Surveillance of nosocomial infections in the Yaounde University Teaching Hospital, Cameroon.

BACKGROUND: Nosocomial infections (NI) represent a real public health problem in developing countries. Their surveillance is recommended to provide needed information for better control. The aim of this study was to describe the frequency and distribution of NI in the Yaoundé University Teaching Hospital (YUTH). METHODS: It was a longitudinal and descriptive study targeting hospitalized patients in the intensive care, gynaecological, surgical and neonatal units. Each consenting patient was administered a questionnaire at the beginning of the study and followed up daily for the duration of their hospitalization using a standardized grid to detect all nosocomial infections. Cumulative incidence was used to estimate NI frequency. RESULTS: There were 307 patients included. The cumulative incidence and specific mortality rate of NI were 19.21% (16.9-21.5) and 28% (16.2-42.5) respectively. Septicaemia (20.34%), infection of the skin and soft tissues (20.34%) and urinary tract infections (15.25%) were the most frequent type of NI. Klebsiella spp. was the most frequently isolated bacterium (27%). CONCLUSION: Nosocomial infections contribute to high hospital morbidity in the Yaounde University Teaching Hospital. Strategies need to be identified for a sustainable and continuous monitoring of NI in all health facilities of Cameroon. In addition, Further studies should identify NI determinants and interventions for efficient and better control.

The expanded program on immunization service delivery in the Dschang health district, west region of Cameroon: a cross sectional survey.

BACKGROUND: Vaccination is the most effective intervention strategy, and the provision of vaccination at fixed posts and outreach posts is a backbone of a sustainable vaccination system in developing countries. Access to immunization services is still limited in Cameroon. Several health districts in the west region have recorded new epidemic outbreaks, including the occurrence of a wild polio virus epidemic outbreak in 2013. The aim of this study was to assess immunization service delivery in one of the largest health districts in the west region of Cameroon; the Dschang Health district. METHODS: It was a cross sectional study conducted in 2013, in 42 health facilities covering 18 health areas in the Dschang Health District. Data were collected with questionnaires administered to health personnel face to face and an observation grid was used to assess resources and tools. Data were entered and analyzed in Epi Info. RESULTS: A total of 42 health facilities were assessed and 77 health personnel were interviewed. Overall, 29 (69.0 %) health facilities organized one vaccination session monthly, 2 (4.8 %) organized an outreach within the last 3 months prior to the study, 15 (35.7 %) did not have a vaccination micro plan, 24 (32.9 %) health personnel had not been supervised for at least the last 6 months prior to the study, 7 (16.7 %) health facilities did not have a functional refrigerator, 1 (2.4 %) did not have a vaccine carrier, 23 (54.8 %) did not have a means of transport (vehicle or motorcycle) and 12 (28.6 %) did not have an EPI guideline. The knowledge of health personnel on vaccine and cold chain management, and on diseases of the EPI under epidemiological surveillance was found to be limited. CONCLUSION: The frequency and strategic provision of immunization services in the Dschang Health district is inadequate. Resource availability for an adequate provision of immunization services is insufficient. The knowledge of health personnel on vaccine management, cold chain management and on diseases under surveillance by the EPI is limited.

Accidental exposures to blood and body fluids among health care workers in a Referral Hospital of Cameroon.

BACKGROUND: Accidental exposure to blood and body fluids is a public health concern, especially among health workers and constitutes a risk of transmission of blood-borne viruses including HIV, hepatitis B virus and hepatitis C virus. The objective of this study was to determine the frequency and the post exposure management of accidental exposures to blood and body fluid among health workers in the Yaoundé University Teaching Hospital. METHODS: It was a cross-sectional hospital-based study conducted from the 1st to the 30th of September 2013. Self-administered questionnaires to health workers were used to collect data on self-reported accidents, circumstances and post-exposure management. Their knowledge on accidental exposure to blood was also assessed. Data were entered and analyzed using Epi Info software version 3.5.4. Descriptive analysis was performed to measure the importance of AEB and to evaluate the risk of contamination. RESULTS: One hundred and fifty health workers were interviewed among which 36.7 % reported having been exposed to blood and body fluid at least once in the preceding 3 months. Splash was the most reported injury (in 60.3 % of cases), followed by needle stick (28.7 %) and cuts (10.9 %). Moreover, 43.6 % of victims were not vaccinated against HBV, 7.3 % were not wearing gloves during the accident and 41 % of splash occurs on injured skin. The majority of victims belong to the surgical Department [20 %, p = 0.2310]. None of these injuries had been reported in the registry of accidental exposure to blood. CONCLUSIONS: There is a high rate of accidental exposure to blood and body fluid in the daily hospital routine. Preventives measures, including wearing of protective equipment's during care and vaccination against HBV are not systematically done among health workers. Health institution should develop and provide standard operating procedures targeting surveillance of occupational risks, staff training, and supervision.