Knowledge Attitude and Practice (KAP) on Ebola Virus Disease (EVD) Among Health Care Workers (HCWs) From the Lyon Teaching Hospitals, France

Abstract

Background. Lyon teaching hospital is one of the 10 French reference centers habilitated to manage highly transmissible and emergent infectious diseases. Methods. KAP of HCWs on EVD was assessed 6 months after the end of the Ebola alert using standardized questionnaires mailed to the 242 HCWs who attended at least one of the different theoretical and practical trainings organized in 2014. Five-items questions (each scored 5 points) assessed different aspects of KAP on EVD, including virus knowledge, disease transmission, case definition, initial management of a possible case, preventive measures, personal protective equipment (PPE) downing and doffing, waste management and environmental cleaning. Scores were compared according to the type of training the responders had attended to. Results. Overall response rate was 34.7% (84 of 242), mainly from the emergency (38%), infectious disease (18%) and gynecology-obstetric (13%) departments. Responders were mainly registered nurses (49%), medicalized transportation HCWs (14%), midwives (14%), caregivers (12%), and medical doctors (8%). Two hundred four HCWs (84%) participated in specific PPE downing and doffing training(s), 79 (94%) in theoretical training(s), 68 (81%) in a practical exercise and 15 (18%) in a simulation exercise. 36% had to manage an EVD suspected case. Median score ranged from 3 [IQR, 3-4] for virus knowledge to 5 [IQR, 4-5] for PPE downing and environmental cleaning. HCWs who had participated to a real suspected case management (Figure 1) or simulation (Figure 2) obtained significantly higher scores regarding practical aspects of EVD management, including initial management, patient isolation, PPE downing and doffing, and waste management (Mann-Whitney U test; P < 0.05). On the opposite, multiplication of theoretical trainings did not improve HCW KAP on EVD (Figure 3). Conclusion. Our survey demonstrates apparent lack of knowledge regarding various aspects of EVD in HCWs, despite multiple theoretical training sessions. On the opposite, patient case management simulation appears to have an important positive impact of HCWs KAP on EVD. (Figure Presented) .