Adherence to Infection Prevention and Control Protocols Among Healthcare Workers in Ebola Treatment Units: A Brief Report from North Kivu, 2020

The Democratic Republic of the Congo faced a major Ebola Virus Disease outbreak. Healthcare workers in Ebola Treatment Units are at high infection risk, making strict adherence to Infection Prevention and Control protocols vital for their safety and outbreak containment. This brief report assessed the level of adherence to IPC protocols among healthcare workers within ETUs in North Kivu province during the outbreak response. A cross-sectional, observational study was conducted using structured checklists to directly observe IPC practices during high-risk procedures. A self-administered questionnaire assessed knowledge and perceived barriers. Participants included a purposive sample of clinical staff from multiple ETUs. Overall adherence to critical IPC protocols was suboptimal, with a mean observed compliance rate of 67%. The most frequent lapses were in the correct sequence of donning and doffing personal protective equipment and in hand hygiene practices between patient contacts. Questionnaire data highlighted resource shortages and fatigue as key perceived barriers. Adherence to essential IPC measures among healthcare workers in this setting was inconsistent, exposing them to preventable risk and underscoring a vulnerability in outbreak response systems. Immediate, intensive refresher training focused on high-risk procedures is required. ETU management must ensure consistent availability of IPC resources and implement supportive supervision to reinforce safe practices and address staff fatigue. Infection Prevention and Control, Ebola, healthcare workers, adherence, outbreak, Democratic Republic of the Congo This report provides field evidence on IPC compliance gaps during a major Ebola outbreak, informing targeted interventions to protect frontline workers in similar high-risk settings.