尼日利亚翁多州拉沙热疫情期间医护人员对拉沙热的认知及感染预防与控制设施的使用情况。

Knowledge of Lassa fever and use of infection prevention and control facilities among health care workers during Lassa fever outbreak in Ondo State, Nigeria.

作者信息

Ijarotimi Ibidolapo Taiwo, Ilesanmi Olayinka Stephen, Aderinwale Adeola, Abiodun-Adewusi Oluwadamilola, Okon Ime-Maria

机构信息

Nigeria Field Epidemiology Training Program, 50 Haile Selassie, Asokoro, Abuja, Nigeria.

出版信息

Pan Afr Med J. 2018 May 24;30:56. doi: 10.11604/pamj.2018.30.56.13125. eCollection 2018.

INTRODUCTION

Hospital-acquired infections of Lassa fever (LF) have been described in many West African countries. We assessed the availability of Infection Prevention and Control (IPC) measures and their use in the health centres (HCs) at the affected Local Government Areas (LGAs) during an ongoing LF outbreak in Ondo State, Nigeria.

METHODS

We included all primary and secondary HCs and their healthcare workers (HCWs) in the affected Ose and Owo LGAs. We collected data from respondents using self-administered questionnaires and used a checklist to assess the IPC measures at the HCs. We generated frequencies and proportions and tested associations using odds ratios at 95% CI.

RESULTS

One hundred and ninety HCWs from 59 HCs were surveyed of which 34 (57.6%) were located in Owo LGA. All HCs had soap for handwashing, 57(96.6%) had wash-hand basins but only 52(88.1%) had water. While 57(96.6%) had gloves and 53(89.8%) had sharps boxes, only 16(27.1%) had an isolation room. Only 44(23.2%) respondents had been trained in IPC. The majority, 144 (91.6%) always had gloves available for their use, 79(41.6%) always had facemask/shield and 71(37.4%) always had full personal protective equipment. At the last patient contact, only 151 (79.8%) washed their hands before the contact, 188(98.9%) washed their hands after and 183 (96.2%) wore gloves. While there was no association between availability of gloves and its use (OR: 0.21, 95%CI 0.04-1.17), there was significant association between having had training in basic universal precautions and having used gloves (OR: 3.64, 95%CI 1.21-19.40) and having washed hands after last patient contact (OR: 2.31, 95%CI 1.67-12.30).

CONCLUSION

Among these HCs that serve as point of first contact with possible cases of LF in these endemic LGAs, none met the minimum standard for IPC. We recommend that IPC committee for each LGA and the whole state should be set up and IPC trainings made mandatory.

引言

许多西非国家都曾报告过医院获得性拉沙热（LF）感染病例。在尼日利亚翁多州持续的拉沙热疫情期间，我们评估了受影响的地方政府辖区（LGAs）的卫生中心（HCs）感染预防与控制（IPC）措施的可用性及其使用情况。

方法

我们纳入了受影响的奥塞和奥沃地方政府辖区内的所有一级和二级卫生中心及其医护人员（HCWs）。我们通过自行填写问卷从受访者那里收集数据，并使用清单评估卫生中心的感染预防与控制措施。我们生成了频率和比例，并使用95%置信区间的比值比检验关联性。

结果

对来自59个卫生中心的190名医护人员进行了调查，其中34名（57.6%）位于奥沃地方政府辖区。所有卫生中心都有用于洗手的肥皂，57个（96.6%）有洗手盆，但只有52个（88.1%）有水源。虽然57个（96.6%）有手套，53个（89.8%）有锐器盒，但只有16个（27.1%）有隔离室。只有44名（23.2%）受访者接受过感染预防与控制培训。大多数人，即144名（91.6%）随时都有手套可供使用，79名（41.6%）随时都有口罩/面罩，71名（37.4%）随时都有全套个人防护装备。在最后一次接触患者时，只有151名（79.8%）在接触前洗手，188名（98.9%）在接触后洗手，183名（96.2%）戴了手套。虽然手套的可用性与其使用之间没有关联（比值比：0.21，95%置信区间0.04 - 1.17），但接受过基本通用预防措施培训与使用手套之间存在显著关联（比值比：3.64，95%置信区间1.21 - 19.40），以及在最后一次接触患者后洗手之间也存在显著关联（比值比：2.31，95%置信区间1.67 - 12.30）。