歯科医療の安全性：リスクと解決策

タイトル: Occupational Exposure and Observance of Standard Precautions Among Bucco-dental Health Workers in Referral Hospitals (Yaounde, Cameroon)

概要: BackgroundThe risk of infection during dental practices is omnipresent for both patients and healthcare workers. Workers within the bucco-dental health services are among the most affected. The most reported infectious agents transmitted through blood and body fluids are Human Immunodeficiency Virus, viral hepatitis B and C. Compliance with standard precautions prevents exposure to hospital associated infections that are acquired through exposure needle sticks and splashes in healthcare settings. The aim of the present investigation was to assess the level of implementation and constraints to the observance of standard precautions in bucco-dental services. MethodologyA cross-sectional study was conducted in five referral hospitals in Yaounde, from March to April 2021, involving a purposeful selection of 40 bucco-dental health workers (BDHW). Workers were submitted to a pre-tested self-administered questionnaire covering their knowledge, level of observance of standard precautions and experiences of occupational exposure to blood and other body fluids. The data collected were analyzed using IBM SPSS software version 26. ResultsOut of the 53 bucco-dental health workers (BDHW) who were selected for inclusion, 40 provided responses for a participation rate of 75.5%. The mean age of participants was 30.65 years and the M/F sex ratio was 0.54. Half of participants (58.5%) had a good overall level of knowledge of standard precautions. Less than a quarter of participants (12.5%) were compliant with standard precautions. Only 35% of BDHW had received training on hospital infection control, while 60% reported to have experience a needle stick injury in the last three months. Gaps in the observance of standard precautions included the lack of disinfectants (70%), application of hand washing techniques and use of personal protective equipment (PPE). Less than half of participant (47,5%) were fully vaccinated against hepatitis B. ConclusionMost bucco-dental health workers had insufficient knowledge of standard precautions, most of whom had experienced needlestick injuries and accidental exposure to body fluids, and were at high risk of hospital acquired infections. There is an urgent need to establish and strengthen hospital-based infection control committees to ensure training and implementation of infection prevention measures in local healthcare settings. A framework for the nationwide scale up of such interventions should be explored.