Analyse de la gestion du risque d’accident d’exposition au sang à la Maternité de l’Hôpital Central de Yaoundé

Abstract

Introduction: Occupational exposure to blood and body fluids refers to healthcare providers coming in contact with blood or other body fluids which are potentially harmful. Every year, there are 66,000 cases of hepatitis B, 16,000 cases of hepatitis C and 1,000 cases of HIV infection arise as a result of occupational exposure to blood. These diseases represent a huge burden for the society in terms of increased medical care costs, avoidable through the risk management of blood exposure. Objective: Analyze the aptitude of the Maternity Unit’s staff of the Yaounde Central Hospital facing occupational exposure to blood (OEB). Methodology: A cross-sectional and descriptive KAP (knowledge, attitudes and practices) study was conducted from October 2022 to May 2023 with the healthcare providers of the Maternity unit of Yaounde Central Hospital (YCH). In order to carry out this study, an ethical clearance and a data collection authorization were obtained from the ethical committee of the Faculty of Medicine and Biomedical Sciences of the University of Yaoundé 1 (FMBS) and from the director of the YCH respectively. Data was collected by administering questionnaire and the interview lasted 20 to 30 minutes. Data analysis was performed using IBM SPSS Statistics 25 software. Results: The population consisted of 225 participants, distributed as follows: 200 participants in P1 (gynecologists and anesthetists, nurses, midwives and students) and 25 participants in P2 (nurse assistants, cleaners, laboratory technicians). The sex ratio was 0.7, the age range of the population was between 20 to 56 years with a mean age of 29.21 ± 7.97 years. Knowledge assessment showed that the majority of staff (53.8%) had low knowledge of OEB. Out of the 225 participants, 20% of P2 and 30.5% of P1 knew the correct definition of OEB and half of the staff (44.5%) did not know the indications of post-exposure prophylaxis. Regarding attitudes, they were correct in 52% of the participants. In fact, almost all (95%) of staff felt at risk of having OEB and more than ¾ of each of the populations (P1: 75.7% and P2: 84%) considered that the risk was not low. The majority (97.5%) believed that it was possible to reduce this risk through prevention. The behaviors identified showed that the OEB management practices were inadequate among the majority of staff (48%). Regarding post-OEB first aid, they were not applied adequately by 58.7% of participants. In addition, a large proportion had not taken PEP (P1: 65.5%; P2: 56.6%) with the main reason: negative HIV serology of the source (P1: 73.7 %; P2: 40 %). The level of competencies of health skills was average among only 13% of the healthcare workers of the Yaounde Central Hospital Maternity Unit. Conclusion: OEB is a real problem to the healthcare providers. It is therefore important that all health personnel be protected by improve the ability to prevent and manage OEB.