Infection prevention and control practices among dental healthcare professionals in Somaliland: a multicity...

Dental healthcare personnel are exposed to blood, saliva, sharp instruments, and procedure-generated aerosols. Evidence on infection prevention and control (IPC) practices in Somaliland dental services is limited. This study assessed IPC practices and examined factors associated with the IPC practice score among dental healthcare professionals.

A facility-based cross-sectional survey included 180 dental healthcare professionals from accessible public and private dental facilities in four Somaliland study areas. A structured self-administered questionnaire measured professional characteristics, IPC systems, vaccination, knowledge, attitudes, reported practices, occupational exposure, and barriers. Five knowledge items produced a score of 0-5. Seven frequency-based practice items were scored from 0 to 4 and summed to a score of 0-28; scores of at least 75% were classified as good practice. Univariable and multivariable linear regression with robust standard errors estimated associations with the continuous practice score. Fractional-logit and workload-restriction analyses assessed sensitivity.

Participants had a mean age of 27.2 years (SD 3.5); 64.4% were male and 74.4% were general dentists. The mean knowledge score was 3.20/5 (SD 1.00), and 33.9% had good knowledge. The mean practice score was 25.73/28 (SD 2.34), and 174/180 (96.7%) reached the prespecified 75% threshold. Always performing hand hygiene before and after each patient was reported by 81.1%; always using and changing gloves between patients was reported by 96.7%. Only 21.7% selected an N95 respirator for aerosol procedures, and 22.2% reported biological-indicator sterilization monitoring. In adjusted analysis, no recent IPC training (adjusted beta -1.44, 95% CI -2.47 to -0.41), PPE supplies available only sometimes (-1.38, 95% CI -2.42 to -0.34) or rarely (-4.99, 95% CI -7.02 to -2.96), and treating 10-19 rather than fewer than 10 patients daily (-0.89, 95% CI -1.67 to -0.11) were associated with lower practice scores. Sensitivity analyses produced materially similar patterns.

Reported compliance with several routine practices was high, but important gaps remained in respiratory protection, sterilization monitoring, occupational vaccination, post-exposure systems, and reliable PPE supply. Because the total eligible population and response rate were unknown, and practices were self-reported, the magnitude and generalizability of these estimates remain uncertain. Facility-level IPC programs should prioritize dependable supplies, recurrent competency-based training, sterilization quality assurance, vaccination, and post-exposure management.