control / Q000592:standards*; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D008297:Male; D016273:Occupational Exposure; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D013019:South Africa; D014376:Tuberculosis / Q000517:prevention & control* / Q000635:transmission
Attitudes; Healthcare workers; Knowledge; Practices; Primary health care; TB infection control