Infection Prevention and Control Practices Among Audiologists in Ghana Using Survey Evidence, Direct Observation and Microbial Analysis

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Audiologists use shared equipment in close patient contact, posing cross-contamination risks. This study aimed to bridge a critical gap by simultaneously investigating the microbial contamination of the audiology clinical environment and the corresponding knowledge, attitudes, and practices (KAP) of practitioners. Methods: A cross-sectional, multi-method design was employed. Firstly, a KAP questionnaire was distributed to licensed audiologists nationwide via online. To triangulate self-reported practices, direct observations of audiologists in practicewere conducted in selected facilities. The data was analysed using STATA MP14. Descriptive analysis was conducted where frequency, percentages, and mean were used to describe the findings.Secondly, swab samples were collected from audiologists’ palms, clothing, work surfaces, and equipment at three audiology centres (2 public and 1 private) in Greater Accra. Samples were cultured to identify microbial load and species. Results: The KAP survey found that, generally, audiologists possessed very good level of knowledge regarding IPC and had positive attitudes. However, the direct in-practice observation identified significant non-compliance with hand hygiene, PPE use, and disinfection protocols. Concurrently, microbial analysis (72 samples) revealed the presence of Bacillus and Staphylococcus species on surfaces, equipment, and skin, significantly higher in the public centres. Conclusion: This integrated study demonstrates that despite adequate theoretical knowledge, a tangible risk of cross-contamination exists in Ghanaian audiology practice, as evidenced by direct microbial isolation and observed lapses in IPC compliance. The disconnect between knowledge and practice, compounded by environmental contamination, highlights an urgent need for targeted interventions, continuous training, and robust IPC protocol enforcement to safeguard both patients and clinicians. Audiology Infection prevention and control Ghana Microbial contamination Figures Figure 1 Figure 2 BACKGROUND Infectious diseases remain one of the world’s leading causes of illness and death, responsible for millions of fatalities each year [1]. Health facilities are recognized as major sites of transmission, where contaminated hands, clothing, and frequently touched surfaces facilitate the spread of infections [2]. As a result, the practice of infection prevention and control (IPC) in healthcare settings has evolved significantly, transitioning from a reactive approach to a proactive paradigm that emphasizes comprehensive strategies [3]. Audiologists are healthcare professionals who in the provision of patient-centred care in the prevention, diagnosis, and evidence-based treatment of hearing, balance, and other auditory disorders require close physical proximity and the use of equipment such as supra-aural headphones, bone conductors, otoscopes, and oscillators devices [4,5]. Without adequate cleaning or disinfection, these tools can become reservoirs for bacteria such as Staphylococcus aureus , Bacillus species , and the Pseudomonas species [5]. Globally, infection control standards for audiologists are based on broader healthcare guidelines established by organizations such as the World Health Organization (WHO) [6], the Centres for Disease Control and Prevention (CDC) [7], and the British Academy of Audiology (BAA) [8]. However, research shows a persistent gap between knowledge and practice in countries like South Africa [9, 2], India [10], Brazil [11] and Turkey [5]. In Ghana, national IPC guidelines exist, but implementation across health disciplines is inconsistent, often hindered by resource constraints such as limited access to disinfectants and water shortages, insufficient training, and a lack of profession-specific standards and structured monitoring systems [12–14, 19]. Furthermore, literature and systems specific to audiological practise is limited. In order to provide a holistic overview of the situation in Ghana, this study therefore integrates two dimensions of baseline investigation: an evaluation of audiologists’ knowledge, attitudes, and practices toward IPC backed by a microbiological analysis of surfaces and equipment commonly used in audiology centres. METHODS Study sites and population The research was carried out in three audiology facilities in the Greater Accra Region (2 public and 1 private). These sites were purposefully selected to represent the two main categories of audiology service provision in Ghana. The public facilities are tertiary-level healthcare centres that provide audiological services as part of broader multidisciplinary care. They usually offer services on a referral-based and appointment-driven system, catering to both adult and pediatric populations. Collectively, these facilities have an estimated bed capacity of 2300 and serve as major referral centres for patients from within the Greater Accra Region and other parts of the country [15, 16]. The private facility, on the other hand, operates as a specialised outpatient audiology clinic, primarily delivering diagnostic, rehabilitative, and follow-up audiological care. It caters mainly to self-referred and clinician-referred clients which functions solely as an ambulatory care centre and so does not provide inpatient services. Study design and participant selection This was a prospective, cross-sectional, multi-method study that triangulated an online survey assessing knowledge, attitude, and practices with an in-person observational assessment of audiologists’ clinical practices towards IPC and a microbiological sampling of the clinical environment and equipment. Audiologists who were licensed by the Allied Health Professions Council (AHPC) and practicing in Ghana at the time of the study were recruited for the study. However, students and interns were excluded from participation. Data collection and analysis Online survey An online questionnaire was developed and uploaded on an online questionnaire distribution platform called the REDCap (version 15.5.x) developed by Vanderbilt University. The questionnaire was arranged in four sections consisting of demographics, knowledge, attitude, and practices. A 5-point Likert scale (strongly disagree, disagree, neutral, agree, strongly agree) was utilised to assess the attitude audiologists have towards the importance of IPC in their work. In-practice observations In-practice observations of random audiologists at study sites were also conducted at least twice using a checklist that was adapted from the British Academy of Audiology [8] and WHO [6]. The checklist used a 4-point frequency scale (4 = Always, 3 = sometimes, 2 = Never) to assess hand hygiene practice, personal protective equipment (PPE) usage, equipment disinfection and sterilization, workspace management, and waste disposal. IPC practices that were not relevant to the audiological procedure being performed at the point of observation was scored “not applicable” (N/A) for 1. In order to reduce bias, the checklist was uploaded on a google form to aid concealed observation by the researcher. Microbial load Swab samples were collected twice daily before the start of clinic sessions and immediately after completion of clinical sessions from key sites including the palms of audiologists, worktables, doorknobs, and frequently used diagnostic equipment (otoscopes and audiometers). Sterile cotton swabs moistened with peptone water were used, and samples were transported within two hours to the microbiology laboratory for processing. Microbiological culture was performed using both chocolate agar and MacConkey agar plates [17]. Swabs were inoculated onto the respective agar media under aseptic conditions. Following inoculation, the plates were incubated at appropriate conditions for 24–48 hours. After incubation, bacterial growth was assessed, and colony counts were performed on each plate, with colonies enumerated and categorised based on distinct morphological characteristics. Statistical analysis Responses obtained from the online survey were encoded and tabulated into Microsoft Excel (365). Stata MP14 Statistical software for data science was used to conduct descriptive analysis of the results. The scores were dichotomized into adequate/ inadequate and positive/ negative for knowledge and attitude, respectively at pre-determined cut-off point of 80%. Frequencies and percentages were used to describe their IPC practices. The Spearman correlation co-efficient was used to assess the association between the demographic characteristics and knowledge. Using Statistical Package for the Social Sciences (SPSS) version 25, descriptive statistics was performed to calculate frequency (total count) and percentage for summary of the distribution of microbial growth. RESULTS Online survey Demographic characteristics of respondents A total of 57 out of 60 practicing audiologists responded to the survey. This constituted a response rate of 95%. Table 1 shows the demographic characteristics of respondents in the online survey. In terms of region of residence/practice, there was a distribution across 7 out of the 16 administrative regions in Ghana; with majority 54.4% (n = 31) of respondents in the Greater Accra region while only 1.7% (n = 1) each were in the Northern and Bono East regions (Fig. 1 ). Table 1 Demographics of respondents in the online survey Characteristics Frequency n Percentage % Age (years) 18–25 16 28.1 26–35 30 52.6 36–45 8 14.0 ≥ 46 3 5.3 Sex Female 30 52.6 Male 27 47.4 Region Ashanti 4 7.1 Greater Accra 31 54.4 Eastern 4 7.0 Central 3 5.3 Volta 13 22.8 Bono East 1 1.7 Northern 1 1.7 Years of experience (years) 1–5 45 78.9 6–10 8 14.0 11–15 2 3.5 16–20 1 1.8 > 20 1 1.8 Highest level of education Bachelor’s 40 70.2 Master’s 17 29.8 PhD 0 0.0 Work setting Government (Rural) 9 15.8 Government (Urban) 24 42.1 Private (Rural) 1 1.8 Private (Urban) 19 33.3 Academic institution 4 7.0 Service provision Pure tone audiometry 50 87.7 Immittance audiometry 42 73.7 Cerumen management 35 61.4 Hearing aid dispensing 41 71.9 Neonatal hearing screening 39 68.4 Vestibular assessment 8 14.0 Others 5 8.7 Level of knowledge of respondents on infection prevention and control (IPC) In determining the level of knowledge of respondents regarding infection prevention and control (Table 2 ), at the 80% cut-off, majority (96.5%) of the respondents had adequate knowledge on IPC. However, for an important question on whether disinfection killed all microbes including spores, many respondents 61.4% answered incorrectly. Table 2 A summary of questions and responses testing respondents’ knowledge regarding infection prevention and control Questions testing respondents’ knowledge Frequency n Percentage % Which of these pathogens can spread through contaminated audiology materials? Hepatitis B 4 7.0 Covid-19 8 14.0 Staphylococcus aureus 10 17.5 √ All the above 34 59.7 Other 1 1.8 What does disinfection refer to? √ Killing germs but not spores 17 29.8 Removing