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Staff knowledge, adherence to infection control recommendations and seroconversion rates in hemodialysis centers in
Sarra Elamin1, Lamya O A M Salih, Sahar I Mohammed
1Ahmed Gasim Kidney Transplant Center and Sudan Peritoneal Dialysis Program, Sudan. sarraelamin@sudanpd.org
Introduction:
We evaluated hemodialysis (HD) staff knowledge, adherence to infection control recommendations and seroconversion rates for hepatitis B virus (HBV) and hepatitis C virus (HCV) in 13 centers that continuously provided HD services in Khartoum State between June 2009 and November 2010.
Methods:
The knowledge of 182 HD staff members was evaluated by a self-filled questionnaire. Relevant data were obtained from 1011 HD patients by direct interviews and record review. Adherence to infection control recommendations was evaluated by direct observation.
Results:
HD staff members achieved a median score of 81% in knowledge evaluation (range 44-100%). Better scores were achieved by more experienced staff. We identified serious gaps in knowledge related to the environmental risk of viral transmission. Regular screening by enzyme-linked immunoassay (ELISA) was performed in 46% of centers. Only half susceptible patients were vaccinated against HBV. Staff dedicated for treatment of HBV positive patients were found in only 57% of centers that served such patients. Hand washing recommendations were strictly observed in 15% of centers, disinfection of HD stations between patients was strictly observed in 23% of centers, medications were prepared in a separate area in 8% of centers and delivered separately to each patient in none of the centers. There were 2.5 HCV seroconversions and 0.6 HBV seroconversions per 100 patient-years. Center characteristics that predicted HCV seroconversion were accommodation of HCV-positive patients in the same center, using ELISA for patient screening, and assigning more than 3 patients for one HD nurse.
Conclusion:
There are serious gaps in HD staff knowledge and adherence to infection control recommendations. A structured training program for HD staff members is urgently required.
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