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.

Healthcare waste management in selected government and private hospitals in Southeast Nigeria

Objective: To assess healthcare workers' involvement in healthcare waste management in public and private hospitals. Methods: Validated questionnaires (n = 660) were administered to randomly selected healthcare workers from selected private hospitals between April and July 2013. Results: Among the healthcare workers that participated in the study, 187 (28.33%) were medical doctors, 44 (6.67%) were pharmacists, 77 (11.67%) were medical laboratory sci-entist, 35 (5.30%) were waste handlers and 317 (48.03%) were nurses. Generally, the number of workers that have heard about healthcare waste disposal system was above average 424 (69.5%). More health-workers in the government (81.5%) than in private (57.3%) hospitals were aware of healthcare waste disposal system and more in government hospitals attended training on it. The level of waste generated by the two hospitals differed significantly (P = 0.0086) with the generation level higher in government than private hospitals. The materials for healthcare waste disposal were significantly more available (P = 0.001) in government than private hospitals. There was no significant difference (P = 0.285) in sy-ringes and needles disposal practices in the two hospitals and they were exposed to equal risks (P = 0.8510). Fifty-six (18.5%) and 140 (45.5%) of the study participants in private and government hospitals respectively were aware of the existence of healthcare waste man-agement committee with 134 (44.4%) and 19 (6.2%) workers confirming that it did not exist in their institutions. The existence of the committee was very low in the private hospitals. Conclusions: The availability of material for waste segregation at point of generation, compliance of healthcare workers to healthcare waste management guidelines and the existence of infection control committee in both hospitals is generally low and unsatisfactory.