[Compliance with hand-hygiene practice in the General Reference Hospitals of the city of Kisangani, Democratic Republic of the Congo]. / Observance de l'hygiène des mains dans les hôpitaux généraux de référence de la ville de Kisangani en République Démocratique du Congo.

INTRODUCTION: the purpose of this study was to assess the compliance with hand-hygiene practice of health-care workers in the General Reference Hospitals (GRH) of the city of Kisangani and to identify factors contributing to it. METHODS: we conducted a cross-sectional study in the Maternity, Surgery, Pediatric and Emergency Departments at four GRH of the city of Kisangani over the period 13th-20th June 2018. One hundred and twenty professionals recruited from among doctors, nurses, laboratory technicians and attendants were asked to complete a self-administered questionnaire to assess their level of knowledge and a grid indicating the compliance with hand-hygiene practice in 44 health professionals (1920 opportunities). RESULTS: the rate of overall compliance with hand-hygiene practice was 39% [CI95 0.37; 0.41]; friction with hydroalcoholic solution was much less frequent (5%); cleaners and physicians had higher compliance rates (49% and 44% respectively) than nurses (33%). Approximately one third of professionals were aware of the indications for hand-hygiene according to the WHO; 37% of health professionals declared that they had followed a on-the-job training on hand-hygiene and 36% knew the importance of hand-hygiene in the healthcare environment. The gap in knowledge was not significant between the occupational categories studied (p >0.05). CONCLUSION: this study and the results obtained from it allowed us to conclude that the level of compliance to precautions standards including hand hygiene by healthcare professionals is insufficient. It is therefore necessary to strengthen the compliance with hand-hygiene practices through training and awareness programs for healthcare professionals, the supply of hygiene products and the awareness of healthcare providers.

[Effectiveness of vaccine management and quality of immunization services in the Expanded Programme on Immunization (EPI) antenna in the Kisangani region, Democratic Republic of Congo]. / Efficacité de la gestion de vaccins et qualité de vaccination à l'antenne PEV Kisangani en République Démocratique du Congo.

INTRODUCTION: The quality of vaccines is critical for good immunization outcomes. It is dependent on the effectiveness of technical and logistics management system put in place. This study aimed to assess the effectiveness of vaccine management and to learn something from this. METHODS: We conducted a retrospective study of logistic management of vaccines in the Expanded Programme on Immunization (EPI) antenna in the Kisangani region over the period 2010-2014. A literature review completed by semi-structured interviews of immunization services managers and providers helped to evaluate vaccine management using the WHO GEV model in order to identify the gaps. RESULTS: Provider's demonstrated low level of knowledge of the vaccines that cannot be frozen, of freezing tests and of other vaccine damages. Computerized data management was properly ensured in the antenna. No evaluation criteria reached the goal of 80%. Compliance with the storage temperature was 70% in the antenna; the criterion for vaccine management was 65% and 67% in the health area central office and in the health centre respectively. The maintenance criterion was zero at all levels. CONCLUSION: Malfunctioning of the logistic system is remarkable at all levels of the health pyramid; this could interfere with the quality and the expected impact of vaccination. Particular attention should be paid to the maintenance of the equipment.