Background: Hands are critical vectors for microorganisms that cause healthcare-associated infections (HAIs). Hand hygiene, being done the right way, at the right time, and being given the right priority in a healthcare setting is an effective strategy to reduce HAIs and associated costs. Different strategies have been put in place to help improve hand hygiene compliance among healthcare workers; amongst them, continuous training is advised at all levels of care. Aim: This study, focusing on nursing students, aimed to describe their knowledge, attitudes, and perceptions towards hand hygiene, highlighting their crucial role in maintaining health and preventing infections. Methods: This study was a quantitative cross-sectional study. One hundred and fourteen questionnaires were distributed; 103 were filled out and returned by willing students at Maluti Adventist College, thus a 90% response rate. Results: 62% (64) demonstrated moderate knowledge, all had positive attitudes, and 61% (63) had a positive perception towards hand hygiene. There was a significant (p-value = 0.012) association between knowledge and training. Conclusions and recommendations: These provide valuable input for enhancing the World Health Organization’s (WHO) hand hygiene multimodal strategy, the SAFE LIFE Clean YOUR HAND campaign, and healthcare workers’ teaching curriculum. All stakeholders should implement strategies that prioritize knowledge dissemination to promote effective hand hygiene practices among healthcare workers worldwide.

Background: Tuberculosis (TB) remains a major public health challenge globally, particularly in high-burden countries such as South Africa. Treatment interruption is a critical barrier to effective TB control, contributing to poor treatment outcomes, increased risk of multidrug-resistant tuberculosis (MDR-TB), and continued community transmission. Understanding the determinants of treatment interruption in rural healthcare settings is essential for strengthening TB programme implementation. Methods: This qualitative study explored the factors influencing TB treatment interruption from the perspectives of professional nurses working in primary healthcare facilities in the Nyandeni Subdistrict, Eastern Cape, South Africa. Semi-structured interviews were conducted with nurses involved in TB programme implementation. Data were analysed using thematic analysis following the six-phase approach described by Braun and Clarke. Descriptive statistical analyses were also used to summarize participant characteristics, including age and years of nursing experience. Conceptual frameworks were developed to illustrate the multilevel determinants of TB treatment interruption. Results: Participants had a mean age of 40.6 years and an average of 14.2 years of nursing experience, reflecting a workforce with substantial clinical exposure to TB management. Thematic analysis identified multiple interconnected determinants of treatment interruption. Key barriers included poverty, food insecurity, transport costs, long distances to healthcare facilities, limited family support, and challenges related to patient tracing. These factors interact across structural, community, health system, and interpersonal levels to influence patient adherence behaviour. Conceptual models developed from the findings illustrate the complex pathways through which these determinants contribute to treatment interruption and programme-level consequences such as reduced treatment success and increased risk of MDR-TB. Conclusions: TB treatment interruption in rural settings is driven by multilevel socioeconomic and health system determinants rather than individual patient behaviour alone. Strengthening community health worker programmes, improving patient tracing systems, addressing socioeconomic barriers, and enhancing community-based support mechanisms are essential for improving treatment adherence. Integrated, multisectoral interventions are required to strengthen TB programme outcomes in rural high-burden settings.