visible dirt 4 7.0 Killing all microbes, including spores 35 61.4 Not sure 1 1.8 What does sterilisation refer to? √ Process that destroys all microbial life 47 82.5 Process that reduces germs to safe level 7 12.3 Removal of visible dirt or organic material from objects 3 5.2 Not sure 0 0.0 What does cleaning refer to? Process that destroys all microbial life 2 3.5 Process that reduces germs to safe level 7 12.3 √ Removal of visible dirt or organic material from objects 48 84.2 Not sure 0 0.0 Which of these are recommended vaccines for audiologists? Hepatitis B 3 5.3 Influenza 0 0.0 Covid-19 2 3.5 √ All the above 50 87.7 None 2 3.5 Hand hygiene is required even if gloves are worn. True/False? √ True 57 100.0 False 0 0.0 Have you received the Hepatitis B vaccine? Yes 38 66.7 No 19 33.3 *Key components of IPC Hand hygiene 51/57 89.5 Use PPE 47/57 82.5 Cleaning 50/57 87.7 Disinfection 50/57 87.7 Sterilisation 49/57 85.9 I know some IPC guidelines for audiology Yes 40 70.2 No 17 29.8 *Sources of information on IPC Media 44/57 77.2 WHO websites 41/57 71.9 Conferences 30/57 52.6 CPD programs 36/57 63.2 *Respondents had the choice to select more than one option √ The correct answer The study did not identify any statistically significant association when level of knowledge regarding IPC was compared with the demographics, apart from work setting (p = 0.026). In our study population, most of the respondents with adequate knowledge regarding infection prevention and control 24 (42.1%) worked in government (urban) settings. Attitude of respondents towards the importance of IPC At the 80% cut-off point, 61% of the respondents had positive attitude towards IPC. Where positive attitude refers to participants who strongly agreed or agreed to the various statements. Almost all respondents, 98.3% (n = 56) agree that IPC measures are necessary in audiology practice. In all, more than half 54.5% (n = 31) of the respondents disagree that wearing personal protective equipment (PPE) makes patients uncomfortable. Table 3 Respondents’ attitude towards IPC using the 5-point Likert Scale Attitude Strongly Agree n (%) Agree n (%) Neutral n (%) Disagree n (%) Strongly disagree n (%) IPC measures are necessary in audiology practice 46 (80.7) 10 (17.5) 0 (0.0) 0 (0.0) 1 (1.8) Wearing PPE makes patients uncomfortable 4 (7.0) 7 (12.3) 15 (26.2) 24 (42.2) 7 (12.3) IPC protocols waste time 0 (0.0) 5 (8.9) 5 (8.9) 31 (55.4) 15 (26.8) My workplace prioritizes IPC 17 (29.8) 30 (52.6) 8 (14.0) 0 (0.0) 2 (3.5) Vaccination for audiologists is unnecessary 6 (10.5) 1 (1.8) 3 (5.3) 16 (28.2) 31 (54.4) IPC should be mandatory for audiologists 35 (61.4) 19 (33.4) 2 (3.5) 0 (0.0) 1 (1.8) IPC is a shared responsibility 34 (59.7) 20 (35.0) 3 (5.3) 0 (0.0) 0 (0.0) IPC guidelines should be adapted 16 (28.1) 30 (52.6) 4 (7.0) 5 (8.8) 2 (3.5) Patients respect clinicians who follow IPC protocols 9 (15.8) 32 (56.1) 13 (22.8) 3 (5.3) 0 (0.0) Government or Professional body (STAAG) should sponsor IPC training 21 (36.8) 19 (33.3) 13 (22.8) 3 (5.3) 1 (1.8) Practice of IPC among audiologists When self-reported practices were compared with observed IPC practices (Table 4 ), a notable divergence was observed between them. Whilst handwashing was largely reportedly done after each patient, no audiologist was seen practicing it in facilities A and C, whilst in facility B it was observed at two different times during the observation. Table 4 Self-reported and observed practices of IPC among respondents IPC MEASURE ACTION SELF REPORTED PRACTICES IN ALL FACILITIES OBSERVED PRACTICE IN EACH FACILITY Respondents who indicated usage/compliance (n/57) Percentage Facility A Facility B Facility C Personal Protective Equipment/ Apparel Scrubs 19 33.3 Sometimes Sometimes Never Face/Nose mask 40 70.2 Sometimes Never Never Laboratory coat 31 54.4 Always Never Never Gloves 29 50.9 Never Never Never When gloves are used During cerumen removal 36 63.0 N/A N/A N/A During hearing aid fittings 0 0.0 N/A N/A N/A When scrubbing for ABR/ASSR 14 24.6 N/A Sometimes N/A When scrubbing for AABR 0 0.0 N/A Never N/A Disinfection of equipment/ instrument Headphones 38 66.7 Never Sometimes Never Otoscope specula 48 84.2 Always Always Never Bone conduction vibrator 34 59.7 Never Sometimes Never Ear mould impressions tools 25 43.9 N/A N/A N/A Probe tip 47 82.5 Always Always N/A Others (desk/work surface, chairs, etc) 6 10.5 Sometimes Sometimes Never None of the above 1 1.8 N/A N/A N/A Frequency of disinfection Daily 46 80.7 Sometimes Sometimes Never After visible contamination 9 15.8 N/A N/A N/A Hand hygiene Soap and water 8 14.0 Never Sometimes Never Alcohol based sanitizer 7 12.3 Sometimes Sometimes Never Both 42 73.7 Never Sometimes Never Frequency of hand washing In between patients 7 30.4 Never Sometimes Never After each patient 33 58.9 Never Sometimes Never After visible contamination 6 10.7 N/A N/A N/A Workplace compliance Maintains a clean clutter-free environment Not asked Not asked Always Always Always Follows facility specific IPC protocols for disinfection/sterilization Not asked Not asked Sometimes Never N/A Avoids eating/drinking in the work area Not asked Not asked Sometimes Always Always Have you attended any IPC training Yes 22 38.6 N/A N/A N/A No 35 61.4 N/A N/A N/A *Respondents had the choice to select more than one option * AABR : Automated Auditory Brainstem Response ABR/ASSR Auditory Brainstem Response/ Auditory Steady State Response *4 = Always, 3 = Sometimes, 2 = never, 1(N/A) = IPC protocols that are not applicable or relevant to audiology procedure being done at the time of observation Microbial load evaluation In total, seventy-two (72) swab samples were collected before the start of work and after closing work from both public and private facilities. Two (2) different species of bacteria, Bacillus spp . and Staphylococcus spp . were identified. A total microbial count of fifty-four (54) Bacillus spp . and forty (40) Staphylococcus spp . were identified from both the private and public facilities (Table 5 , Fig. 2 ). The total percentage distribution for the presence of mixed growth (growth of both Bacillus spp . and Staphylococcus spp . on the same agar plate) on skin (face and palms), surfaces (tables and doorknob), equipment (audiometer and otoscope) are 22%, 67% and 11% respectively. Table 5 : Distribution of bacteria species a cross all centres before the start of work and after the close of work Bacteria species Number detected before the start of work Number detected after the close of work Location (2 swab per location) Location (2 swabs per location) Skin (Face and Palms) Surfaces (Table and Door knob) Equipment (Otoscope and Audiometer) Total Skin (Face and Palms) Surfaces (Table and Door knob) Equipment (Otoscope and Audiometer) Total Bacillus spp. 2 12 12 26 2 12 12 26 Staphylococcus spp. 12 2 0 14 12 10 2 24 Mixed growth 2 2 0 4 2 10 2 14 DISCUSSION This study provides foundational evidence on the knowledge, attitudes, and practices of audiologists in Ghana regarding infection prevention and control. To contextualise these findings, the bacterial profiles of work surfaces and commonly used equipment in audiology centres were also characterised. Knowledge of IPC measures by audiologists in this study was generally good and significantly associated with those who work in public/government health settings. Additionally, there was an overall positive attitude towards IPC. However, whilst there seemed to be a general alignment between their knowledge and self-reported practices, a direct observation of their practices during the observational phase of the study revealed otherwise. For instance, when it came to hand hygiene most respondents self-reported good compliance, but it was observed that audiologists consistently neglected handwashing before and in-between patient contact in all the audiology centres in this study. There was also a disparity between what they reported about disinfection of equipment and what was actually observed. Whilst 66.7% and 84.2% said they disinfected the headphones and otoscope specula respectively, this was never observed in some facilities and occasionally observed in one. These reflected in the types and counts of bacteria identified on the face, palms and equipment of audiologists in our study before seeing the first patient and after seeing the last patient. The microorganisms identified, Bacillus spp. and Staphylococcus spp. , are similar to those found in a similar study of microbial contamination on audiological equipment in Istanbul [5]. While these bacteria are environmental, their presence on work surfaces and equipment ( Bacillus spp. ) and hands and face of the audiologists ( Staphylococcus spp. ), indicate possible poor IPC practice in disinfection and hand hygiene, emphasising the risk of cross contamination [18]. A potential explanation for this finding is a gap in how hand hygiene practices are integrated into routine audiology care. Similar trends have been reported elsewhere; for example, a study in South Africa also documented high self-reported compliance with hand hygiene before (76%) and after (96%) each patient in audiology practice [9]. However, the absence of an observational component limits the ability to validate these self‑reported behaviours. In contrast, a global observational study conducted in 2010 reported a 51% compliance rate for hand hygiene before patient contact - an improvement from 21% in 2009 - although these data reflected all categories of healthcare workers rather than audiologists specifically and spanned multiple geographic regions [1]. The WHO recommends a minimal effort of multimodal hand hygiene improvement strategy which is a framework of five elements aimed at 50% reduction in HAIs. It incorporates system changes, education, monitoring, reminders, safety culture to improve compliance and its adoption by audiologists can improve IPC compliance. Global evidence highlights disparities in infection prevention and control (IPC) compliance between low‑ and high‑income countries, as well as across different health professions [1]. In response, the Ghana Ministry of Health recently launched the National Infection Prevention and Control Strategy (2024–2028), which prioritises strengthening IPC education, training, and the development of national guidelines. Our findings suggest that expanding this strategy to include discipline‑specific policies applicable across both public and private sectors may be warranted, given that audiologists in the public sector demonstrated comparatively higher IPC knowledge. Importantly, the advocacy and implementation of such discipline‑specific IPC measures should not rest solely with the Ministry of Health; professional bodies such as the Speech Therapists and Audiologists Association of Ghana (STAAG) are well positioned to champion and operationalise these efforts. In countries like the United States of America (USA), the United Kingdom and South Africa their professional associations such as the American Academy of Audiology (AAA), British Academy of Audiology (BAA) and the South African and the South African Speech-Language-Hearing Association (SASLHA) have