Occupational risk awareness and standard precaution practices regarding hepatitis C among healthcare workers in the Republic of Moldova

Abstract

Introduction. Healthcare workers (HCW) face elevated occupational exposure to hepatitis C virus (HCV). In the Republic of Moldova, HCV prevalence is estimated at 3.8%, yet HCW-specific knowledge, attitudes, and practices (KAP) remain scarce. This study compared KAP scores among physicians, nurses, and the general population, focusing on standard precaution compliance. Materials and methods. A cross-sectional study (2024-2025) enrolled 567 adults (18-65 years) from four Moldovan regions by random sampling: 151 physicians, 280 nurses, and 136 general-population representatives. Participants completed a structured questionnaire administered via EpiInfo, scored using a 30-point KAP scale (knowledge 0–10, attitudes 0–10, practices 0–10). Kruskal-Wallis and Mann-Whitney U tests compared subgroups; Spearman rho assessed inter-component correlations (p<0.05). Results. KAP total scores differed significantly (H=220.10, p<0.001): physicians 19.85±2.95 (66.2%), nurses 18.76±2.91 (62.5%), general population 13.62±3.07 (45.4%). Knowledge was higher in physicians (5.65±0.85) than nurses (5.40±0.95; p=0.037) and the general population (3.67±1.55; p<0.001). Attitudes were comparable across groups (71–73%; p=0.617), with no statistically significant differences. Practice scores diverged most (H=183.08, p<0.001): physicians 69.3%, nurses 60.4%, general population 28.5%. Risky occupational behaviors persisted: needle recapping was reported by 24.4% of physicians and 37.2% of nurses; glove change per patient by only 52.3% and 39.3%, respectively. Needlestick injuries affected 15.9% of physicians and 18.2% of nurses. HCV testing rates were higher in HCW (physicians 89.4%, nurses 86.8%) than in the general population (46.3%). Knowledge correlated positively with practices (rho=0.336, p<0.001); attitudes did not correlate with either component. Conclusions. Despite superior overall KAP profiles, HCW exhibit critical gaps in standard precaution adherence. The attitude-practice disconnect confirms that positive beliefs alone do not guarantee safe behavior. Competency-based infection-prevention training and reinforced post-exposure protocols are warranted. Longitudinal research should assess whether targeted interventions reduce occupational HCV transmission in Moldovan healthcare settings.