DOI: 10.4103/abhs.abhs_26_26 ISSN: 2773-1545

Risk factors of nosocomial infections in an urban health district, Cameroon: A cross-sectional study

Ngale Ebong Darlintine Ejede, Lingracia Nanga Nche Manju, Ebolo Mongo Guylaine Louise
Show PDF Cite

Background:

Nosocomial infections (NIs) remain a major public health challenge in low- and middle-income countries, where infection prevention and control (IPC) systems are often weak. Evidence from district-level health facilities in Cameroon is limited, despite their role as first points of referral care for large urban populations.

Methods:

A cross-sectional study was conducted from August to November 2023 in three health facilities of the Biyem-Assi Health District, Yaoundé, Cameroon. Hospitalized patients were enrolled, and IPC performance was assessed using the World Health Organization IPC Assessment Framework. Individual, facility-level, and environmental factors were documented through structured questionnaires and an observational checklist. Associations were analyzed using Chi-square tests and multivariable logistic regression.

Results:

Among 80 patients, the overall NI prevalence was 35.0% (95% confidence interval [CI]: 28.99–41.59). Female sex, lower educational level, lower income, and employment status were significantly associated with NI occurrence ( P < 0.05). In multivariable analysis, patients under 60 years of age (adjusted odds ratio [aOR] = 0.07; 95% CI: 0.02–0.16; P < 0.001) and unemployed patients (aOR = 0.16; 95% CI: 0.05–0.51; P = 0.003) had significantly lower odds of NIs. IPC performance was intermediate across all facilities, with critical gaps identified in hand hygiene infrastructure, toilet sanitation, cleaning frequency, and use of clinical uniforms. Proximity of food vendors, inadequate drainage, and poor waste management were the dominant extra-hospital risk factors.

Conclusion:

NIs are frequent in this urban Cameroonian health district and are driven by patient-level vulnerabilities, gaps in IPC implementation, and surrounding environmental sanitation deficits. Strengthening IPC core components and engaging multisector partners to address sanitation at the health facility–community interface are essential to reduce NI burden and limit antimicrobial resistance spread in rapidly urbanizing African settings.

More from our Archive