spearheaded IPC specific to the profession and published policy documents [8, 2, 9]. Achieving optimal IPC knowledge and compliance requires engagement across all levels of the health system, including policymakers, health workers such as audiologists, facility managers in both public and private sectors, and the patients who access care. Despite progress, substantial challenges to effective IPC implementation persist in many low‑ and middle‑income countries, including Ghana. These include limited financial investment, competing health system priorities, inadequate use of data for decision‑making, and insuffiecient staff‑to‑patient ratios [1]). Although Ghana has developed a national IPC programme and accompanying guidelines, implementation remains uneven, with activities concentrated in selected facilities and no designated IPC focal person at the ministry level. [1, 19]. Audiologists in Ghana are predominantly located in the capital, yet differences in years of experience, educational background, and practice environments (rural versus urban, public versus private) may influence exposure to IPC protocols. Importantly, gaps in awareness and compliance often reflect broader systemic constraints - such as dependence on alcohol‑based hand rubs due to inconsistent access to potable water - rather than a lack of knowledge alone [20]. Consistent with evidence from other contexts, audiologists in this study strongly supported mandatory IPC training for all practitioners. This underscores the potential value of a widely implemented, discipline‑specific IPC programme across audiology clinics and facilities nationwide. In our study, despite a 95% response rate, most respondents reported no formal IPC training, underscoring the urgent need for targeted, competency‑based education. The observed inter‑facility variation across actionable IPC practices suggests that workplace culture and institutional policies exert substantial influence beyond individual knowledge. This aligns with the KAP framework, which emphasizes that behavioural intention is shaped not only by knowledge but also by subjective norms - what individuals perceive as standard practice within their environment. These findings reinforce the importance of fostering a strong IPC culture and ensuring the availability of visual cues, such as educational materials and reminder posters, to reinforce adherence. A key strength of this study lies in its pioneering triangulation of methods, combining self‑reported data with direct in‑practice observation and microbial load assessment. This approach provides a more accurate representation of real‑world clinical behaviour than reliance on self‑report alone. The findings establish an essential baseline for future research and for the development of standardised, evidence‑based IPC protocols tailored to audiology practice in Ghana. Certain limitations must be considered when interpreting these findings. The use of closed‑ended survey items restricted the depth of qualitative insight into the knowledge and practices of audiologists. In addition, the cross‑sectional design offers only a single time‑point perspective and cannot infer causality. Despite these constraints, the study provides critical foundational evidence to inform policy, training, and implementation efforts aimed at strengthening IPC within audiology services nationwide. CONCLUSION In conclusion, this study has provided data on important gaps in formal IPC training and highlighted how workplace culture and institutional policies can shape adherence beyond individual knowledge. These insights offer a critical baseline for strengthening IPC within the audiology profession in Ghana. The launch of Ghana’s National IPC Strategy (2024–2028) presents an opportunity to develop discipline‑specific guidance for audiology, supported by professional bodies such as STAAG. LIST OF ABBREVIATIONS AAA American Academy of Audiology AABR Automated Auditory Brainstem Response ABR Auditory Brainstem Response AHPC Allied Health Professions Council ASSR Auditory Steady State Response BAA British Academy of Audiology CDC Centres for Disease Control IPC Infection Prevention and Control MOH Ministry of Health PPE Personal Protective Equipment SASLHA South African Speech-Language- and-Hearing Association SPPS Statistical Package for Social Sciences STAAG Speech Therapists and Audiologists Association of Ghana WHO World Health Organisation DECLARATIONS Ethical approval This study was conducted in full accordance with the ethical principles outlined in the Declaration of Helsinki and followed all relevant institutional and national guidelines for research involving human participants. Ethical clearance was obtained from the School of Biomedical and Allied Health Sciences Ethics and Protocol Review Committee (SBAHS/AA/AUDY/11366390/2024–2025 and SBAHS/AA/MLAB/ 10984869/2024–2025 ). Informed consent was obtained from participating audiologists before microbial sample collection. Permission was also sought from facility managers prior to in-person observation. Clinical trial number Not applicable Competing Interest The authors declare that they have no competing interests. Funding Statement The authors received no specific funding for this work. Author Contribution EDAO conceived the research. EDAO, JAF, DNA and MO planned the implementation. EKA collected the data among audiologists for online survey and in-practice observations while EKAO and MO did the microbial profile. DNA cleaned and analysed the data. EDAO, EKA and JAF were major contributors to the writing of the manuscript. All authors read and approved the final manuscript. Acknowledgement We are grateful to all audiologists and the staff of all participating audiology centres, as well as Speech Therapists and Audiologists Association of Ghana (STAAG) for access to its database of registered audiologists. Data Availability The data supporting the conclusions of this article are included within the article. REFERENCES World Health Organization. Infection prevention and control. 2022. https://www.who.int/health-topics/infection-prevention-and-control. Accessed 20 March 2026. Ehlert K, Naudé AM. Infection prevention and control measures currently applied in South African audiology. S Afr J Commun Disord. 2014;61(1):Art. #55, 10 pages. doi:10.4102/sajcd.v61i1.55 Garcia R, Barnes S, Boukidjian R, Goss LK, Spencer M, Septimus EJ, et al. Recommendations for change in infection prevention programs and practice. 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University of Cape Coast Institutional Repository. https://efaidnbmnnnibpcajpcglclefindmkaj/http://erl.ucc.edu.gh:8080/jspui/bitstream/123456789/6443/1/DELE-%20SOGBEY%2C%202020.pdf Accessed 24 March 2026. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 11 May, 2026 Reviewers agreed at journal 05 May, 2026 Reviewers agreed at journal 03 May, 2026 Reviews received at journal 27 Apr, 2026 Reviewers agreed at journal 27 Apr, 2026 Reviewers invited by journal 27 Apr, 2026 Editor invited by journal 09 Apr, 2026 Editor assigned by journal 07 Apr, 2026 Submission checks completed at journal 07 Apr, 2026 First submitted to journal 07 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9225208","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":635009844,"identity":"8c7d20fe-b65d-4d88-b8a2-fb2e29f431fe","order_by":0,"name":"Elizabeth Kekeli Ahiabu","email":"","orcid":"","institution":"University of Ghana","correspondingAuthor":false,"prefix":"","firstName":"Elizabeth","middleName":"Kekeli","lastName":"Ahiabu","suffix":""},{"id":635009845,"identity":"efa82197-b787-456e-8c62-2333474623e8","order_by":1,"name":"Ebenezer Kofi Amponsah Ofori","email":"","orcid":"","institution":"University of Ghana","correspondingAuthor":false,"prefix":"","firstName":"Ebenezer","middleName":"Kofi Amponsah","lastName":"Ofori","suffix":""},{"id":635009847,"identity":"37d8ee40-68bf-4e92-bee4-e8c81972709d","order_by":2,"name":"Jemima Anowaa Fynn","email":"","orcid":"","institution":"Korle Bu Teaching Hospital","correspondingAuthor":false,"prefix":"","firstName":"Jemima","middleName":"Anowaa","lastName":"Fynn","suffix":""},{"id":635009852,"identity":"047db289-0424-4e16-8c72-72d634e92678","order_by":3,"name":"Michael Olutaiwo","email":"","orcid":"","institution":"University of Ghana","correspondingAuthor":false,"prefix":"","firstName":"Michael","middleName":"","lastName":"Olutaiwo","suffix":""},{"id":635009858,"identity":"542f0de4-6f9a-485e-b7f3-62e61f1ae5c4","order_by":4,"name":"David Nana Adjei","email":"","orcid":"","institution":"University of Ghana","correspondingAuthor":false,"prefix":"","firstName":"David","middleName":"Nana","lastName":"Adjei","suffix":""},{"id":635009860,"identity":"6e2795ad-2b08-4b29-851c-0a47f4ee805d","order_by":5,"name":"Ewurama Dedea Ampadu Owusu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+ElEQVRIiWNgGAWjYFCCBBDBDOVUgEkDID5ArJYzJGthbCNCCz978tPNBTXWif0SOcafeecdtmtgb94mwfDrDk4tkj3PzG7POJaeOHNGjpk077bDyQ08x8okGPue4dRicCPB7DYP2+HEDbdzzJhBWhgkcswkGHsO49RifyP9222ef2AtQIfNAWqRf4NfiwHQzNu8bWAtBtK8DYftGCR4zCQYfuDWInHmTdntmX3pxjPnPyuTnHMsPYGNJ63YIrEBtxb+9vRttwu+Wcv28xze/OFNjbU9P/vhjTc+/MGtBQSYkTmJbQiSSC32EOoPfi2jYBSMglEwogAAwZ5bIo8u79IAAAAASUVORK5CYII=","orcid":"","institution":"University of Ghana","correspondingAuthor":true,"prefix":"","firstName":"Ewurama","middleName":"Dedea Ampadu","lastName":"Owusu","suffix":""}],"badges":[],"createdAt":"2026-03-25 15:53:37","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9225208/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9225208/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":108940346,"identity":"64fe92a1-314c-49ef-8ada-ce8808f34c13","added_by":"auto","created_at":"2026-05-11 05:12:02","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":201186,"visible":true,"origin":"","legend":"\u003cp\u003eA map of Ghana showing the regional distribution of survey respondents.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9225208/v1/5a5c32c7f94fd17a89c4fc15.png"},{"id":108940361,"identity":"0a7939d2-7e94-4ec6-83f8-760f1a25136b","added_by":"auto","created_at":"2026-05-11 05:12:21","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":31487,"visible":true,"origin":"","legend":"\u003cp\u003eChart of distribution of bacteria in the private and public facilities\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-9225208/v1/240d2f13d7bf8fbf1de049ea.png"},{"id":108940391,"identity":"41e271e0-6947-4545-87df-bb12f195369a","added_by":"auto","created_at":"2026-05-11 05:12:37","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":776513,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9225208/v1/05cefc11-2d92-43d4-af4c-724a2a918469.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Infection Prevention and Control Practices Among Audiologists in Ghana Using Survey Evidence, Direct Observation and Microbial Analysis","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eInfectious diseases remain one of the world\u0026rsquo;s leading causes of illness and death, responsible for millions of fatalities each year [1]. Health facilities are recognized as major sites of transmission, where contaminated hands, clothing, and frequently touched surfaces facilitate the spread of infections [2]. As a result, the practice of infection prevention and control (IPC) in healthcare settings has evolved significantly, transitioning from a reactive approach to a proactive paradigm that emphasizes comprehensive strategies [3].