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Effect of Lassa Fever Infection-Control Education on Infection Prevention Practices among Healthcare Workers in Nigeria

Abstract

Lassa fever is an important viral haemorrhagic fever and public health concern in Nigeria, with healthcare workers facing occupational risks of exposure during the care of suspected or confirmed cases. Transmission within healthcare settings may occur through contact with infected blood, body fluids, contaminated materials, or inadequate implementation of infection prevention and control measures. Healthcare workers may be particularly vulnerable when suspected cases are not identified promptly, appropriate personal protective equipment is unavailable or incorrectly used, isolation procedures are inadequate, or infection prevention protocols are inconsistently followed. Lassa fever infection-control education provides healthcare workers with knowledge and practical skills relating to Lassa fever transmission, signs and symptoms, case identification, standard precautions, contact precautions, appropriate use of personal protective equipment, hand hygiene, safe injection practices, environmental cleaning, safe handling of contaminated materials, patient isolation, waste management, and appropriate procedures following occupational exposure. Infection prevention practices refer to actions undertaken by healthcare workers to reduce the risk of transmission of Lassa fever and other infectious diseases within healthcare settings, including appropriate use of personal protective equipment, hand hygiene, safe handling of blood and body fluids, safe injection practices, environmental cleaning, isolation procedures, waste disposal, and adherence to established infection prevention and control guidelines. In Nigeria, limited Lassa fever-specific training, inadequate availability of personal protective equipment, heavy workloads, insufficient isolation facilities, inadequate infection prevention infrastructure, and inconsistent compliance monitoring may affect healthcare workers' ability to implement appropriate infection prevention practices. Effective Lassa fever infection-control education may improve healthcare workers' knowledge, practical skills, risk perception, and adherence to recommended infection prevention measures. Against this background, this study investigates the effect of Lassa fever infection-control education on infection prevention practices among healthcare workers in Nigeria. The study is anchored on Social Cognitive Theory, the Health Belief Model, and Protection Motivation Theory. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, behavioural capabilities, social influences, and environmental conditions in shaping healthcare workers' infection prevention behaviour. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding healthcare workers' adoption of recommended infection prevention practices. Protection Motivation Theory explains how perceived health threats, response efficacy, self-efficacy, and perceived response costs influence individuals' decisions to adopt protective measures against infectious disease transmission. Collectively, these theoretical perspectives provide a suitable framework for explaining how Lassa fever infection-control education may influence infection prevention practices among healthcare workers in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from healthcare workers in selected public and private hospitals and primary healthcare facilities in Nigeria using a structured self-administered questionnaire, Lassa fever infection-control knowledge assessment, and an observational infection prevention practices checklist. A multistage sampling technique will be employed to select states, local government areas, healthcare facilities, departments or units, and eligible healthcare workers. Where feasible, selected healthcare facilities or healthcare worker groups will be assigned to intervention and comparison groups. Healthcare workers in the intervention group will receive structured Lassa fever infection-control education covering Lassa fever transmission, signs and symptoms, early recognition and notification of suspected cases, standard precautions, appropriate use of personal protective equipment, hand hygiene, safe injection practices, handling of blood and body fluids, patient isolation, environmental cleaning and disinfection, safe management of contaminated materials and healthcare waste, and procedures following occupational exposure. Infection prevention practices will be assessed using indicators such as appropriate use of personal protective equipment, hand hygiene, safe injection practices, appropriate handling of blood and body fluids, patient isolation, environmental cleaning, safe healthcare waste disposal, and adherence to Lassa fever and general infection prevention and control guidelines. Direct observation will be prioritized where feasible to reduce reliance on self-reported behaviour. Descriptive statistics will be used to summarize healthcare workers' sociodemographic and professional characteristics, Lassa fever knowledge, exposure to infection-control education, and infection prevention practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic or multiple regression analysis, will be used to determine the effect of Lassa fever infection-control education on infection prevention practices. Where appropriate, pre-intervention and post-intervention practice scores will be compared. Diagnostic tests will also be conducted to assess the reliability of the research instruments, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that Lassa fever infection-control education has a significant positive effect on infection prevention practices among healthcare workers in Nigeria. Healthcare workers exposed to structured Lassa fever infection-control education are expected to demonstrate improved knowledge of Lassa fever transmission and greater adherence to recommended infection prevention procedures. Education may improve appropriate use of personal protective equipment, hand hygiene, safe injection practices, handling of blood and body fluids, patient isolation, environmental cleaning, healthcare waste disposal, and appropriate procedures following occupational exposure. It may also improve early recognition and notification of suspected Lassa fever cases and strengthen healthcare workers' understanding of the importance of preventing nosocomial transmission. However, education alone may not guarantee sustained infection prevention practices because healthcare workers may continue to face barriers such as inadequate personal protective equipment, shortages of essential supplies, insufficient isolation facilities, overcrowding, heavy workloads, inadequate staffing, and weak institutional compliance monitoring. Consequently, Lassa fever infection-control education is expected to be most effective when supported by adequate infection prevention infrastructure, reliable supplies of protective equipment, functional isolation facilities, regular supervision, continuous training, effective surveillance systems, and strong hospital infection prevention and control programmes. The study is expected to contribute to the literature on Lassa fever prevention, infection prevention and control, healthcare worker safety, occupational health, viral haemorrhagic fever preparedness, health education, infectious disease prevention, and public health in Nigeria by providing empirical evidence on the effect of Lassa fever infection-control education on infection prevention practices among healthcare workers. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Nigeria Centre for Disease Control and Prevention, National Primary Health Care Development Agency, state ministries of health, hospital management authorities, infection prevention and control committees, occupational health professionals, healthcare professional associations, public health practitioners, development partners, and policymakers regarding strategies for reducing healthcare-associated transmission of Lassa fever. The study will also provide evidence-based recommendations for strengthening Lassa fever infection-control education, improving access to personal protective equipment, strengthening isolation and infection prevention infrastructure, enhancing healthcare worker surveillance and preparedness, improving compliance monitoring, and promoting effective infection prevention and control practices in Nigerian healthcare facilities.

Keywords: Lassa fever infection-control education, infection prevention practices, healthcare workers, Lassa fever, infection prevention and control, viral haemorrhagic fever, personal protective equipment, occupational health, healthcare safety, infectious disease prevention, health education, public health, Nigeria.