Health-workers' awareness, facilitators and barriers of HSV-2 screening and management of pregnant women at two national referral hospitals in Uganda

Abstract

Background Herpes Simplex Virus type 2 (HSV-2) is the leading cause of genital herpes in the world. It can have an asymptomatic presentation and so diagnosis can easily be missed. HSV-2 infection in pregnancy has poor health outcomes such as; preterm labor, low birth weight and premature rupture of membranes in women. Hence early diagnosis in pregnant women is of utmost importance. This study aimed at establishing the level of awareness of health workers’ about HSV-2, the facilitators and barriers to its screening and management in pregnant women. Methods A sequential explanatory mixed methods approach employing both cross-sectional and phenomenological study designs was used for the quantitative and qualitative components of this study respectively. Awareness data about HSV-2 was collected from 255 health workers who were directly involved in care of pregnant women who attended Mulago Specialized Women and Neonatal Hospital (MSWNH), and Kawempe National Referral Hospital (KNRH) between 5th September and 4th November 2022. Qualitative data was collected by 9 key informant interviews. Measures of central tendency, dispersion, and frequencies were used for quantitative data analysis using STATA version 16 application software and the COM-B model was used for qualitative data analysis. Results Overall, less than half 42.4% of the health workers were aware of HSV-2 screening in pregnant women, and only 32.3% knew its management. 56% of health workers recommend against vaginal delivery in pregnant women who come in labor presenting with primary HSV-2 infection. Barriers for screening and management of HSV-2 included; lack of knowledge, lack of screening protocols, and lack of screening facilities. Facilitators included; affordable drugs, and willingness of patients to be screened. Conclusion Health workers levels of awareness of HSV-2 screening and management of pregnant women were low implying that there is need for increased health worker sensitization and awareness of the impacts of HSV-2 in pregnancy.