\u003c/p\u003e \u003cp\u003eAudiologists are healthcare professionals who in the provision of patient-centred care in the prevention, diagnosis, and evidence-based treatment of hearing, balance, and other auditory disorders require close physical proximity and the use of equipment such as supra-aural headphones, bone conductors, otoscopes, and oscillators devices [4,5]. Without adequate cleaning or disinfection, these tools can become reservoirs for bacteria such as \u003cem\u003eStaphylococcus aureus\u003c/em\u003e, \u003cem\u003eBacillus species\u003c/em\u003e, and the \u003cem\u003ePseudomonas species\u003c/em\u003e [5].\u003c/p\u003e \u003cp\u003e Globally, infection control standards for audiologists are based on broader healthcare guidelines established by organizations such as the World Health Organization (WHO) [6], the Centres for Disease Control and Prevention (CDC) [7], and the British Academy of Audiology (BAA) [8]. However, research shows a persistent gap between knowledge and practice in countries like South Africa [9, 2], India [10], Brazil [11] and Turkey [5].\u003c/p\u003e \u003cp\u003e In Ghana, national IPC guidelines exist, but implementation across health disciplines is inconsistent, often hindered by resource constraints such as limited access to disinfectants and water shortages, insufficient training, and a lack of profession-specific standards and structured monitoring systems [12\u0026ndash;14, 19]. Furthermore, literature and systems specific to audiological practise is limited. In order to provide a holistic overview of the situation in Ghana, this study therefore integrates two dimensions of baseline investigation: an evaluation of audiologists\u0026rsquo; knowledge, attitudes, and practices toward IPC backed by a microbiological analysis of surfaces and equipment commonly used in audiology centres.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy sites and population\u003c/h2\u003e \u003cp\u003eThe research was carried out in three audiology facilities in the Greater Accra Region (2 public and 1 private). These sites were purposefully selected to represent the two main categories of audiology service provision in Ghana.\u003c/p\u003e \u003cp\u003eThe public facilities are tertiary-level healthcare centres that provide audiological services as part of broader multidisciplinary care. They usually offer services on a referral-based and appointment-driven system, catering to both adult and pediatric populations. Collectively, these facilities have an estimated bed capacity of 2300 and serve as major referral centres for patients from within the Greater Accra Region and other parts of the country [15, 16]. The private facility, on the other hand, operates as a specialised outpatient audiology clinic, primarily delivering diagnostic, rehabilitative, and follow-up audiological care. It caters mainly to self-referred and clinician-referred clients which functions solely as an ambulatory care centre and so does not provide inpatient services.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy design and participant selection\u003c/h3\u003e\n\u003cp\u003eThis was a prospective, cross-sectional, multi-method study that triangulated an online survey assessing knowledge, attitude, and practices with an in-person observational assessment of audiologists\u0026rsquo; clinical practices towards IPC and a microbiological sampling of the clinical environment and equipment.\u003c/p\u003e \u003cp\u003eAudiologists who were licensed by the Allied Health Professions Council (AHPC) and practicing in Ghana at the time of the study were recruited for the study. However, students and interns were excluded from participation.\u003c/p\u003e\n\u003ch3\u003eData collection and analysis\u003c/h3\u003e\n\u003cp\u003e \u003cstrong\u003eOnline survey\u003c/strong\u003e \u003cp\u003eAn online questionnaire was developed and uploaded on an online questionnaire distribution platform called the REDCap (version 15.5.x) developed by Vanderbilt University. The questionnaire was arranged in four sections consisting of demographics, knowledge, attitude, and practices. A 5-point Likert scale (strongly disagree, disagree, neutral, agree, strongly agree) was utilised to assess the attitude audiologists have towards the importance of IPC in their work.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eIn-practice observations\u003c/strong\u003e \u003cp\u003eIn-practice observations of random audiologists at study sites were also conducted at least twice using a checklist that was adapted from the British Academy of Audiology [8] and WHO [6]. The checklist used a 4-point frequency scale (4\u0026thinsp;=\u0026thinsp;Always, 3\u0026thinsp;=\u0026thinsp;sometimes, 2\u0026thinsp;=\u0026thinsp;Never) to assess hand hygiene practice, personal protective equipment (PPE) usage, equipment disinfection and sterilization, workspace management, and waste disposal. IPC practices that were not relevant to the audiological procedure being performed at the point of observation was scored \u0026ldquo;not applicable\u0026rdquo; (N/A) for 1. In order to reduce bias, the checklist was uploaded on a google form to aid concealed observation by the researcher.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eMicrobial load\u003c/strong\u003e \u003cp\u003eSwab samples were collected twice daily before the start of clinic sessions and immediately after completion of clinical sessions from key sites including the palms of audiologists, worktables, doorknobs, and frequently used diagnostic equipment (otoscopes and audiometers). Sterile cotton swabs moistened with peptone water were used, and samples were transported within two hours to the microbiology laboratory for processing. Microbiological culture was performed using both chocolate agar and MacConkey agar plates [17]. Swabs were inoculated onto the respective agar media under aseptic conditions. Following inoculation, the plates were incubated at appropriate conditions for 24\u0026ndash;48 hours. After incubation, bacterial growth was assessed, and colony counts were performed on each plate, with colonies enumerated and categorised based on distinct morphological characteristics.\u003c/p\u003e \u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eResponses obtained from the online survey were encoded and tabulated into Microsoft Excel (365). Stata MP14 Statistical software for data science was used to conduct descriptive analysis of the results. The scores were dichotomized into adequate/ inadequate and positive/ negative for knowledge and attitude, respectively at pre-determined cut-off point of 80%. Frequencies and percentages were used to describe their IPC practices. The Spearman correlation co-efficient was used to assess the association between the demographic characteristics and knowledge.\u003c/p\u003e \u003cp\u003eUsing Statistical Package for the Social Sciences (SPSS) version 25, descriptive statistics was performed to calculate frequency (total count) and percentage for summary of the distribution of microbial growth.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n \u003ch2\u003eOnline survey\u003c/h2\u003e\n \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e\n \u003ch2\u003eDemographic characteristics of respondents\u003c/h2\u003e\n \u003cp\u003eA total of 57 out of 60 practicing audiologists responded to the survey. This constituted a response rate of 95%.\u003c/p\u003e\n \u003cp\u003eTable \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the demographic characteristics of respondents in the online survey. In terms of region of residence/practice, there was a distribution across 7 out of the 16 administrative regions in Ghana; with majority 54.4% (n\u0026thinsp;=\u0026thinsp;31) of respondents in the Greater Accra region while only 1.7% (n\u0026thinsp;=\u0026thinsp;1) each were in the Northern and Bono East regions (Fig. \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n \u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eDemographics of respondents in the online survey\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eCharacteristics\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e18\u0026ndash;25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e28.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e26\u0026ndash;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e52.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e36\u0026ndash;45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e14.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u0026ge;\u0026thinsp;46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e52.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e47.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u003cstrong\u003eRegion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eAshanti\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eGreater Accra\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e54.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eEastern\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e7.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eCentral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eVolta\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e22.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eBono East\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eNorthern\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u003cstrong\u003eYears of experience (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e1\u0026ndash;5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e78.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e6\u0026ndash;10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e14.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e11\u0026ndash;15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e16\u0026ndash;20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e1.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u0026gt;\u0026thinsp;20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e1.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u003cstrong\u003eHighest level of education\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e70.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eMaster\u0026rsquo;s\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e29.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003ePhD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u003cstrong\u003eWork setting\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eGovernment (Rural)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e15.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eGovernment (Urban)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e42.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003ePrivate (Rural)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e1.