Prevalence and factors associated with Blood Exposure Accidents Among Healthcare Workers in Kalemie, Democratic Republic of Congo, March 2024: A Cross-Sectional Study

Prevalence and factors associated with Blood Exposure Accidents Among Healthcare Workers in Kalemie, Democratic Republic of Congo, March 2024: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence and factors associated with Blood Exposure Accidents Among Healthcare Workers in Kalemie, Democratic Republic of Congo, March 2024: A Cross-Sectional Study Joe KABAMBA DIBWE, Michel MWANANGONGO LUHEMBWE, Olivier MUKUKU, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7616605/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Blood exposure accidents (BEAs) represent a major occupational hazard for healthcare workers, particularly in low-resource settings. In Kalemie, Democratic Republic of Congo, limited access to protective equipment and inconsistent adherence to safety protocols increase the risk of exposure to blood and body fluids. Methods: A cross-sectional study was conducted in March 2024 among 316 healthcare providers working in various health facilities in Kalemie. Data were collected using a structured questionnaire and analyzed with SPSS version 26. Descriptive statistics, bivariate analysis, and multivariate logistic regression were used to identify factors associated with BEA occurrence. Results: Among participants, 64.8% [95% CI: 60.4–70.8] reported experiencing a BEA during their professional career, and 60.4% [95% CI: 54.9–65.6] within the past 12 months. The most common causes were unexpected patient movement (42.4%) and lack of attention (34.6%). In multivariate analysis, working in secondary-level facilities (AOR = 0.31; 95% CI: 0.14–0.67; p = 0.003) and inconsistent compliance with standard precautions (AOR = 2.92; 95% CI: 1.50–5.68; p = 0.001) were significantly associated with BEAs occurrence. Conclusion: BEAs remain highly prevalent among healthcare workers in Kalemie. Strengthening training on standard precautions, improving access to personal protective equipment, and promoting a culture of safety are essential to reduce occupational risks and improve worker protection. Blood exposure accidents associated factors healthcare workers Kalemie What This Study Adds What is known about this topic: Blood exposure accidents (BEAs) are a major occupational risk for healthcare workers in low-resource settings. Compliance with standard precautions is often inconsistent, and underreporting of BEAs is common. What this study adds: BEAs remain highly prevalent in Kalemie, DRC, particularly among nurses and general service staff. Non-compliance with standard precautions and needle recapping are key risk factors. Working in secondary-level facilities may offer protective institutional advantages. 1. Introduction Occupational exposure to blood and infectious body fluids remains a major public health concern, particularly for healthcare workers in low-resource settings. Blood exposure accidents (BEAs) refer to any accidental percutaneous or mucocutaneous contact with blood or biological fluids potentially contaminated by pathogens such as bacteria, viruses, parasites, or fungi(1,2). These exposures typically occur through needle-stick injuries, cuts, or splashes during clinical procedures. In addition to blood, other biological fluids including cerebrospinal fluid, synovial fluid, amniotic fluid, and genital secretions may also pose a risk of infection, even when not visibly contaminated with blood(2). According to the World Health Organization (WHO), approximately 3 out of 35 million healthcare workers are exposed to bloodborne pathogens annually, with the majority of these exposures occurring in developing countries (6,11). BEAs carry a substantial risk of transmitting serious infections such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). The likelihood of transmission varies depending on the pathogen and the nature of the exposure. For instance, the risk of HBV transmission following a needle-stick injury ranges from 10% to 40%, while the risk for HCV is approximately 2.1%, and 0.32% for HIV(3). The consequences of such infections can be severe, leading to chronic illness, permanent disability, or even death among healthcare workers(4,5). WHO estimates that nearly two million needle-stick injuries occur annually among healthcare workers; 40–60% of HBV and HCV infections in this population are occupationally acquired (5,6) Multiple factors contribute to the occurrence of BEAs, including lack of infection prevention