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Unmasking the failure: isolation and cohorting practice in low-resource healthcare settings
Fairoze Masuda Akther1, Shariful Amin Sumon2, Tanjeemay Tamanna2
1Infectious Disease Division, The International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Health Equity Sciences, College of Population Health, The University of New Mexico, Albuquerque, NM, USA.
Background:
Isolation and cohorting are essential for effective infection prevention and control within healthcare settings to reduce infectious disease transmission. In Bangladesh, no prior study has systematically explored healthcare workers' (HCWs') knowledge or practices on these measures. This study assessed HCWs' (physicians, nurses, and supporting staff) perceptions and practices regarding isolation and cohorting in low-resource healthcare settings.
Methods:
A multi-centre cross-sectional study was conducted from September 2020 to January 2021 across seven public tertiary care hospitals. Data were collected through in person interviews using a semi-structured questionnaire. Descriptive and multi-variate analyses were performed with STATA version 15.
Results:
A total of 1511 HCWs were interviewed, 88.7% were familiar with the terms 'isolation' and 'cohorting', while 40.5% misunderstood their application. Only 18.0% showed good compliance. Entry-level HCWs (<31 years) had higher adherence (59.6%) than mid-level HCWs (29.4%). Training recipients reported 93.7% compliance. Physicians and nurses had greater adherence odds (odds ratio [OR] = 11.0) than supporting staff; those with <5 years' experience showed increased likelihood (OR = 1.56; 95% confidence interval: 1.09-2.21) versus those with >10 years' experience.
Conclusions:
Despite the fact that awareness exists, isolation and cohorting practices are suboptimal in Bangladesh. Findings underscore the urgent need for structured, hands-on training programs, and institutional support to enhance compliance and reduce healthcare-associated infections.
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