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003ePrivate (Urban)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e33.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eAcademic institution\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e7.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u003cstrong\u003eService provision\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003ePure tone audiometry\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e87.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eImmittance audiometry\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e73.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eCerumen management\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e61.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eHearing aid dispensing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e71.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eNeonatal hearing screening\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e68.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eVestibular assessment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e14.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e8.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003cp\u003e\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003ch3\u003eLevel of knowledge of respondents on infection prevention and control (IPC)\u003c/h3\u003e\n\u003cp\u003eIn determining the level of knowledge of respondents regarding infection prevention and control (Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e), at the 80% cut-off, majority (96.5%) of the respondents had adequate knowledge on IPC. However, for an important question on whether disinfection killed all microbes including spores, many respondents 61.4% answered incorrectly.\u003c/p\u003e\n\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eA summary of questions and responses testing respondents\u0026rsquo; knowledge regarding infection prevention and control\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eQuestions testing respondents\u0026rsquo; knowledge\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eWhich of these pathogens can spread through contaminated audiology materials?\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eHepatitis B\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e7.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eCovid-19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e14.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u003cem\u003eStaphylococcus aureus\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e17.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u0026radic; All the above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e59.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e1.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhat does disinfection refer to?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u0026radic; Killing germs but not spores\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e29.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eRemoving visible dirt\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e7.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eKilling all microbes, including spores\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e61.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eNot sure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e1.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhat does sterilisation refer to?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u0026radic; Process that destroys all microbial life\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e82.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eProcess that reduces germs to safe level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e12.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eRemoval of visible dirt or organic material from objects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e5.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eNot sure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhat does cleaning refer to?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eProcess that destroys all microbial life\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eProcess that reduces germs to safe level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e12.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u0026radic; Removal of visible dirt or organic material from objects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e84.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eNot sure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhich of these are recommended vaccines for audiologists?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eHepatitis B\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eInfluenza\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eCovid-19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u0026radic; All the above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e87.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u003cstrong\u003eHand hygiene is required even if gloves are worn. True/False?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u0026radic; True\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eFalse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u003cstrong\u003eHave you received the Hepatitis B vaccine?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e66.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e33.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u003cstrong\u003e*Key components of IPC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eHand hygiene\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e51/57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e89.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eUse PPE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e47/57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e82.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eCleaning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e50/57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e87.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eDisinfection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e50/57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e87.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eSterilisation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e49/57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e85.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u003cstrong\u003eI know some IPC guidelines for audiology\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e70.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e29.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u003cstrong\u003e*Sources of information on IPC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eMedia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e44/57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e77.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eWHO websites\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e41/57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e71.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eConferences\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e30/57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e52.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eCPD programs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003e36/57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e63.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\"\u003e*Respondents had the choice to select more than one option\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\"\u003e\u0026radic; The correct answer\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cp\u003eThe study did not identify any statistically significant association when level of knowledge regarding IPC was compared with the demographics, apart from work setting (p\u0026thinsp;=\u0026thinsp;0.026). In our study population, most of the respondents with adequate knowledge regarding infection prevention and control 24 (42.1%) worked in government (urban) settings.\u003c/p\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n \u003ch2\u003eAttitude of respondents towards the importance of IPC\u003c/h2\u003e\n \u003cp\u003eAt the 80% cut-off point, 61% of the respondents had positive attitude towards IPC. Where positive attitude refers to participants who strongly agreed or agreed to the various statements. Almost all respondents, 98.3% (n\u0026thinsp;=\u0026thinsp;56) agree that IPC measures are necessary in audiology practice. In all, more than half 54.5% (n\u0026thinsp;=\u0026thinsp;31) of the respondents disagree that wearing personal protective equipment (PPE) makes patients uncomfortable.\u003c/p\u003e\n \u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eRespondents\u0026rsquo; attitude towards IPC using the 5-point Likert Scale\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eAttitude\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eStrongly Agree\u003c/p\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003eAgree\u003c/p\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003eNeutral\u003c/p\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eDisagree\u003c/p\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eStrongly disagree\u003c/p\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eIPC measures are necessary in audiology practice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e46 (80.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e10 (17.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\n \u003cp\u003e1 (1.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eWearing PPE makes patients uncomfortable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e4 (7.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e7 (12.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\n \u003cp\u003e15 (26.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\n \u003cp\u003e24 (42.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\n \u003cp\u003e7 (12.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eIPC protocols waste time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e5 (8.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\n \u003cp\u003e5 (8.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\n \u003cp\u003e31 (55.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\n \u003cp\u003e15 (26.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eMy workplace prioritizes IPC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e17 (29.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e30 (52.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\n \u003cp\u003e8 (14.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\n \u003cp\u003e2 (3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eVaccination for audiologists is unnecessary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e6 (10.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e1 (1.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\n \u003cp\u003e3 (5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\n \u003cp\u003e16 (28.