The change in manicurists/pedicurists’ knowledge and attitudes after an individually applied education program on infection control

Introduction
Manicuring/pedicuring are among the routes of transmission of HBV, HCV, HIV viruses. Our aim was to evaluate the effects of an education program targeted to manicurists/pedicurists, given by health officer students and determine whether their level of knowledge and attitudes had changed after the education.

Methods
Among 211 establishments registered to vocational chamber, 83.7% were contacted. A total of 131 manicurists/pedicurists were interviewed and educated using standard visual guides in November-December 2009 by health officer students. The participants were revisited in March-April 2010, with 60.3% (n=79) followed-up. The same questionnaire including 70 questions covering socio-demographics, experience, working conditions, knowledge and practice on infection control was applied. A knowledge score was calculated from the 25 true/false type questions on knowledge, and an attitude score from 14 questions. Paired samples t-test and McNemar’s test were used as analyses.

Results
The mean age was 28.3±8.4. 41.5% had primary schooling and 24.6% vocational training. They were working for 10.5±7.9 years.
The mean knowledge and attitude scores had significantly increased after the education, from 17.0±2.1 to 17.6±2.6 (t=-2.113, p=0.038) for knowledge and from 7.8±2.5 to 8.9±2.8 (t=-3.230, p=0.002) for attitude. There was no significant increase in the correct response rates to individual items of the knowledge scale, while significant increases were observed in four of the attitude items: Hepatitis B vaccination rate increased from 68.4% to 77.6%, hand washing before and after each operation 55.8% to 70.1%, avoiding cleaning the tools when having an open wound 47.2% to 69.4% and recommending the clients to bring their own tools 68.8% to 88.3% (p<0.05). Besides, nasopharyngeal culture rate had increased from 28.6% to 50.0% (p<0.05).

Discussion
An individual face-to-face education to manicurists/pedicurists, given by health officer undergraduate students with the aid of a standard visual guide effectively increased the knowledge of manicurists/pedicurists and improved their infection control practices and prevention behavior.