training, inadequate availability of personal protective equipment (PPE), poor compliance with standard precautions, absence of infection control committees, improper handling of surgical instruments, and overcrowded or poorly designed workspaces (2,7,8). High-income countries have implemented surveillance systems and preventive measures to mitigate occupational exposure risks, including continuous staff training, routine use of PPE, and strict adherence to standard precautions (8). However, in many African countries, occupational exposure remains frequent, underreported and poorly documented (5,9). In West Africa, studies have reported BEAs prevalence rates as high as 72% (4), while in Lubumbashi, Democratic Republic of the Congo (DRC), 73.2% of healthcare workers have experienced BEAs (10). These exposures frequently occur in operating rooms and during suturing procedures, with needle-stick injuries being the most common mechanism (10,11). Although studies in the DRC suggest that nearly 50% of BEAs could be prevented through simple measures (16), implementation remains limited. In resource-constrained settings such as Kalemie, healthcare facilities often lack sufficient PPE and training programs. While some initiatives were introduced during the COVID-19 pandemic, support has since declined, leaving many facilities with inadequate capacity to sustain prevention efforts. Moreover, the absence of BEA surveillance systems, understaffing in primary care centers compared to hospitals, and insufficient data on prevention practices contribute to elevated occupational risks. This study aims to determine the prevalence of BEAs among healthcare providers in Kalemie and to identify the factors associated with these exposures. 2. Methods 2.1 Study Design and Setting A cross-sectional study was conducted in March 2024 among healthcare providers working in health facilities of Kalemie, Tanganyika Province, eastern Democratic Republic of Congo (DRC). Kalemie comprises two health zones Kalemie and Nyemba covering 11 health areas and a total of 45 public, private, and faith-based health facilities. 2.2 Sample Size and Sampling Technique The sample size was calculated using the single population proportion formula: n = [(zα/2)² × p (1 − p)] / d² , where z = 1.96 (for 95% confidence), p = 73.2% (estimated BEA prevalence from Malonga & Mbutshu, 2018), and d = 0.05 (margin of error). After accounting for a 10% non-response rate, the final sample size was set at 335 participants. A two-stage random sampling technique was applied. First, 34 health facilities were selected from the SNIS database. At the second stage, proportional allocation was used to distribute the sample across facilities, we first enumerated the healthcare providers within each health facility using declarative lists. The proportion of healthcare providers per facility was then calculated to determine the relative weight of each facility, using the following formula: Proportion per facility = (Number of healthcare providers in the facility) / (Total number of healthcare providers across all facilities) × 100 Based on this, the number of healthcare providers to be selected per facility was determined using the formula: Number of healthcare providers to be selected per facility = Proportion of healthcare providers per facility × Total number of healthcare providers to be selected. And healthcare providers were randomly selected using a random number generator based on staff rosters 2.3 Inclusion and Exclusion Criteria Inclusion criteria : Healthcare providers (nurses, physicians, midwives, laboratory technicians) with direct contact with blood or body fluids. Exclusion criteria : Providers with less than one month of professional experience, to ensure familiarity with workplace procedures and reduce onboarding variability. 2.4 Data Collection Tools and Procedures Data were collected using a structured questionnaire adapted from validated tools (5,17,18). The questionnaire included closed-ended items covering sociodemographic characteristics, BEA knowledge, attitudes, compliance with standard precautions, and exposure history. Face-to-face interviews were conducted using KoboCollect on tablets. Seven trained data collectors and one supervisor were recruited locally and trained over two days. Internal reliability was assessed using Cronbach’s alpha (α = 0.766). A pilot test was conducted at Baraka Health Post and Shalom Polyclinic. Each data collector interviewed approximately 10 healthcare providers per day over five days. Appointments were scheduled in advance with facility managers to ensure availability and minimize disruption. 