Factors associated with compliance with Infection Prevention and Control measures during the COVID-19 pandemic among healthcare workers in Kampala City, Uganda

by Mitima Jean-Marie Limenyande, Joyce Owens Kobusingye, Tonny Tindyebwa, Dorothy Akongo, John Bosco Isunju, David Musoke

In the context of the COVID-19 pandemic that originated from China in December 2019 and spread around the world, Kampala City witnessed a high number of infections and deaths among healthcare workers (HCWs). This study assessed the level of compliance with Infection Prevention and Control (IPC) measures and its associated factors among HCWs during the COVID-19 pandemic, in Kampala City, Uganda.

A cross-sectional study was conducted in Nakawa Division, Kampala City, among 240 HCWs and used multistage sampling in government and private not-for-profit (PNFP) healthcare facilities. The outcome variable was self-reported IPC compliance which was composed of the use of masks, gloves, and hand hygiene. These were assessed using a 4-scale tool: always as recommended, most of the time, occasionally, and rarely. Only HCWs who responded “always as recommended” were considered compliant while the rest were considered non-compliant. Data was analyzed in STATA 14.0 using Modified Poisson regression to obtain factors associated with IPC compliance at 95% confidence interval (CI).

Forty-six (19.2%) respondents were compliant with all the three IPC measures, and this was associated with the presence of a COVID-19 patients’ ward in the healthcare facility (Adjusted Prevalence Ratio, APR: 2.51, 95%CI: 1.24–5.07). Factors associated with the use of masks were being of the Muslim religion (APR: 1.31, CI: 1.05–1.65), and working in a healthcare facility that has COVID-19 patients’ ward (APR: 1.29, CI: 1.06–1.59). Factors associated with the use of gloves were the age of the HCW, those above 40 years old being less complaint (APR: 0.47, CI: 0.24–0.93), working in the diagnosis department (APR: 2.08, CI: 1.17–3.70), and working in a healthcare facility that has COVID-19 patients’ ward (APR: 1.73, CI: 1.13–2.64). Factors associated with hand hygiene were working in a health center (HC) IV (PR: 1.7, CI: 1.26–2.30) or a HC II (PR: 1.68, CI: 1.28–2.21).

Considering the elevated risk of disease transmission in health settings, IPC compliance was low; indicating an increased risk of COVID-19 infection among health care workers in Kampala City.