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\n \u003cp\u003e31 (54.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eIPC should be mandatory for audiologists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e35 (61.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e19 (33.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\n \u003cp\u003e2 (3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\n \u003cp\u003e1 (1.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eIPC is a shared responsibility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e34 (59.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e20 (35.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\n \u003cp\u003e3 (5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eIPC guidelines should be adapted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e16 (28.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e30 (52.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\n \u003cp\u003e4 (7.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\n \u003cp\u003e5 (8.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\n \u003cp\u003e2 (3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003ePatients respect clinicians who follow IPC protocols\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e9 (15.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e32 (56.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\n \u003cp\u003e13 (22.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\n \u003cp\u003e3 (5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eGovernment or Professional body (STAAG) should sponsor IPC training\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e21 (36.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e19 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\n \u003cp\u003e13 (22.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\n \u003cp\u003e3 (5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\n \u003cp\u003e1 (1.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\n \u003ch2\u003ePractice of IPC among audiologists\u003c/h2\u003e\n \u003cp\u003eWhen self-reported practices were compared with observed IPC practices (Table \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e), a notable divergence was observed between them. Whilst handwashing was largely reportedly done after each patient, no audiologist was seen practicing it in facilities A and C, whilst in facility B it was observed at two different times during the observation.\u003c/p\u003e\n \u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eSelf-reported and observed practices of IPC among respondents\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\n \u003cp\u003eIPC MEASURE\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\n \u003cp\u003eACTION\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\n \u003cp\u003eSELF REPORTED PRACTICES IN ALL FACILITIES\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e\n \u003cp\u003eOBSERVED PRACTICE IN EACH FACILITY\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003eRespondents who indicated usage/compliance (n/57)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eFacility A\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eFacility B\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eFacility C\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cstrong\u003ePersonal Protective Equipment/ Apparel\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eScrubs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e33.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eFace/Nose mask\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e70.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eLaboratory coat\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e54.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eAlways\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eGloves\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e50.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhen gloves are used\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eDuring cerumen removal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e63.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eDuring hearing aid fittings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eWhen scrubbing for ABR/ASSR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e24.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eWhen scrubbing for AABR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\" morerows=\"6\" rowspan=\"7\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisinfection of equipment/ instrument\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eHeadphones\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e66.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eOtoscope specula\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e84.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eAlways\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eAlways\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eBone conduction vibrator\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e59.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eEar mould impressions tools\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e43.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eProbe tip\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e82.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eAlways\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eAlways\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eOthers (desk/work surface, chairs, etc)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e10.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eNone of the above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e1.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency of disinfection\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eDaily\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e80.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eAfter visible contamination\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e15.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eHand hygiene\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eSoap and water\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e14.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eAlcohol based sanitizer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e12.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eBoth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e73.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency of hand washing\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eIn between patients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e30.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eAfter each patient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e58.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eAfter visible contamination\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e10.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eWorkplace compliance\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eMaintains a clean clutter-free environment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003eNot asked\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003eNot asked\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eAlways\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eAlways\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eAlways\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eFollows facility specific IPC protocols for disinfection/sterilization\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003eNot asked\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003eNot asked\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eAvoids eating/drinking in the work area\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003eNot asked\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003eNot asked\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eAlways\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eAlways\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eHave you attended any IPC training\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e38.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003e61.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colname=\"c7\"\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003cp\u003e*Respondents had the choice to select more than one option\u003c/p\u003e\n \u003cp\u003e*\u003cstrong\u003eAABR\u003c/strong\u003e: Automated Auditory Brainstem Response\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eABR/ASSR\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eAuditory Brainstem Response/ Auditory Steady State Response\u003c/p\u003e\n \u003cp\u003e*4\u0026thinsp;=\u0026thinsp;Always, 3\u0026thinsp;=\u0026thinsp;Sometimes, 2\u0026thinsp;=\u0026thinsp;never, 1(N/A)\u0026thinsp;=\u0026thinsp;IPC protocols that are not applicable or relevant to audiology procedure being done at the time of observation\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\n \u003ch2\u003eMicrobial load evaluation\u003c/h2\u003e\n \u003cp\u003eIn total, seventy-two (72) swab samples were collected before the start of work and after closing work from both public and private facilities. Two (2) different species of bacteria, \u003cem\u003eBacillus spp\u003c/em\u003e. and \u003cem\u003eStaphylococcus spp\u003c/em\u003e. were identified. A total microbial count of fifty-four (54) \u003cem\u003eBacillus spp\u003c/em\u003e. and forty (40) \u003cem\u003eStaphylococcus spp\u003c/em\u003e. were identified from both the private and public facilities (Table \u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e, Fig. \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The total percentage distribution for the presence of mixed growth (growth of both \u003cem\u003eBacillus spp\u003c/em\u003e. and \u003cem\u003eStaphylococcus spp\u003c/em\u003e. on the same agar plate) on skin (face and palms), surfaces (tables and doorknob), equipment (audiometer and otoscope) are 22%, 67% and 11% respectively.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e5\u003c/strong\u003e\u003cstrong\u003e: Distribution of bacteria species a\u003c/strong\u003e\u003cstrong\u003ecross all centres before the start of work and after the close of work\u003c/strong\u003e\u003c/p\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"671\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBacteria species\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber detected before the start of work\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber detected after the close of work\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLocation (2 swab per location)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLocation (2 swabs per location)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eSkin\u003c/p\u003e\n \u003cp\u003e(Face and Palms)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eSurfaces\u003c/p\u003e\n \u003cp\u003e(Table and Door knob)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eEquipment\u003c/p\u003e\n \u003cp\u003e(Otoscope and Audiometer)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003eSkin\u003c/p\u003e\n \u003cp\u003e(Face and Palms)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003eSurfaces\u003c/p\u003e\n \u003cp\u003e(Table and Door knob)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eEquipment\u003c/p\u003e\n \u003cp\u003e(Otoscope and Audiometer)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cem\u003eBacillus spp.