Knowledge, Attitude and Practice Toward Needle Stick Injury Among Health Care Workers in Mogadishu Somalia

Needlestick injuries (NSIs) remain a major occupational hazard among healthcare workers (HCWs), increasing the risk of exposure to blood-borne infections such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Although largely preventable, NSIs continue to occur frequently in fragile and resource-limited health systems, including Somalia. This study assessed healthcare workers' knowledge, attitudes, and practices regarding NSIs in Mogadishu, Somalia, to identify existing gaps and inform occupational safety interventions.

A facility-based cross-sectional study was conducted in Mogadishu, Somalia, from July 2024 to January 2025. A total of 422 healthcare workers from public and private health facilities were selected using stratified random sampling. Data were collected through a validated self-administered electronic questionnaire covering sociodemographic characteristics and knowledge, attitudes, and practices related to NSIs. Scores for knowledge, attitude, and practice were categorized using Bloom's cut-off criteria. Data were analyzed using descriptive statistics and multivariable logistic regression in SPSS version 20, with statistical significance set at p ≤ 0.05.

Overall, 82.94% of participants demonstrated good knowledge of needlestick injuries (NSIs), with a mean score of 8.15 ± 2.23. However, gaps remained in awareness of post-exposure prophylaxis (PEP) and the recommended timing of follow-up viral testing. Attitudes toward NSI prevention were generally positive, with 96.21% of participants classified as having a positive attitude. Nevertheless, some respondents continued to prioritize patient care over healthcare worker safety. Preventive practices were less satisfactory, with only 44.79% of participants reporting good practice. Underreporting of injuries and delayed uptake of PEP were also notable concerns. In the adjusted analysis, healthcare workers aged 18-30 years were less likely to report good preventive practices than those aged over 40 years (AOR = 0.30, p = 0.001). In contrast, nurses (AOR = 3.29, p = 0.002) and specialists (AOR = 2.67, p = 0.048) were more likely to report good preventive practices than laboratory technicians. Estimates from the attitude model were unstable because of sparse outcome data and should therefore be interpreted cautiously.

Despite relatively high knowledge and generally positive attitudes toward NSI prevention, important gaps in preventive practice remain among healthcare workers in Mogadishu. Underreporting of injuries and inadequate post-exposure management highlight a persistent gap between awareness and action. Targeted interventions aimed at younger healthcare workers, improved reporting systems, better access to PEP, and stronger institutional safety practices are needed to reduce the burden of NSIs in resource-limited settings.