CHAPTER ONE

INTRODUCTION

1.1  Background to the study

Health-care-associated infection (HCAI) refers to infection that is acquired during the process of care and not manifested at the time of admission to a hospital or other health-care facility (Pittet et al., 2011). It has been estimated that the risk of health care-associated infection is 2 to 20 times higher in developing countries compared to developed countries and 5% and 10% of patients admitted to hospitals in developed countries acquire these infections (WHO, 2008) A total of 3 million out of 35 million HCWs worldwide experienced percutaneous exposure to blood borne pathogens (BBPs) each year; 2 million of those were to HBV; 0.9 million to HCV; and 0.17 million to HIV. The annual economic impact of HAIs in the US alone was approximately US$ 6.5 billion. HAIs have also been reported to contribute to serious mental health disorders, including anxiety, depression, adjustment disorder, panic attacks, and post-traumatic stress disorder (Alhumaid et al. 2021)Hospital acquired infections (HAIs) are still the main cause of morbidity and mortality in hospitalized patients and health professions ( Mehta et al., 2014).

The pooled of global  prevalence of HAI between 2000 and 2021 was 0.14%, with an annual rate increase of 0.06%. The Central African region had the highest rate of HAI, estimated at 0.27%. Systematic review and meta-analyses in 2022 and 2024 revealed the prevalence of HAI in Africa at 12.76% and 15%, respectively(Mbapah et al. 2025).  HAIs are particularly relevant in developing countries where a small amount of resources are available for use; which increase the number of days a patient spends in the hospital, requiring additional cost and hours spent providing patient care (Nag et al., 2018) (Asfaw 2021)

According to 2011 WHO report, the prevalence of HAI in Africa varied between 2.5% and 14.8% and it’s magnitude would be much higher than in the developed countries (Bagheri et al., 2011). There is an available low-cost intervention for infection prevention. Even though, the proportion of HCAIs are much higher in sub-Saharan Africa (18.9% in Mali, 14.8%, in Tanzania, 9.8% in Algeria and 14.90%, in Ethiopia  and the majority of healthcare knowledge and adherence towards infection prevention strategies is still very low . For this, improving the knowledge and practice of healthcare workers towards infection prevention is paramount to reduce the burden of HAIs. In the resource constrained setting like many hospitals in Ethiopia, it’s difficult to control the infection rates of patients acquiring hospital infections and exposure of the HCWs to such infection(Asfaw 2021).

Some multi-targeted simple practical procedures that are part of the components of standard precautions against HCAIs and improving knowledge of infection prevention have been found to be effective in reducing the HCAIs. Despite, evidence regarding the level of knowledge and practice towards infection prevention and associated factors are not well explored in Ethiopia, including Amhara region (Desta et al. 2018). Many infection control measures, such as appropriate hand hygiene and the correct application of basic precautions during invasive procedures are simple and of low-cost, but require staff accountability and behavioral change, in addition to improving staff education, reporting and surveillance systems (Boujaafar, 2013).

1.2 Statement of the problem

Healthcare-associated infections (HAIs) are a major problem for patients’ and healthcare workers’ (HCWs’) safety and their prevention must be a top priority for healthcare systems and organizations (Alhumaid et al. 2021). Given the potential negative impacts on patients and HCWs by HAIs, clinical and national economic and psychological burden as mentioned, it is important to discuss literature on HCWs’ knowledge of IPC to prevent such harmful exposures. Moreover, this paper was also focus on reviewing potential factors influencing compliance of HCWs with the IPC measures so that some suggestions can be made to improve the quality and safety of health service delivery and the health outcomes of the people who access those services (Alhumaid et al. 2021).

Although there are many previous studies which revealed that the levels of nurses’ knowledge and practices are relatively poor and insufficient, to the researcher’s best of knowledge, so far, no study has been conducted in St Albert Le Grand Hospital which was the context of the current study. Therefore, this study aimed to identify gaps in nurses’ knowledge and practices regarding infection control measures in order to improve the current training courses and enhance future good practice.

1.3 Significance of the study

The results of this study was to enable nurses at St Albert Le Grand Hospital to develop more effective methods on infection control in the hospital.

The findings from this study was to create more awareness about infection control to the health staff.

This study was  also to reduce the rate of infection to the health staff and promote public health.

The findings from this study was to serve as a reference for future research.

1.4 Research questions

1.4.1 Main research question

What is the knowledge, practice and challenges with infection control among nurses at St Albert Le Grand hospital?

1.4.2 Specific Research question

1. What is the level of knowledge concerning infection control among nurses at St Albert LE Grand HOSPITAL?
2. What are practice regarding infection control among nurses at St Albert Le Grand Hospital Douala?

• What are the challenges with infection control among nurses at St Albert Le Grand hospital Douala?

1.5 Research objectives

1.5.1 Main research objective

To assess the knowledge, practice and challenges with infection control among nurses at St Albert Le Grand hospital Douala.

1.5.2 Specific research objective

1. To assess the level of knowledge concerning infection control among nurses atSt Albert Le Grand hospital douala
2. To evaluate the practice concerning infection control among nurses at St Albert le Grand hospital douala

• To identify the challenges with infection control among nurses at St Albert le grand hospital douala.