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e26\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e26\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cem\u003eStaphylococcus spp.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e14\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e24\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eMixed growth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e14\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis study provides foundational evidence on the knowledge, attitudes, and practices of audiologists in Ghana regarding infection prevention and control. To contextualise these findings, the bacterial profiles of work surfaces and commonly used equipment in audiology centres were also characterised. Knowledge of IPC measures by audiologists in this study was generally good and significantly associated with those who work in public/government health settings. Additionally, there was an overall positive attitude towards IPC.\u003c/p\u003e \u003cp\u003eHowever, whilst there seemed to be a general alignment between their knowledge and self-reported practices, a direct observation of their practices during the observational phase of the study revealed otherwise. For instance, when it came to hand hygiene most respondents self-reported good compliance, but it was observed that audiologists consistently neglected handwashing before and in-between patient contact in all the audiology centres in this study. There was also a disparity between what they reported about disinfection of equipment and what was actually observed. Whilst 66.7% and 84.2% said they disinfected the headphones and otoscope specula respectively, this was never observed in some facilities and occasionally observed in one. These reflected in the types and counts of bacteria identified on the face, palms and equipment of audiologists in our study before seeing the first patient and after seeing the last patient. The microorganisms identified, \u003cem\u003eBacillus spp.\u003c/em\u003e and \u003cem\u003eStaphylococcus spp.\u003c/em\u003e, are similar to those found in a similar study of microbial contamination on audiological equipment in Istanbul [5]. While these bacteria are environmental, their presence on work surfaces and equipment (\u003cem\u003eBacillus spp.\u003c/em\u003e) and hands and face of the audiologists (\u003cem\u003eStaphylococcus spp.\u003c/em\u003e), indicate possible poor IPC practice in disinfection and hand hygiene, emphasising the risk of cross contamination [18]. A potential explanation for this finding is a gap in how hand hygiene practices are integrated into routine audiology care. Similar trends have been reported elsewhere; for example, a study in South Africa also documented high self-reported compliance with hand hygiene before (76%) and after (96%) each patient in audiology practice [9]. However, the absence of an observational component limits the ability to validate these self‑reported behaviours. In contrast, a global observational study conducted in 2010 reported a 51% compliance rate for hand hygiene before patient contact - an improvement from 21% in 2009 - although these data reflected all categories of healthcare workers rather than audiologists specifically and spanned multiple geographic regions [1]. The WHO recommends a minimal effort of multimodal hand hygiene improvement strategy which is a framework of five elements aimed at 50% reduction in HAIs. It incorporates system changes, education, monitoring, reminders, safety culture to improve compliance and its adoption by audiologists can improve IPC compliance.\u003c/p\u003e \u003cp\u003eGlobal evidence highlights disparities in infection prevention and control (IPC) compliance between low‑ and high‑income countries, as well as across different health professions [1]. In response, the Ghana Ministry of Health recently launched the National Infection Prevention and Control Strategy (2024\u0026ndash;2028), which prioritises strengthening IPC education, training, and the development of national guidelines. Our findings suggest that expanding this strategy to include discipline‑specific policies applicable across both public and private sectors may be warranted, given that audiologists in the public sector demonstrated comparatively higher IPC knowledge. Importantly, the advocacy and implementation of such discipline‑specific IPC measures should not rest solely with the Ministry of Health; professional bodies such as the Speech Therapists and Audiologists Association of Ghana (STAAG) are well positioned to champion and operationalise these efforts. In countries like the United States of America (USA), the United Kingdom and South Africa their professional associations such as the American Academy of Audiology (AAA), British Academy of Audiology (BAA) and the South African and the South African Speech-Language-Hearing Association (SASLHA) have spearheaded IPC specific to the profession and published policy documents [8, 2, 9].\u003c/p\u003e \u003cp\u003eAchieving optimal IPC knowledge and compliance requires engagement across all levels of the health system, including policymakers, health workers such as audiologists, facility managers in both public and private sectors, and the patients who access care. Despite progress, substantial challenges to effective IPC implementation persist in many low‑ and middle‑income countries, including Ghana. These include limited financial investment, competing health system priorities, inadequate use of data for decision‑making, and insuffiecient staff‑to‑patient ratios [1]). Although Ghana has developed a national IPC programme and accompanying guidelines, implementation remains uneven, with activities concentrated in selected facilities and no designated IPC focal person at the ministry level. [1, 19].\u003c/p\u003e \u003cp\u003eAudiologists in Ghana are predominantly located in the capital, yet differences in years of experience, educational background, and practice environments (rural versus urban, public versus private) may influence exposure to IPC protocols. Importantly, gaps in awareness and compliance often reflect broader systemic constraints - such as dependence on alcohol‑based hand rubs due to inconsistent access to potable water - rather than a lack of knowledge alone [20]. Consistent with evidence from other contexts, audiologists in this study strongly supported mandatory IPC training for all practitioners. This underscores the potential value of a widely implemented, discipline‑specific IPC programme across audiology clinics and facilities nationwide.\u003c/p\u003e \u003cp\u003eIn our study, despite a 95% response rate, most respondents reported no formal IPC training, underscoring the urgent need for targeted, competency‑based education. The observed inter‑facility variation across actionable IPC practices suggests that workplace culture and institutional policies exert substantial influence beyond individual knowledge. This aligns with the KAP framework, which emphasizes that behavioural intention is shaped not only by knowledge but also by subjective norms - what individuals perceive as standard practice within their environment. These findings reinforce the importance of fostering a strong IPC culture and ensuring the availability of visual cues, such as educational materials and reminder posters, to reinforce adherence.\u003c/p\u003e \u003cp\u003eA key strength of this study lies in its pioneering triangulation of methods, combining self‑reported data with direct in‑practice observation and microbial load assessment. This approach provides a more accurate representation of real‑world clinical behaviour than reliance on self‑report alone. The findings establish an essential baseline for future research and for the development of standardised, evidence‑based IPC protocols tailored to audiology practice in Ghana.\u003c/p\u003e \u003cp\u003eCertain limitations must be considered when interpreting these findings. The use of closed‑ended survey items restricted the depth of qualitative insight into the knowledge and practices of audiologists. In addition, the cross‑sectional design offers only a single time‑point perspective and cannot infer causality. Despite these constraints, the study provides critical foundational evidence to inform policy, training, and implementation efforts aimed at strengthening IPC within audiology services nationwide.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eIn conclusion, this study has provided data on important gaps in formal IPC training and highlighted how workplace culture and institutional policies can shape adherence beyond individual knowledge. These insights offer a critical baseline for strengthening IPC within the audiology profession in Ghana. The launch of Ghana\u0026rsquo;s National IPC Strategy (2024\u0026ndash;2028) presents an opportunity to develop discipline‑specific guidance for audiology, supported by professional bodies such as STAAG.\u003c/p\u003e"},{"header":"LIST OF ABBREVIATIONS","content":"\u003cp\u003eAAA American Academy of Audiology\u003c/p\u003e \u003cp\u003eAABR Automated Auditory Brainstem Response\u003c/p\u003e \u003cp\u003eABR Auditory Brainstem Response\u003c/p\u003e \u003cp\u003eAHPC Allied Health Professions Council\u003c/p\u003e \u003cp\u003eASSR Auditory Steady State Response\u003c/p\u003e \u003cp\u003eBAA British Academy of Audiology\u003c/p\u003e \u003cp\u003eCDC Centres for Disease Control\u003c/p\u003e \u003cp\u003eIPC Infection Prevention and Control\u003c/p\u003e \u003cp\u003eMOH Ministry of Health\u003c/p\u003e \u003cp\u003ePPE Personal Protective Equipment\u003c/p\u003e \u003cp\u003eSASLHA South African Speech-Language- and-Hearing Association\u003c/p\u003e \u003cp\u003eSPPS Statistical Package for Social Sciences\u003c/p\u003e \u003cp\u003eSTAAG Speech Therapists and Audiologists Association of Ghana\u003c/p\u003e \u003cp\u003eWHO World Health Organisation\u003c/p\u003e "},{"header":"DECLARATIONS","content":"\u003cp\u003e \u003cstrong\u003eEthical approval\u003c/strong\u003e \u003cp\u003e This study was conducted in full accordance with the ethical principles outlined in the Declaration of Helsinki and followed all relevant institutional and national guidelines for research involving human participants. Ethical clearance was obtained from the School of Biomedical and Allied Health Sciences Ethics and Protocol Review Committee (SBAHS/AA/AUDY/11366390/2024\u0026ndash;2025 and SBAHS/AA/MLAB/\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10984869/2024\u0026ndash;2025\u003c/span\u003e\u003cspan address=\"10984869/2024\u0026ndash;2025\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e). Informed consent was obtained from participating audiologists before microbial sample collection. Permission was also sought from facility managers prior to in-person observation.