Occupational Health and Infection Control Practices Related to COVID-19 in Sana'a City Public Hospitals – Yemen

Abstract

Background of the study The novel coronavirus COVID-19 was originally identified in December 2019 as a severe case of pneumonia in China and since that it has become a global pandemic affecting the greatest nations around the whole world. COVID-19 is an important cause of mortality and morbidity which it reached over 193 657 725 cases. This can be primarily prevented by increasing the knowledge and practice of health workers to improve health care which will play an important role to enhance the health system. Methods A descriptive cross-sectional study was conducted among health workers (HWS) at public hospitals in Sana a city-Yemen to assess the occupational health and infection control practices-related to COVID-19. The sample size was 386 HWs from the five public hospitals that participated in this study. Data was collected using a close-ended questionnaire, focus discussion group, and observation list. Three hundred eighty-six HWs were tested for the individual factors (acknowledge, practice and perception), 40 HWS were tested for risk perception and organization factors using focus group discussion (FGDs), five hospitals were tested for organization and environmental factors using an observation list. Results The results of the study showed that 53.9% of HWs were females and 46.1 % male, 58.5% of HWs aged more than 25 years old. The jobs of health workers were 19.4 % doctor, 19.4 % medical assistant, 5.4% technician, 21.8% laboratorian, 23.3% nurse, 3.1% midwife and 7.5% others. More than half (50.8 %) of the study attendance were undergraduated, about the half (51.3%) has more than 3 years of experience. The general knowledge of the health workers was 39.4% good and 60.6% was poor, the concept of the disease was 61.9% good knowledge and 38.1% was poor knowledge, knowledge of HWs on COVID-19 transmission was 92.5% good knowledge and 7.5% poor knowledge. The knowledge of symptoms and signs was 22.5 % good knowledge and 77.5% was poor knowledge, a good knowledge of HWs prevention with 47.4 % and 52.6 % was poor acknowledge. The HWs good acknowledge toward treatment was 69.9% and 30.1% for poor knowledge. The general practice of HWs toward COVID-19 was 55.4% good practice and 44.6% bad practice. The WHO that recommended the number of hand hygiene practices were performed by 10.6% of HWs. Using the observation list, four hospitals had adequate ventilation in the rooms, the suitable distance between each bed and the PPE was available. Three hospitals from five have a sufficient quantity of PPE and have a well -equipped triage station at the entrance. Two hospitals adhere that the suspected patient wore mask when they arrive at the hospital and two from five hospitals have soap and water for hand hygiene and just one hospital adopts the universal masking policy. No hospitals have available alcohol-based hand rub or have a negative pressure room. There was no significant association between the overall level of knowledge and sex (P = 0.41) but there was a statistically significant association between the overall level of knowledge and age, (P= 0.00), job (P=0.00), experience (P=0.00) and education (P= 0.00). Also, a significant association between level of health workers practice toward COVID-19 and sex (P = 0.02), age (P= 0.02) and job (P=0.03) and there is no significant association between level of health workers practice and education (P= 0.19) and experience (P=0.44). Although, there is significant association between level of health workers perception and age (P= 0.02), there is no significant association between level of health workers perception toward sex (P= 0.31), education (P=0.92), job (P=0.63) and experience (P=0.48).Conclusion The health workers' knowledge of COVID-19 was inadequate and their practice was found good and most perception of HWs was negative. There was a significant association between knowledge and age, job, education, and experience whereas no association between knowledge and sex. There was a significant association between the level of health workers' practice and sex, age and job but no significant association between the level of health workers' practice and education, and experience. There was a significant association between the level of health workers' perception and age while there was no significant association between the level of health workers' perception and sex, education, job, and experience. Recommendations It is recommended that the formal authorities should increase the acknowledge of HWs and train them on COVID guidelines and supply the health care facilities with all kinds of PPEs. Therefore, improvement is needed in various areas related to the character of the disease, best practices, and the experience of health workers. New information about COVID-19 can be translated into guidance for HWs. Similar studies should be conducted with a large sample size in other health facilities in Yemen are recommended.