Are Future Health Workers Protected? A Cross-Sectional Study of SARS-CoV-2 Infection Control Practices Among Clinical Students at the University of Zimbabwe

Abstract

Background: SARS-CoV-2 poses a persistent occupational risk to healthcare workers (HCWs) and, by extension, to health professions students undertaking clinical placements. Undergraduate clinical students represent a bidirectional transmission risk potentially carrying infection between campus and clinical environments, yet their specific infection prevention and control (IPC) practices remain poorly characterised in sub-Saharan African academic settings. This study examined IPC practices among health professions students at the University of Zimbabwe during the active phase of the COVID-19 pandemic. Methods: An analytical cross-sectional survey was conducted between April and July 2021 at the University of Zimbabwe's Faculty of Medicine and Health Sciences. Using convenience lottery sampling, 320 undergraduate health professions students were enrolled. Data were collected via a researcher-administered structured questionnaire the Clinical Student IPC Practices Questionnaire (CSIPQ) comprising 38 items across five domains: (1) hand hygiene, (2) medical mask use, (3) personal protective equipment (PPE) use, (4) scrubs and clinical wear management, and (5) community IPC conduct. The manuscript was prepared in accordance with the STROBE Statement checklist for cross-sectional observational studies. Results: The cohort comprised 320 frontline clinical students, predominantly young adults aged 20-25 years (95.3%) with a male preponderance (65.0%). Participants were drawn from five clinical programmes, with Medicine and Surgery (35.6%) and Nursing Science (28.8%) representing the largest groups, and half were in their fourth year of study, indicating advanced clinical exposure. The prevalence of optimal IPC practice was critically low across all clinical domains: medical mask use (0.6%), PPE use (0.3%), and handwashing (15.3%). Significant associations were observed between handwashing and degree programme (p=0.002) and age (p<.0001). No significant demographic or academic associations were identified for mask use or PPE use, indicating that deficits were uniformly distributed across the cohort. Conclusion: While specific student demographics were associated with better hand hygiene, near-universal gaps in PPE and medical mask use indicate a systemic failure transcending individual characteristics. Transformative, competency-based IPC education, resource security, and institutional safety culture reform are urgently needed to protect future health professionals and their patients.