Knowledge, attitudes, and practices regarding tetanus: a case of healthcare workers in the emergency and intensive care departments of a regional hospital in the northern region of Morocco

Abstract

Background: Tetanus is a potentially fatal, vaccine-preventable infection caused by Clostridium tetani. Healthcare workers play a crucial role in preventing this disease and managing infections in the community. Methods: A cross-sectional study was conducted between March and August 2023 in the emergency and intensive care units of a regional hospital in northern Morocco to evaluate healthcare workers’ knowledge, diagnostic attitudes, treatment practices, and preventive awareness regarding tetanus. A purposive sampling strategy was used to recruit participants, and data were collected through a structured, self-administered, and anonymous questionnaire. Descriptive statistics summarized demographic characteristics and competencies related to tetanus management. Associations between variables were explored using chi-squared or Fisher’s exact tests, as appropriate, followed by multivariate logistic regression to identify independent socio-demographic predictors. Statistical significance was set at p < 0.05, and the strength of associations was expressed as odds ratios (ORs) with corresponding 95% confidence intervals (CIs). Results: The study included 83 healthcare workers, comprising 72.29% nurses and 27.71% physicians. Among these participants, 62.65% demonstrated limited knowledge about tetanus. The accuracy of disease diagnosis was reported at 43.48% for physicians and 25% for nurses. A significant lack of adherence to treatment guidelines and protocols was noted in 76.66% of nurses and 78.26% of physicians. Furthermore, 60.24% of participants reported either a lack of ongoing training in tetanus management or a lack of access to published guidelines to support their continuous learning. A low level of diagnostic accuracy among healthcare workers was significantly associated with inadequate treatment expertise (OR = 3.63; 95% CI: 1.24–10.58; p = 0.02). Additionally, nurses were more likely than physicians to demonstrate low prevention awareness (OR = 3.59; 95% CI: 1.12–12.9; p = 0.04). Conclusion: Our findings indicate substantial gaps in the knowledge and clinical management of tetanus among healthcare workers in the emergency and intensive care units of this hospital. We recommend implementing structured initial and ongoing training programs for both physicians and nurses to enhance the management of tetanus.