2.5 Variables Dependent variable : Occupational exposure to blood within the past 12 months, defined as percutaneous or mucocutaneous contact with blood or biological fluids. Independent variables : Type of health facility: General Referral Hospital (GRH)/Referral Health Center (RHC)/Polyclinic vs Health Center (HC)/Health Post (HP)/Dispensary Sex, age, marital status Professional category (nurse, midwife, physician, lab technician) Service area (surgery, obstetrics, laboratory, internal medicine, pediatrics, general services, emergency) Years of experience Daily working hours Training on standard precautions Compliance with standard precautions Needle recapping practices Availability and use of PPE Syringe reuse 2.6 Data Analysis Data were verified, cleaned, and exported from KoboCollect to Excel 2016, then analyzed using SPSS version 25.0. Descriptive statistics summarized participant characteristics. Continuous variables (age, experience, working hours) were tested for normality using the Kolmogorov–Smirnov test and presented as medians with interquartile ranges (IQR). Knowledge scores were calculated from 31 items. Correct answers = 1 point; incorrect = 0. Scores were classified as: optimal (> 85%), moderate (70–85%) or poor (< 70%), as per Feyissa et al.(2) Bivariate associations were assessed using Chi-square tests. Variables with p ≤ 0.20 were included in a multivariate logistic regression model. Adjusted odds ratios (ORs) and 95% confidence intervals (CI) were reported. Statistical significance was set at p < 0.05. 2.7 Ethical Considerations Ethical approval was obtained from the Ethics Committee of the School of Public Health, University of Kinshasa (Ref: ESP/CE/38/2024). Written informed consent was obtained from all participants. Confidentiality was maintained, and no financial compensation was provided. 3. Results 3.1 Sociodemographic and Professional Characteristics Out of 316 healthcare providers surveyed, the majority (81.0%) worked in secondary-level health facilities (GRH, RHC, polyclinics); most were female (56.6%), married (72.8%), and aged 40 years or older (40.5%). Nurses represented the largest professional category (78.2%), followed by physicians (9.5%), laboratory technicians (6.6%), and midwives (5.7%) (Table 1 ). Regarding service assignment, 37.0% worked in general services, 19.3% in obstetrics and gynecology, and 12.7% in internal medicine. Most respondents had ≥ 5 years of professional experience (78.8%) and reported working ≤ 8 hours per day (66.1%) (Table 1 ). Table 1 Sociodemographic and Professional Characteristics of Healthcare Providers Characteristics Categories n = 316 % Type of Health Facility General/Referral Hospital/Polyclinic 256 81.0 Health Center/Post/Dispensary 60 19.0 Age (median: 38 years; IQR: 16 years) 19–29 years 66 20.9 30–39 years 122 38.6 ≥ 40 years 128 40.5 Sex Male 137 43.4 Female 179 56.6 Marital Status Single 57 18.0 Married 230 72.8 Common-law Union 4 1.3 Widowed 25 7.9 Professional Category Nurse 247 78.2 Midwife/Birth Attendant 18 5.7 Laboratory Technician 21 6.6 Physician 30 9.5 Department of Assignment Surgery/Operating Room 31 9.8 Obstetrics and Gynecology 61 19.3 Laboratory 31 9.8 Internal Medicine 40 12.7 Pediatrics 26 8.2 General Services 117 37.0 Emergency 10 3.2 Years of Experience (median: 9 years; IQR: 10 years) 8 hours 107 33.9 3.2 Prevalence and Circumstances of Blood Exposure Accidents (BEAs) (Table 2 ) Among the participants, 65.8% [95% CI: 60.4–70.8] reported experiencing a BEA during their career, and 60.4% [95% CI: 54.9–65.6] within the past 12 months. The most frequently cited causes of BEAs were unexpected patient movement (42.4%) and lack of attention (34.6%). BEAs occurred primarily in treatment rooms (33.5%), delivery rooms (17.3%), operating rooms (14.1%), laboratories (11.0%), patient rooms and emergency units (each 9.0%) The leading mechanism of exposure was needlestick injury (59.2%), followed by Splash on damaged skin (22.5%), Splash on mucous membranes (9.4%) and Blade injuries (7.3%). Objects most often involved included hollow needles (40.3%), defective surgical equipment (25.7%), catheters (15.2%), suture needles (12.6%) and blades (6.3%). Risky procedures included intramuscular injection (32.5%), suturing (14.1%), needle insertion/removal (11.5%) and blood sampling (11.0%) Only 36.1% of BEAs were formally reported. The main reason for non-reporting was the perception that the incident was not risky (57.4%). Table 2 