What question did this study set out to answer?

This research aims to evaluate health care workers' perspectives on infection prevention and control measures for Ebola.

April 8, 2026Open Access

Infection prevention and control measures for Ebola disease and their outcomes from the perspective of health care workers: a mixed-methods study

GHGladys N. Honein-AbouHaidarAmerican University of Beirut JKJoanne KhabsaAmerican University of Beirut VWVictoria WilletWorld Health Organization - Pakistan

Puntos clave

This research aims to evaluate health care workers' perspectives on infection prevention and control measures for Ebola.
Conducted a mixed-methods study with surveys and interviews
Assessed perspectives on IPC measures among health care workers managing Ebola patients
Evaluated the feasibility, acceptability, and equity concerns of various IPC strategies
Preventing transmission was deemed critical by 90% of participants
49% reported side effects from chlorine exposure as problematic, and 38% faced issues with PPE
72% found covering the head, neck, and mucous membranes more acceptable than just covering mucous membranes
62% raised equity concerns regarding disposable versus reusable PPE
More participants preferred wiping over spraying for decontamination (67%)

Resumen

This study assessed health care workers (HCWs) perspectives related to eight infection prevention and control (IPC) measures (three personal protective equipment (PPE) and five decontamination and disinfection) for Ebola disease discussed during WHO guideline development. We conducted a mixed-methods study guided by the Evidence to Decision framework, targeting HCWs involved in managing patients. We assessed: (1) the value of preventing transmission of Orthoebolavirus, adverse effects of PPE and chlorine exposure; (2) perspectives on resource, health equity, feasibility, and acceptability of IPC measures. Analysis included 73 survey respondents and 16 interviews. Preventing risk of transmission was critical (90%), due to high fatality. Side effects of chlorine (49%) and PPE (38%) were critical due to irritation and heat stress, but benefits outweighed harms. Covering head, neck, and mucous membranes was more acceptable (72%) than covering mucous membranes only as it enhances safety but is more costly (49%). Use of disposable PPE versus reusable raised equity concerns (62%) due to supply sustainability. Goggles under vs. over the hood was less feasible (55%) as they restrict visibility for those wearing glasses. Spraying was less acceptable (67%) than wiping as the latter is more effective. Spraying HCWs during doffing was less acceptable (57%) due to risk of transmission. Out of four options, removing outer and inner glove was less acceptable (70%) to avoid exposing the skin. Hand hygiene trade-offs between alcohol-based hand rub (ABHR), chlorine, and soap & water varied, 45% found ABHR more acceptable, less pungent and kills the virus, but is resource-intensive (58%). Incineration was more acceptable (59%) and feasible (58%) than disinfection, but incinerator is costly. This study highlighted variability in acceptability, feasibility, and equity concerns for IPC measures. Discussion of those findings during guideline development was crucial to increase applicability and acceptability by end users.

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