Knowledge, attitude and self-reported practice of healthcare workers on infection control in a health facility in Akure, Nigeria

  • Abiola O. Oluwagbemiga Department of Environmental Health Sciences, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
  • Shade J. Akinsete Department of Environmental Health Sciences, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
  • Godson R. Ana Department of Environmental Health Sciences, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
  • Olusola O. Ogunseye Department of Environmental Health Sciences, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
Keywords: healthcare-associated infections, infection control, hand hygiene, disinfection, healthcare workers, knowledge, attitudes, Nigeria


Background: Infection control is pivotal in reducing healthcare-associated infections (HAIs), one of the leading causes of morbidity with growing prevalence in sub-Saharan Africa.

Objectives: We investigated the knowledge, attitude and self-reported hygiene practices towards hospital infection control among healthcare workers (HCWs) at the State Specialist Hospital, Akure, Nigeria.

Methods: This descriptive cross-sectional study involving self-administered, structured questionnaires administered to 137 randomly selected HCWs (19 doctors, 66 nurses and 52 health assistants) was conducted in 2015. Descriptive and inferential statistics were used for data analysis at 5% level of significance.

Results: Mean age of HCWs was 39.81 ± 8.69 years. Majority (84.7%) was trained on hand hygiene and was knowledgeable about HAIs (86.9%), modes of transmission (57.7%) and effectiveness of hand hygiene (94.9%). However, about half (48.9%) of the HCWs reported did not adhere to hand hygiene often, because of the distance between a water source and the wards. This study also showed that there are relationships between categories of respondents and their knowledge of routes of HAI transmission (P < 0.01) and practice of hand hygiene after contacts with hospital surfaces (P < 0.01).

Conclusions: Hospital and hand hygiene can be improved by ensuring water supply located close to the wards. There is need for the provision of clear guidance on procedures for hospital hygiene and sanitation.


Download data is not yet available.


Garner JS. Guideline for isolation precautions in hospitals. Infect Control Hosp Epidemiol 1996; 17: 54–65. doi: 10.1017/S0195941700006123

Anderson JL, Warren CA, Perez E, Louis RI, Phillips S, Wheeler J, et al. Gender and ethnic differences in hand hygiene practices among college students. Am J Infect Control 2008; 36 (5): 361–8. doi: 10.1016/j.ajic.2007.09.007

Yildirim I, Ceyhan M, Cengiz AB, Bagdat A, Barin C, Kutluk T, et al. A prospective comparative study of the relationship between different types of ring and microbial hand colonization among pediatric intensive care unit nurses. Int J Nurs Stud 2008; 45(11): 1572–6. doi: 10.1016/j.ijnurstu.2008.02.010

Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S, et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Infection Control Programme. Lancet 2000; 356(9238): 1307–12. doi: 10.1016/S0140-6736(00)02814-2

Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients’ care. Lancet 2003; 362(9391): 1225–30. doi: 10.1016/S0140-6736(03)14546-1

Bischoff W, Reynolds T, Sessler C, Edmond M, Wenzel R. Hand-washing compliance by health care workers: impact of introducing an accessible, alcohol-based hand antiseptic. Arch Intern Med 2000; 160(7): 1017–21. doi: 10.1001/archinte.​160.7.1017

Maury M, Elzieu A, Baudel J, Haram H, Barbut A, Guidet J, et al. Availability of an alcohol solution can improve hand disinfection compliance in an intensive care unit. Am J Respir Crit Care Med 2000; 162(1): 324–7. doi: 10.1164/ajrccm.162.1.​9908118

Moongtu W, Gauthier D, Turner J. Using peer feedback to improve hand-washing and glove usage among Thai health care workers. Am J Infect Control 2000; 28: 365–9. doi: 10.1067/mic.2000.107885

Pittet D, Allegranzi B, Storr J, Donaldson L. ‘Clean care is safer care’: the global patient safety challenges 2005–2006. Int J Infect Dis 2006; 10(6): 419–24. doi: 10.1016/j.ijid.2006.06.001

Engdaw GT, Gebrehiwot M, Andualem Z. Hand hygiene compliance and associated factors among health care providers in Central Gondar zone public primary hospitals, Northwest Ethiopia. Antimicrob Resist Infect Control 2019; 26(8): 190. doi: 10.1186/s13756-019-0634-z

Pittet D. Burden of endemic healthcare-associated infection in Africa. 16th International Congress on Infecious Diseases (ICID). 16th ICID Abstracts. Int J Infect Dis 2014; 21S: 51. doi: 10.1016/j.ijid.2014.03.1371

Agaba P, Tumukunde J, Tindimwebwa JVB, Kwizera A. Nosocomial bacterial infections and their antimicrobial susceptibility patterns among patients in Ugandan intensive care units: a cross sectional study. BMC Res Notes 2017; 10: 349. doi: 10.1016/j.apjtb.2017.01.019

Khan HA, Baig FK, Mehboob R. Nosocomial infections: epidemiology, prevention, control and surveillance. Asian Pac J Trop Biomed 2017; 7(5): 478–82. doi: 10.1016/j.apjtb.2017.01.019