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eClinical trial number\u003c/strong\u003e \u003cp\u003eNot applicable\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eCompeting Interest\u003c/h2\u003e \u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding Statement\u003c/h2\u003e \u003cp\u003eThe authors received no specific funding for this work.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eEDAO conceived the research. EDAO, JAF, DNA and MO planned the implementation. EKA collected the data among audiologists for online survey and in-practice observations while EKAO and MO did the microbial profile. DNA cleaned and analysed the data. EDAO, EKA and JAF were major contributors to the writing of the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003e We are grateful to all audiologists and the staff of all participating audiology centres, as well as Speech Therapists and Audiologists Association of Ghana (STAAG) for access to its database of registered audiologists.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe data supporting the conclusions of this article are included within the article.\u003c/p\u003e"},{"header":"REFERENCES","content":"\u003col\u003e\n \u003cli\u003eWorld Health Organization. Infection prevention and control. 2022. https://www.who.int/health-topics/infection-prevention-and-control. Accessed 20 March 2026.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eEhlert K, Naud\u0026eacute; AM. Infection prevention and control measures currently applied in South African audiology. S Afr J Commun Disord. 2014;61(1):Art. #55, 10 pages. doi:10.4102/sajcd.v61i1.55\u003c/li\u003e\n \u003cli\u003eGarcia R, Barnes S, Boukidjian R, Goss LK, Spencer M, Septimus EJ, et al. Recommendations for change in infection prevention programs and practice. Am J Infect Control. 2022;50(12):1281-95. doi:10.1016/j.ajic.2022.04.007\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eThe Profession of Audiology. https://www.asha.org/students/audiology/ Accessed 23 Feb 2025\u003c/li\u003e\n \u003cli\u003e\u0026Ccedil;elikg\u0026uuml;n B, B\u0026uuml;y\u0026uuml;kkal F, Esra Ko\u0026ccedil;oğlu M, Tayyar Kalcioğlu M, Mehmet Akşit A. Evaluation of the microbial contamination of the audiological diagnostic equipment and their current disinfection techniques. Am J Infect Control. 2024;S0196655324008551. doi:10.1016/j.ajic.2024.11.014\u003c/li\u003e\n \u003cli\u003eWorld Health Organization. Global strategy on infection prevention and control. 2023. \u0026nbsp;https://www.who.int/publications/i/item/9789240057664 Accessed 20 March 2026\u003c/li\u003e\n \u003cli\u003eCentres for Disease Control and Prevention. Infection control. 2020 https://www.cdc.gov/infectioncontrol/index.html Accessed 20 March 2026.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eBrennan S, Evans L, Jackson L, Jeffery H, Lough M, Randall H, et al. Infection Prevention and Control Practices and Processes in Audiology. 2021 https://efaidnbmnnnibpcajpcglclefindmkaj/https://www.baaudiology.org/wp-content/uploads/2021/02/BAA-Infection-Control-v9.2.pdf. Accessed 20 March 2026.\u003c/li\u003e\n \u003cli\u003eKhan NB, Charles CR, Naidoo N, Nokubonga A, Mkhwanazi NA, Moustache HMTE. Infection prevention and control measures in audiology practice within public healthcare facilities in KwaZulu-Natal province, South Africa. S Afr J Commun Disord. 2019;66(1):a636. doi:10.4102/sajcd.v66i1.636\u003c/li\u003e\n \u003cli\u003eSundaram M, Seethapathy CJ. Infection Control and Hygienic Measures Practiced Among Audiologists in India. Indian J Otolaryngol Head Neck Surg. 2020;74(3):3541-59. doi:10.1007/s12070-020-01799-9\u003c/li\u003e\n \u003cli\u003eDuarte PB, Aita ADC. Audiologists\u0026apos; knowledge of and adherence to biosafety measures. Speech Lang Hear Sci Educ J. 2021;24(4). doi:10.1590/1982-0216/20222444722\u003c/li\u003e\n \u003cli\u003eMinistry of Health, Ghana. National Policy \u0026amp; Guidelines for Infection Prevention and Control in Healthcare settings. 2015 https://www.moh.gov.gh/moh-launches-national-infection-prevention-and-control-strategy/ Accessed 20 March 2026.\u003c/li\u003e\n \u003cli\u003eMutaru AM, Balegha AN, Kunsu R, Gbeti C. Knowledge and determinants of infection prevention and control compliance among nurses in Yendi municipality, Ghana. PLoS ONE. 2022;17(7):e0270508. doi:10.1371/journal.pone.0270508\u003c/li\u003e\n \u003cli\u003eSunkwa-Mills G, Senah K, Breinholdt M, Aberese-Ako M, Tersb\u0026oslash;l BP. A qualitative study of infection prevention and control practices in the maternal units of two Ghanaian hospitals. Antimicrob Resist Infect Control. 2023;12:125. doi:10.1186/s13756-023-01330-\u003c/li\u003e\n \u003cli\u003eMinistry of Defense, Ghana. Defense Minister Signs Agreement for the Expansion of the 37 Military Hospital. 2023. https://mod.gov.gh/defence-minister-signs-agreement-for-the-expansion-of-the-37-military-hospital/ Accessed 24 March 2026.\u003c/li\u003e\n \u003cli\u003eMinistry of Health. Korle-Bu Teaching Hospital. https://www.moh.gov.gh/korle-bu-teaching-hospital/ Accessed 26 January 2026.\u003c/li\u003e\n \u003cli\u003eTripathi N, Zubair M, Sapra A. Gram Staining. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025. \u0026nbsp;https://www.ncbi.nlm.nih.gov/books/NBK562156/ \u0026nbsp; Accessed 20 March 2026.\u003c/li\u003e\n \u003cli\u003eMunoz-Price LS, Arheart KL, Mills JP, Cleary T, DePascale D, Jimenez A, et al. Associations between bacterial contamination of health care workers\u0026apos; hands and contamination of white coats and scrubs. Am J Infect Control. 2012;40(9):e245-8. doi:10.1016/j.ajic.2012.03.032\u003c/li\u003e\n \u003cli\u003eMinistry of Health, Ghana. (2023). \u003cem\u003e2022 holistic assessment report\u003c/em\u003e. https://efaidnbmnnnibpcajpcglclefindmkaj/https://www.moh.gov.gh/wp-content/uploads/2025/01/2023-HOLISTIC-ASSESSMENT-REPORT.pdf \u0026nbsp;Accessed on 5 January 2026.\u003c/li\u003e\n \u003cli\u003eDele-Sogbey, P. V. (2020). \u003cem\u003eHand Washing as a Practice Among Healthcare Workers at the Kaneshie Polyclinic, Accra.\u003c/em\u003e Master\u0026apos;s dissertation, Presbyterian University College, Ghana. University of Cape Coast Institutional Repository. https://efaidnbmnnnibpcajpcglclefindmkaj/http://erl.ucc.edu.gh:8080/jspui/bitstream/123456789/6443/1/DELE-%20SOGBEY%2C%202020.pdf \u0026nbsp;Accessed 24 March 2026.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Audiology, Infection prevention and control, Ghana, Microbial contamination","lastPublishedDoi":"10.21203/rs.3.rs-9225208/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9225208/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Infection prevention and control (IPC) is critical in healthcare, yet the unique risks in audiology practice remain underexplored, particularly in Ghana. Audiologists use shared equipment in close patient contact, posing cross-contamination risks. This study aimed to bridge a critical gap by simultaneously investigating the microbial contamination of the audiology clinical environment and the corresponding knowledge, attitudes, and practices (KAP) of practitioners.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e A cross-sectional, multi-method design was employed. Firstly, a KAP questionnaire was distributed to licensed audiologists nationwide via online. To triangulate self-reported practices, direct observations of audiologists in practicewere conducted in selected facilities. The data was analysed using STATA MP14. Descriptive analysis was conducted where frequency, percentages, and mean were used to describe the findings.Secondly, swab samples were collected from audiologists’ palms, clothing, work surfaces, and equipment at three audiology centres (2 public and 1 private) in Greater Accra. Samples were cultured to identify microbial load and species.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The KAP survey found that, generally, audiologists possessed very good level of knowledge regarding IPC and had positive attitudes. However, the direct in-practice observation identified significant non-compliance with hand hygiene, PPE use, and disinfection protocols.\u003c/p\u003e\n\u003cp\u003eConcurrently, microbial analysis (72 samples) revealed the presence of \u003cem\u003eBacillus\u003c/em\u003e and \u003cem\u003eStaphylococcus\u003c/em\u003e species on surfaces, equipment, and skin, significantly higher in the public centres.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e This integrated study demonstrates that despite adequate theoretical knowledge, a tangible risk of cross-contamination exists in Ghanaian audiology practice, as evidenced by direct microbial isolation and observed lapses in IPC compliance. The disconnect between knowledge and practice, compounded by environmental contamination, highlights an urgent need for targeted interventions, continuous training, and robust IPC protocol enforcement to safeguard both patients and clinicians.\u003c/p\u003e","manuscriptTitle":"Infection Prevention and Control Practices Among Audiologists in Ghana Using Survey Evidence, Direct Observation and Microbial Analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-11 05:10:47","doi":"10.21203/rs.3.rs-9225208/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-11T10:15:41+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"321636562433756948439601669424861785835","date":"2026-05-05T18:54:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"17786154089425238324504483144361695989","date":"2026-05-04T00:11:55+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-27T17:42:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"21272764983159523529348402026437856288","date":"2026-04-27T17:11:37+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-27T16:34:51+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-04-09T07:35:38+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-08T01:59:09+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-07T12:46:45+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Public Health","date":"2026-04-07T10:09:10+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c61dc5c2-41ec-412e-b09a-bced9e7d5efa","owner":[],"postedDate":"May 11th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-11T10:15:41+00:00","index":78,"fulltext":""},{"type":"reviewerAgreed","content":"321636562433756948439601669424861785835","date":"2026-05-05T18:54:08+00:00","index":75,"fulltext":""},{"type":"reviewerAgreed","content":"17786154089425238324504483144361695989","date":"2026-05-04T00:11:55+00:00","index":72,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-11T05:10:48+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-11 05:10:47","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9225208","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9225208","identity":"rs-9225208","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}