Readiness To Manage Ebola Virus Disease Among Emergency Healthcare Workers in Uganda: A Nationwide Multicenter Survey.

ABSTRACT

Background: Emerging infectious diseases like the Ebola Virus Disease (EVD) pose significant global public health threats. Uganda has experienced multiple EVD outbreaks, the latest occurring in 2022. Frontline healthcare workers (HCWs) are at increased risk, yet there isn't sufficient evidence of existing knowledge of EVD of these health workers. We aimed to assess the readiness of Uganda's emergency healthcare workers to manage Ebola virus disease (EVD) and identify their training needs to inform targeted capacity-building interventions for future outbreaks. Methods: This multicentre nationwide cross-sectional study was conducted from July to August 2023 among 691 HCWs providing emergency care in 14 secondary and tertiary hospitals across Uganda. Participants were consecutively recruited using the probability-proportional-to-size sampling technique, and data was collected using a self-reported questionnaire. Factors associated with EVD knowledge were identified through a mixed-effect linear model. Results: Data from 691 eligible HCWs with a median age of 32 (IQR 28-38) was analyzed (response rate 92%). Only one-third (34.4%, n = 238) had received EVD training in the past year. The median EVD knowledge score was 77.4% (IQR 71.2% - 83.4%). EVD knowledge was associated with longer professional experience in years (ß 0.21, 95% CI 0.03 to 0.39, p = 0.024) and higher level of education diploma (ß 3.37, 95% CI 1.49 to 5.25, p < 0.001), undergraduate degree (ß 6.45, 95% CI 4.11 to 8.79) and postgraduate degree (ß 7.13, 95% CI 4.01 to 10.25, p < 0.001). Being a doctor (ß 2.55, 95% CI 0.35 to 4.74, p = 0.023), providing care in the obstetrics/gynecology department (ß -1.90, 95% CI -3.47 to - 0.32, p = 0.018), previous EVD training (ß 2.27, 95% CI 0.96 to 3.59, p = 0.001) and accessing EVD information through social media (ß 2.52, 95% CI 1.17 to 3.88, p < 0.001) were also significantly associated with EVD knowledge. Conclusion: Our study reveals that Ugandan HCWs' EVD response readiness varies by individual factors and information sources. We recommend targeted training and suggest future research on educational innovations and social media's potential to fill knowledge gaps.