Original article

Vol. 22 No. 3 (2024): Blood Transfusion 3-2024 (May-June)

Knowledge, attitude and practice survey of bacterial contamination of blood for transfusion in the Democratic Republic of the Congo

Authors

Key words: blood transfusion, bacterial contamination, transfusion-transmitted infections, Africa South of the Sahara

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.

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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 https://orcid.org/0000-0002-3930-3100

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 https://orcid.org/0000-0001-7709-0153

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 https://orcid.org/0000-0002-8820-3843

Jan Jacobs - Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium https://orcid.org/0000-0002-8657-6777

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