Lesotho has a high prevalence rate of tuberculosis (TB) that has been exacerbated by high prevalence of HIV. Adherence to the TB infection control guidelines recommended by the World Health Organization is pivotal in TB infection control.

We assessed the level of adherence to the TB infection control guidelines by nurses in TB wards and outpatient departments and the factors associated with nonadherence to the guidelines in Lesotho.

This was an analytical study based on a semistructured questionnaire administered on 55 purposively sampled nurses working in TB wards and outpatient departments at Motebang and Mafeteng Hospitals. Logistic regression analysis was used to determine the variables associated with nonadherence to TB infection control guidelines.

Fear of occupational exposure (P = .026), female gender (P = .03), lack of equipment (P = .02), inadequate staff (P = .005), and the keeping of guidelines by certain nurses (P = .02) were significantly associated with nonadherence. Overall, 43.6% of the respondents had poor adherence to the guidelines. Adherence to the guidelines was not influenced significantly by age, TB ward work experience, and qualifications of nursing staff.

There is poor adherence to World Health Organization TB infection control guidelines by nurses in Lesotho. There is need to improve access to equipment, increase accessibility of guidelines, and ensure adequate staff to increase adherence to TB infection control guidelines.