Analyse des pratiques et connaissances du personnel soignant sur les accidents d'exposition au sang à Abidjan (Côte d'Ivoire)

[Management of medical waste and biological risks in the teaching hospital of Cocody, Ivory Coast]

Objectif: This study describes the management of medical waste at the University Hospital of Cocody, and appreciates the biological risk for care and cleaning staff.

METHODS

From August 1st to 21st, 2015, a cross-sectional survey was conducted in intensive care units, gynecology-obstetrics, pediatrics-neonatology and anatomy-pathology. Care and cleaning staff filled in a standardized questionnaire. Empirical data was obtained on professional characteristics and management policy; treatment of biomedical waste and biological risk.

RESULTS

The management of biomedical waste was irrational because of: inadequate management policy, lack of material resources and staff training. Biological exposure of the staff was so obvious. We noted: lack of microplans (92.23%) and tools for managing biomedical waste (83.50%). Any medical waste manager was identified in the services (78.64%). Selective sorting was practiced for needLe and blades with conventional safety boxes (59.22%), filled to over flow (44.6%). Color-coding wasn't respected for others infectious waste (95.15%) and the garbage used for their collection lacked closures (84.4%).Participants were not immunized against hepatitis B virus (40%) and 16% reported cases of blood exposure accident. About 30% of them were neither sensitized nor trained to treat BMW.

CONCLUSION

A participatory management policy, training and staff awareness are essential to improve the quality of biomedical waste management in this hospital.

[Blood exposure accidents: knowledge and practices of hospital health workers in Mali]

This is a prospective study conducted in December 2012 among 128 at the Nianankoro Fomba Hospital in Segou in order to assess their knowledge and practices on Blood Exposure Accidents (BEA). The average age of caregivers was 35.4 ± 9 years (range: 22-59 years). The nurses were predominant with 37.5%. The definition of BEA was mastered by 43.8%. The main transmissible infectious agents (HIV, HBV and HCV) were ignored by 76.6%. Questioning revealed that during the treatment, 78.9% wore gloves and 36.0% recapped needles after use. The concept of washing and disinfection after BEA was known by 68.8%. The disinfectant applied was correct for 21.9% of the cases, the time of application for 69.5%. Consulting a referring physician after BEA was mandatory for 32% of them. The time limit of 48 hours delay for the declaration of BEA was experienced by 51.3%. Among staff interviewed 82 caregivers (64.1%) experienced at least one BEA. Students and nursing students were most at risk. Needle pricks were the most frequent (73.2%). BEA is a major problem in the Segou Nianankoro Fomba Hospital. Compliance with standard precautions is not of common practice. Post-exposure care is not widely known. The experienced cases show poor management of BEA in the structure.

Needlestick and sharp object injuries among health care workers in Hamadan Province, Iran

INTRODUCTION

Exposure to septic fluids through mucus and needlestick injuries is of great concern among health care workers (HCWs). The purpose of this study was to acquire epidemiological data, including occupation, level of education, and mode of exposure, in HCWs.

METHODS

The data on this group was gathered during 6 months and analyzed using SPSS version 16.

RESULTS

In this study, we detected 89 cases of needlestick injuries and exposure to septic body fluids in the health care centers. Nurses were the most exposed group (39.3%). The most exposed age group was 25-34 years (51.6%). Of those injured, 51.7% were evaluated for antibody titration after vaccination, and of them, 47.2% had titration above 10 mIU/mL and the remaining had titration below 10 mIU/mL.

DISCUSSION

Numerous educational programs on care are still necessary to inform active workers in the health system about the warning trends and consequences in this part of Iran.

Prise en charge des accidents d'exposition au sang au CHU de Treichville, Abidjan (Côte-d'Ivoire)

OBJECTIVE

The aim of this study was to assess care and preventive measures for accidental exposure to blood (AEB) in Abidjan.

METHODS

A retrospective study of all AEB reported in the Infectious and Tropical Diseases Center of the Treichville University Hospital was made between January 2000 and December 2005. Epidemiology, management, clinical and biological post-exposure follow-up were analyzed.

RESULTS

One hundred eighty-two AEB were managed over 6 years (151 needlesticks, 14 ocular projections of blood, 12 cuts, and 5 mucocutaneous exposure to blood). 94 men (51.6%) and 68 women (48.4%) were included [sex ratio 1.4] mean age 33.8 years+/-7.4 years. Physicians (29.1%), nurses (19.8%), assistant nurse (12.1%), and medical students (11.4%) were the professional categories which declared most accidents. Among them, only 51.1% was correctly vaccinated against hepatitis B. The average delay of consultation was 26.5 hours (1-240 hours), and 82.9% of victims consulted before the 48th hour. Antiretroviral prophylaxis was prescribed to 151 patients among whom 45% with bitherapy (Zidovudine and Lamivudine), and 55% with HAART including an antiprotease. Only 60 patients had one actual month of treatment. Despite the weak follow-up, no case of HIV seroconversion was reported 6 month after exposure.

CONCLUSION

This work underlines once again the high frequency of AEB in Abidjan despite a under reporting, and calls for the implementation of a policy to train health care workers on AEB preventive measures.

Needlestick and sharps injuries among nurses in the healthcare sector in a city of western Turkey

The aims of this study were to determine the rate of bloodborne infections after needlestick and sharps injuries in nurses at work, to estimate the number of vaccinations administered, and to assess whether universal precautions were being followed. The study involved 289 nurses working in five hospitals and six primary healthcare centres. Between 1 April 2002 and 31 June 2002, a total of 139 practising nurses were included in the study following a needlestick or sharps injury. The results of completed questionnaires were collated, and Chi-squared test was used for analysis. The rate of hollow-bored needle-related injuries was 76.2% (106/139). Most nurses (69.1%) did not report any details of their injuries and 32.4% (45/139) of nurses had not been vaccinated against hepatitis B virus (HBV). Only 5.3% of the nurses who responded to the compliance question indicated that they always complied with universal precautions. Of 139 nurses, 1.4% and 7.9% showed evidence of HBV infection and hepatitis C virus (HCV) infection, respectively. All those who had hepatitis B were aged 30 years or under, whereas most of those who were anti-HCV positive (81.8%) were over 30 years old (P < 0.05). Nurses working in the Turkish healthcare sector are frequently exposed to bloodborne infections. Precautions and protection from needlestick and sharps injuries are important in preventing infection of nurses. Education about the transmission of bloodborne infections, vaccination and post-exposure prophylaxis must be implemented. Further investigations are warranted to elucidate the risk to nurses of contracting these potentially serious infections.