Infection prevention and control practices among audiologists in Ghana using survey evidence, direct observation and microbial analysis

Background: 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. 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.