Distribution of Healthcare Providers by Characteristics of Blood Exposure Accidents (BEA), Kalemie, March 2024 Characteristics n = 191 % BEA occurrence during professional career No 108 34.2 Yes 208 64.8 BEA occurrence in the past 12 months No 125 39.6 Yes 191 60.4 Cause of BEA Unexpected patient movement 81 42.4 Lack of attention 66 34.6 Lack of safety devices 23 12.0 Work context (stress, overload) 10 5.2 Lack of practical experience 7 3.7 Restricted workspace 4 2.1 Location of occurrence Treatment room 64 33.5 Delivery room 33 17.3 Operating room 27 14.1 Laboratory 21 11.0 Patient room 17 9.0 Emergency room 17 9.0 Other 8 4.2 Vaccination session 4 2.2 Mechanism of occurrence Needle stick 113 59.2 Splash on damaged skin 43 22.5 Splash on mucous membrane 18 9.4 Blade injury 14 7.3 Other 3 1.6 Incriminated object Hollow needle (syringe) 77 40.3 Defective surgical equipment 49 25.7 Catheter 29 15.2 Suture needle 24 12.6 Blade 12 6.3 Risky procedure responsible for BEA Intramuscular injection 62 32.5 Suturing 27 14.1 Needle insertion/removal 22 11.5 Blood sampling 21 11.0 Other 19 10.0 Surgical procedure 14 7.3 Delivery management 13 6.8 Puncture 7 3.7 Recapping used needle 6 3.1 3.3 Knowledge, Attitudes, and Practices Nearly all participants (97.8%) had heard of BEAs, mainly through formal education (40.5%) and training (40.5%). However, 72.8% had never received specific training on standard precautions, and 94.3% demonstrated poor knowledge levels (Table 3 ). Attitudes toward BEA prevention were mixed, 48.4% strongly agreed on the importance of reporting BEAs, 72.2% emphasized knowing the serological status of the source patient, 69.0% considered it important to know their own status and 73.4% expressed willingness to initiate post-exposure prophylaxis (Table 3 ). In practice, 76.6% claimed to always follow standard precautions, only 25.0% consistently washed hands before and after patient contact, 27.8% practiced needle recapping, 19.6% reported always using PPE during procedures and 16.5% admitted to reusing syringes (Table 3 ). Table 3 Knowledge of Healthcare Providers on Blood Exposure Accidents, Kalemie, March 2024 Characteristics n = 316 % Has information about BEA No 7 2.2 Yes 309 97.8 Source of information School/University 125 40.5 Radio 5 1.6 Colleague 25 8.1 Training 125 40.5 Official memo 8 2.6 Other sources 21 6.8 Training on standard precautions No 230 72.8 Yes 86 27.2 Level of knowledge on BEA Low 298 94.3 Moderate 16 5.1 Optimal 2 0.6 Importance of reporting BEA Strongly disagree 26 8.3 Slightly agree 29 9.2 Agree 106 33.5 Strongly agree 153 48.4 Don’t know 2 0.6 Importance of knowing patient’s serostatus Strongly disagree 10 3.1 Slightly agree 9 2.9 Agree 67 21.2 Strongly agree 228 72.2 Don’t know 2 0.6 Importance of knowing own serostatus Strongly disagree 6 1.9 Slightly agree 10 3.2 Agree 81 25.6 Strongly agree 218 69.0 Don’t know 1 0.3 Importance of PPE use in BEA prevention Strongly disagree 28 8.9 Slightly agree 69 21.8 Agree 139 44.0 Strongly agree 80 25.3 Post-exposure prophylaxis consideration No 84 26.6 Yes 232 73.4 Compliance with standard precautions Never 1 0.3 Rarely 36 11.4 Usually 37 11.7 Always 242 76.6 Hand hygiene Never 14 4.4 Rarely 67 21.2 Usually 156 49.4 Always 79 25.0 Needle recapping Never 89 28.2 Rarely 49 15.5 Usually 90 28.5 Always 88 27.8 Mouth pipetting Never 182 57.6 Rarely 7 2.2 Usually 11 3.5 Not applicable 116 36.7 Availability of PPE Rarely 99 31.0 Usually 137 43.4 Always 80 25.3 Use of PPE Never 1 0.3 Rarely 92 29.1 Usually 161 50.9 Always 62 19.6 Reuse of syringes No 264 83.5 Yes 52 16.5 a. Factors Associated with BEAs Bivariate analysis identified six factors significantly associated with BEA occurrence: Type of health facility, daily working hours, compliance with standard precautions, needle recapping practices, PPE usage, PPE availability. Healthcare providers in secondary-level facilities were significantly more likely to experience blood exposure accidents (BEAs) compared to those in primary-level settings (OR = 3.07; p 8 hours/day were also associated with increased risk (OR = 2.23; p = 0.001). Non-compliance with standard precautions markedly elevated the likelihood of BEAs (OR = 2.92; p < 0.001), while the practice of needle recapping was independently linked to a 2.59-fold increase in risk (aOR = 2.59; p < 0.001) (Table 4 ). Multivariate logistic regression confirmed two independent predictors: Working in secondary-level facilities was protective (AOR = 0.31; 95% CI: 0.14–0.67; p = 0.003) and non-compliance with standard precautions