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Prevalence and Determinants of Blood Exposure Accidents Among Health Care Workers in Kalemie, Democratic Republic of the Congo: Cross-Sectional Study

JMIR Public Health Surveill. 2026 Aug 5;12:e97009. doi: 10.2196/97009.

ABSTRACT

BACKGROUND: Blood exposure accidents (BEAs) remain a major occupational hazard for health care providers, particularly in low‑resource settings. Despite their preventable nature, BEAs continue to occur frequently due to gaps in compliance with standard precautions and limited institutional surveillance.

OBJECTIVE: This study aimed to determine the prevalence and factors associated with BEAs among health care providers in Kalemie, Tanganyika Province, Democratic Republic of the Congo.

METHODS: A cross-sectional study was conducted in March 2024 among 316 health care providers randomly selected from 34 health facilities: public facilities (20/34, 58.8%), private facilities (9/34, 26.5%), and faith‑based facilities (5/34, 14.7%). Data were collected using a structured questionnaire adapted from World Health Organization and Centers for Disease Control and Prevention tools. Logistic regression was performed to identify predictors of BEAs, with adjusted odds ratios (AORs), 95% CIs, and P values reported.

RESULTS: The lifetime prevalence of BEAs was 65.8% (208/316), and the 12-month prevalence was 60.4% (191/316). The most frequent causes were unexpected patient movement (81/191, 42.4%) and lack of attention (66/191, 34.6%). Needlestick injuries accounted for 59.2% (113/191) of exposures. Only 36.1% (69/191) of incidents were formally reported. Multivariate analysis identified two independent predictors: (1) noncompliance with standard precautions (AOR 2.921, 95% CI 1.503-5.677; P=.001) and (2) facility type (working in secondary‑level facilities was protective; AOR 0.310, 95% CI 0.144-0.670; P=.003).

CONCLUSIONS: BEAs were highly prevalent among health care providers in Kalemie. Most incidents were preventable, and noncompliance with standard precautions significantly increased risk. Strengthening infection prevention and control measures, ensuring consistent availability of personal protective equipment, and establishing effective surveillance systems are urgently needed to protect health care workers and reinforce health system resilience.

PMID:42555929 | DOI:10.2196/97009

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