Adegboye MB, Zakari S, Ahmed BA, Olufemi GH. Knowledge, awareness and practice of infection control by health care workers in the intensive care units of a tertiary hospital in Nigeria. African Health Sci 2018; 18(1): 72–8. doi: 10.4314/ahs.v18i1.11

Onyedibe KI, Shehu NY, Pires D, Isa SE, Okolo MO, Gomerep SS, et al. Assessment of hand hygiene facilities and staff compliance in a large tertiary health care facility in northern Nigeria: a cross sectional study. Antimicrob Resist Infect Control 2020; 9: 30. doi: 10.1186/s13756-020-0693-1

Olalekan AW, Olusegun BJ, Olufunmilayo AE, Lanre AO. Awareness and attitude of health care workers in a teaching hospital in southwestern Nigeria towards nosocomial infections. J Publ Health Epidemiol 2012; 4(10): 285–9. doi: 10.5897/JPHE11.106

Raka L, Kalenic S, Zoutman D, Berisha L, Berisha M, Salihu D, et al. Knowledge, attitudes and practices of health care workers in Kosovo hospitals regarding nosocomial infections. 16th European Congress of Clinical Microbiology and Infectious Diseases Nice, France, 1–4 April 2006. Clin Microbiol Infect 2006; 12(4): 84.

Ekwere TA, Okafor IP. Hand hygiene knowledge and practices among healthcare providers in a tertiary hospital, south-west Nigeria. Int J Infect Control 2013; 9: 4. doi: 10.3396/IJIC.v9i4.032.13

Oli AN, Ekejindu CC, Ejiofor OS, Oli AH, Ezeobi I, Ibeh CC. The knowledge of and attitude to hospital-acquired infections among public and private healthcare workers in south-east, Nigeria. J Adv Med Med Res 2016; 11(3): 1–10. doi: 10.9734/BJMMR/2016/18272

Saloojee H, Steenhoff A. The health professional’s role in preventing nosocomial infections. Postgrad Med J 2001; 77: 16–19. doi: 10.1136/pmj.77.903.16

Beggs C, Knibbs LD, Johnson GR, Morawska L. Environmental contamination and hospital-acquired infection: factors that are easily overlooked. Indoor Air 2015; 25(5): 462–74. doi: 10.1111/ina.12170

Sarani H, Balouchi A, Masinaeinezhad N, Ebrahimitabas E. Knowledge, attitude and practice of nurses about standard precautions for hospital-acquired infection in teaching hospitals affiliated to Zabol University of Medical Sciences (2014). Global J Health Sci 2015; 8(3): 193–8. doi: 10.5539/gjhs.v8n3p193

Kudavidnange BP, Gunasekara TDCP, Hapuarachchi S. Knowledge, attitudes and practices on hand hygiene among ICU staff in Anuradhapura teaching hospital. Anuradhapura Med J 2011; 1: 29–40. doi: 10.4038/amj.v5i1.5781

Bello S, Effa E, Okokon E, Oduwole O. Handwashing practice among healthcare providers in a teaching hospital in southern Nigeria. Int J Infect Control 2013; 9: 4. doi: 10.3396/IJIC.v9i4.031.13

Abd Elaziz KM, Bakr IM. Assessment of knowledge, attitude and practice of hand washing among health care workers in Ain Shams university hospitals in Cairo. J Prev Med Hyg 2009; 50(1): 19–25. doi: 10.3396/IJIC.v9i4.031.13

Kieft RA, de Brouwer BB, Francke AL, Delnoij DMJ. How nurses and their work environment affect patient experiences of the quality of care: a qualitative study. BMC Health Serv Res 2014; 14: 249. doi: 10.1186/1472-6963-14-249

Cohen B, Hyman S, Rosenberg L, Larson E. Frequency of patient contact with health care personnel and visitors: implications for infection prevention. Jt Comm J Qual Patient Saf 2012; 38(12): 560–5. doi: 10.1016/S1553-7250(12)38073-2

Butler R, Monsalve M, Thomas GW, Herman T, Segre AM, Polgreen PM, et al. Estimating time physicians and other health care workers spend with patients in an intensive care unit using a sensor network. Am J Med 2018; 131(8): 972. doi: 10.1016/j.amjmed.2018.03.015

Askarian M, Honarvar B, Tabatabaee HR, Assadian O. Knowledge, practice and attitude towards standard isolation precautions in Iranian medical students. J Hosp Infect 2004; 58(4): 292–6. doi: 10.1016/j.jhin.2004.07.004

World Health Organization. WHO guidelines on hand hygiene in health care, 2009. Geneva: World Health Organization. Available from: [cited 20 June 2021].

Samuel R, Almedom AM, Hagos G, Albin S, Mutungi A. Promotion of handwashing as a measure of quality of care and prevention of hospital-acquired infections in Eritrea: The Keren study. Afr Health Sci 2005; 5(1): 4–13.

Boyce JM. Antiseptic technology: access, affordability and acceptance. Emerg Infect Dis 2001; 7(2): 231–3. doi: 10.3201/eid0702.010216

How to Cite
Oluwagbemiga, A., Akinsete, S., Ana, G., & Ogunseye, O. (2021). Knowledge, attitude and self-reported practice of healthcare workers on infection control in a health facility in Akure, Nigeria. International Journal of Infection Control, 17(1).
Original Articles