Abstract
Background - We assessed healthcare worker’s knowledge-attitude-practice regarding bacterial contamination of blood products in the Democratic Republic of the Congo.
Materials and methods - In three hospitals and the National Blood Transfusion Centre (NBTC), two multiple-choice surveys were completed on a tablet computer: one each, for blood bank (31 questions) and for clinical ward staff (20 questions). A score was calculated for 11 overlapping knowledge questions.
Results - Among 247 participants (blood bank No.=62, ward No.=185), median (range) knowledge score was 10 (2-19) on a maximum of 20, with blood bank staff (12/20) scoring higher than clinical ward staff (9/20) (p<0.0001). Half (50.2%) of 247 participants recalled previous training in transfusion medicine. Participants had limited understanding of and compliance with NBTC-recommended preventive measures: incorrect assumption that wearing gloves prevents bacterial contamination (83.8%) and that blood banks test donor blood for bacteria (59.9%). Half (50.0%) of blood bank staff did not acknowledge the NBTC-recommended antisepsis procedure, 62.1% did not apply the appropriate number of antisepsis steps, and 32.3% saw no harm in touching the venipuncture site after antisepsis. Presence of bacteria on healthy skin (62.3%) and blood bank fomites (examination gloves: 30.8%, soap: 62.8%) was underestimated. Although 92.4% of clinical ward staff said to easily recognize transfusion reactions, only 15.7% recognized septic reactions and post-transfusion antibiotic treatment practices were not consistent. Challenges reported by blood bank staff and particular for low-resource settings were: frequent power cuts (98.4%), transport of blood products by patient attendants (41.1%), without cooling elements (64.4%), and reuse of finished antiseptic/disinfectant containers (75.4%).
Discussion - The present study points to gaps in knowledge, attitudes, practices along sampling, cold chain and transfusion which can feed customized training and monitoring.
References
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Authors
Anne-Sophie Heroes
Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
Paul Kabamba Education office, Centre National de Transfusion Sanguine, Kinshasa, Democratic Republic of the Congo
Aimée Luyindula Blood Bank, Hôpital Saint-Luc, Kisantu, Democratic Republic of the Congo
Bernard Bongenya Blood Bank, Hôpital Provincial Général de Référence, Kinshasa, Democratic Republic of the Congo
Pierre Nzazi Blood Bank, Hôpital Provincial Général de Référence, Kinshasa, Democratic Republic of the Congo
Monica Nasali Blood Bank, Hôpital Provincial Général de Référence, Kinshasa, Democratic Republic of the Congo
Cathérine Akele Director Office, Hôpital Pédiatrique Kalembe Lembe, Kinshasa, Democratic Republic of the Congo
Marie-Paule Lusinga Blood Bank, Hôpital Pédiatrique Kalembe Lembe, Kinshasa, Democratic Republic of the Congo
John Ekofo Nursing Department, Hôpital Pédiatrique Kalembe Lembe, Kinshasa, Democratic Republic of the Congo
José Coene Blood Service, Belgian Red Cross-Flanders, Mechelen, Belgium
Inge Van Cauwenberg Democratic Republic of the Congo Office, Institute of Tropical Medicine, Antwerp, Belgium
Philippe Vandekerckhove
Blood Service, Belgian Red Cross-Flanders, Mechelen, Belgium; Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
Octavie Lunguya
Department of Microbiology, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Department of Clinical Biology, Cliniques Universitaires, Kinshasa, Democratic Republic of the Congo
Jan Jacobs
Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
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