Optimized and Non-Optimized Personal Protective Equipment use During the COVID-19 Pandemic in Thailand: A National Cross-Sectional Survey in a Resource-Limited Setting
Abstract Background: Coronavirus disease (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-COV2). COVID-19 is highly contagious, potentially fatal, and a global public health concern. Combining optimized personal protective equipment (PPE) use and hand hygiene is the best strategy for preventing COVID-19 in health care workers (HCWs).Methods: We conducted a national cross-sectional survey of HCWs in the infection control program in Thailand between May 5, 2020 and May 15, 2020. The primary objective was the prevalence of optimized PPE use amongst HCWs. The secondary objective was identification of the independent predictors of optimized PPE use. Results: Seven hundred and fifty-six HCWs responded. Five HCWs were excluded because of non responsible of care team, and 751 were included in the final analysis. The prevalence of optimized PPE use was 22 % (168/751), 78% (583/751) were non-optimized PPE use, 35% (263/751) over-used PPE, and 43% (320/751) under-used PPE. In univariate analysis, optimized PPE use was significantly associated with age, education level, knowledge of appropriate negative pressure room selection and knowledge of apparently milder symptom severity in children than adults. In multivariate analysis, independent predictors of optimized PPE use were knowledge of appropriate negative pressure room selection (aOR=1.95, 95% CI=1.18-3.22) , the difference in symptom severity between children and adults (aOR=0.55, 95% CI=0.37-0.81) and education level (aOR=1.54, 95% CI=1.04-2.27).Conclusion: The prevalence of optimized PPE use amongst HCWs was 22 %. Independent predictors of optimized PPE use were COVID-19 knowledge-based factors and education level.Continued education is advised among Thai HCWs.