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Infection Control Measures Among Dental Health Care Workers

Fawzia Butt,1 Hinal Thakkar,2 Jeremiah Munguti,1 Evelyne Waigayu 1

1School of Medicine, University of Nairobi

  1. Hurlingham Medicare Plaza, Nairobi

Correspondence to: Dr. Fawzia Butt, PO Box 30197–00100, Nairobi; email: fawziamaxfax@gmail.com

Abstract

The aim of this study was to establish the knowledge, attitudes and behavior of infection control among dental health care workers (DHCW) in a dental hospital in Kenya. Methods: A descriptive cross-sectional study that used a close-ended questionnaire to collect data from a sample of 110 DHCW. Estimation of 95% confidence intervals was used to test the proportions of the knowledge levels. Data were analyzed using MS Excel. Results: Out of 150 DHCW, a convenient sample of 110 DHCW participated in the study, with 10 non-respondents. Female participants (58) were more than males (42); M:F = 1:1.38. Age range was 21–41 years (mean=25.7 years). Most respondents (n=79, 79%) were students aged 20 to 24 years. Overall, 46% of the participants were ill informed about infection control, 32% did not practice the recommended infection control practices, while 39% had a negative attitude towards various aspects of infection control. Conclusion: These results show that infection control measures need enforcement and daily practice regularly. Continuous and compulsory training in infection control is recommended for those working in clinics.

Key words: Infection, Dental, Sterilization

Ann Afr Surg. 2019; 16(1):26–29

DOI:http://dx.doi.org/10.4314/aas.v16i1.6

Conflicts of Interest: None

Funding: None

 

© 2019 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.

Introduction

Although the transmission of infectious agents between patients and dental health care workers (DHCW) in dental settings is rare, cases of cross-contamination in dental settings, including patient-to-patient transmissions, were reported from 2003 to 2015 (1, 2). These reports highlighted the need for comprehensive training to improve the understanding of underlying principles, recommended practices, their implementation, and the conditions that must be met to prevent disease transmission (3). Infection is a major problem for health care systems in many countries. Despite advances in infection control and the emphasis placed on standard measures to follow, in recent years the problem has persisted in health care centers such as dental clinics and hospitals (4). Disease transmission can be from health care-associated infections to patients through contaminated instruments and environments, occupational hazard to DHCW through aerosol, improper handling of contaminated instruments, and accidents with sharp equipment. DHCW are at high risk of exposure to cross-infection with blood-borne pathogens such as hepatitis B virus, hepatitis C virus, human immunodeficiency virus (HIV), mycobacterium tuberculosis, streptococci, among other viruses and bacteria that colonize the oral cavity and upper respiratory tract (5). In the health care set up, care of the instruments and work environment to prevent cross-infection is paramount. To eliminate microorganisms, instruments should be exposed to steam at a specified temperature for a specific time. Although other options exist, the preferred temperature–pressure–time relationship for all small steam sterilizers is 134–137°C, 2.1–2.25 bar gauge pressure for at least a 3-minute holding time, or steam under pressure at a temperature of 121–134°C with time depending on the size of the load (6).

The working environment requires disinfection with the recommended disinfectants in-between patients to prevent cross-infection through the aerosol. Although medical and dental societies as well as governmental organizations have issued several recommendations and guidelines, studies show that infection is not well-controlled in dental settings and hospitals in many countries (7). Even in places where infection control protocols are followed and sterilization is carried out, sterilization is not regularly monitored. Monitoring sterilization is important, otherwise standards of sterilization bec