The Knowledge of and Attitude to Hospital-acquired Infections among Public and Private Healthcare Workers in South-East, Nigeria.

Aims: To ascertained and compared the knowledge and attitude of public and private health-care workers in South-East, Nigeria on hospital-acquired infections. Study Design: A cross sectional surveillance report. Place and Duration of Study: Randomly selected hospital workers in private and public hospital in South-east Nigeria were administered questionnaire between April and July 2013. Methodology: Proportional sampling technique was used to obtain a representative sample of the health-care workers. Structured and validated questionnaires (n=660) were self-administered to randomly selected healthcare workers present on the days of visit and consenting to participate in the study. Data were analyzed using Chi square statistical tool. Results: The workers have good knowledge of HAIs but their attitude to preventive measures is poor and significantly different (p = 0.0002: Chi-square (X2) test). Hospital-acquired infections occurred more in public than private hospitals. The prevalence of nosocomial infections in the hospitals surveyed (as reported by the respondents) is urinary tract infection (34.9%), Gastroenteritis (27.1%), Hospital acquired pneumonia (20.3%), yeast infections (10.8%), Tuberculosis (9.0%), ventilator associated pneumonia (3.6%) and methicillin and/or vancomycin resistant infections (1.5%). The prevalence of the etiological agents of the nosocomial infections are the Staphylococcus aureus (31.0%), Candida albicans/ Aspergillus species (10.8%), Pseudomonas aeruginosa (10.5%), Mycobacterium tuberculosis (9.0%) and Clostridium difficile (3.9%). The workers know well about hospital-acquired infections, 322 (97.58%) and 297 (90%) in public and private hospitals respectively. About 11 (3.6%) and 19 (6.2%) workers in private and public hospitals respectively process their equipment as well as practice hand hygiene and use of personal protective equipment. Conclusions/Recommendation: The burden of HAI is very high. UTI is the most prevalent HAI. The most common causative agent in both hospital setting is Staphylococcus aureus. The knowledge of the workers concerning hospital acquired infections is adequate but their attitude to the infections’ prevention is poor and significantly different. Standardized surveillance of nosocomial infections has to be urgently addressed in Nigeria.

Safety evaluation in mice of the childhood immunization vaccines from two south-eastern states of Nigeria

Objective: To check the effects of the vaccines on the hematopoietic system and weight of mice after immunization. Methods: The study was done with the Expanded Programme on Immunization vaccines donated by the Ministries of Health of Abia and Imo States of Nigeria. The vaccines were collected from the cold-chain stores and transported in vaccine carriers to the cold-chain facility in Nnamdi Azikiwe University Teaching Hospital within 3 hours of collection. They were used to immunize a total of 160 mice. The Ethics Committee of Nnamdi Azikiwe University Teaching Hospital, Nnewi of Anambra State, Nigeria approved the protocol. Results: Mice body weight changes test showed that the mice all had increased body weight at Days 3 and 7 post-immunization and none died during the 7 d post-immunization observation. The percentage weight gains of the mice compared with the control were 69%, 70%, 64%, 63%, 65% and 68% for oral polio vaccine, diphtheria-pertussis-tetanus, bacillus Calmette- Guérin, measles, yellow fever and hepatitis B vaccines respectively collected from Imo State. The mice immunized with oral polio vaccine, pentavalent, bacillus Calmette-Guérin, measles, yellow fever and hepatitis B vaccines collected from Abia State had 123%, 114%, 121%, 116%, 142% and 119% weight gain respectively compared with the control. Leukocytosis promoting toxicity test showed that none of the vaccines was able to induce proliferation of leukocytes up to ten folds. Leukopenic toxicity test showed that all the vaccines had an leukopenic toxicity test value higher than 80% of the control (physiological saline). Conclusions: The vaccine samples tested were safe and did not affect the hematopoietic system adversely. The storage conditions of the vaccines in the States' cold-chain stores had not compromised the safety of the vaccines.