significantly increased risk (AOR = 2.92; 95% CI: 1.50–5.68; p = 0.001) (Table 4 ). Table 4 Bivariate and Multivariate Analysis of Factors Associated with Blood Exposure Accidents (BEA) Among Healthcare Providers in Kalemie, March 2024 Characteristics BEA Occurrence Bivariate Analysis Multivariate Analysis No (n = 125) Yes (n = 191) OR (95% CI) p-value Adjusted OR (95% CI) p-value Type of Health Facility General/Referral Hospital/Polyclinic 88 168 3.071 [1.718–5.490] < 0.001* 0.310 [0.144–0.670] 0.003* Health Center/Post/Dispensary 37 23 1 (ref) 1 (ref) Sex Male 58 79 0.815 [0.517–1.284] 0.377 — — Female 67 112 1 (ref) — — Age Group 19–29 years 32 34 0.681 [0.374–1.240] 0.209 — — 30–39 years 43 79 1.178 [0.704–1.969] 0.533 — — ≥ 40 years 50 78 1 (ref) — — Professional Category Midwife 7 11 1.179 [0.327–4.250] 0.802 — — Nurse 101 146 1.084 [0.440–2.669] 0.860 — — Physician 8 22 2.062 [0.631–6.739] 0.231 — — Lab Technician 9 12 1 (ref) — — Department of Assignment Surgery/Operating Room 6 25 2.206 [0.663–7.344] 0.197 0.458 [0.130–1.613] 0.224 Obstetrics & Gynecology 20 41 1.085 [0.412–2.859] 0.868 0.521 [0.171–1.589] 0.252 Laboratory 15 16 0.565 [0.193–1.649] 0.296 1.735 [0.314–9.593] 0.528 Internal Medicine 18 22 0.647 [0.233–1.795] 0.403 1.352 [0.463–3.944] 0.581 General Services 55 61 0.577 [0.238–1.398] 0.223 0.988 [0.370–2.641] 0.982 Emergency 1 9 4.765 [0.518–43.798] 0.168 0.282 [0.030–2.680] 0.270 Pediatrics 9 17 1 (ref) 1 (ref) Years of Experience 8 hours 56 51 2.228 [1.383–3.588] 0.001* 0.627 [0.359–1.093] 0.100 ≤ 8 hours 69 140 1 (ref) 1 (ref) Training on Standard Precautions No 95 135 0.761 [0.455–1.274] 0.300 — — Yes 30 56 1 (ref) — — Compliance with Standard Precautions Not always 14 38 2.915 [1.707–4.980] < 0.001** 2.921 [1.503–5.677] 0.001* Always 111 153 1 (ref) 1 (ref) Needle Recapping Always/Usually/Rarely 75 39 2.598 [1.573–4.292] < 0.001** 0.884 [0.459–1.703] 0.713 Never 50 152 1 (ref) 1 (ref) Availability of PPE Not always 85 151 0.563 [0.337–0.940] 0.028* 0.760 [0.397–1.458] 0.409 Always 40 40 1 (ref) 1 (ref) Use of PPE during procedures Not always 39 54 2.362 [1.344–4.152] 0.003* 0.546 [0.263–1.135] 0.105 Always 86 137 1 (ref) 1 (ref) Significance codes : • *p < 0.05 • **p < 0.001 4. Discussion This study revealed a high prevalence of blood exposure accidents (BEAs) among healthcare providers in Kalemie, with 65.8% [95% CI: 60.4–70.8] reporting at least one incident during their career and 60.4% [95% CI: 54.9–65.6] within the past 12 months. These findings confirm that occupational exposure to blood remains a persistent risk in low-resource settings and align with studies conducted in Ethiopia, China, and Morocco, where BEA rates range from 56.2% to 65.3% (6,12,13). However, the prevalence observed in Kalemie is lower than that reported in Lubumbashi (73.2%) and Southeast Ethiopia (78.3%) (10,14), yet significantly higher than rates documented in Malaysia (25.1%), Nigeria (34%), Iran (57.5%), Benin (14%), and Serbia (39%) (7,9,15–17). These disparities may reflect differences in training, infrastructure, supervision, and access to personal protective equipment (PPE). Moreover, a systematic review across sub-Saharan Africa reported lifetime needlestick injury prevalence ranging from 22% to 95%, with one-year rates between 39% and 91%. The review emphasized that poor training, limited access to PPE, and unsafe practices such as needle recapping were prevalent across all experience levels.(18) Beyond structural factors, individual and organizational predictors play a critical role in shaping BEA risk. Studies have shown that the lack of supervisory support and reliance on external or temporary staff have been associated with increased incidence rates(19). Workload intensity also emerges as a significant determinant: healthcare workers clocking more than 40 hours per week are nearly ten times more likely to experience BEAs. Inadequate PPE supply, poor adherence to infection prevention protocols such as recapping used needles and insufficient training in infection control further exacerbate the risk(20). Addressing these challenges calls for a multifaceted strategy. Structural improvements must be paired with behavioral interventions, including strengthened staff management, reliable PPE supply, and regular infection prevention and patient safety training. Such measures are essential to reduce occupational exposure and foster a safer clinical environment. The predominance of nurses among exposed professionals is consistent with findings from West Africa and Ethiopia, where nurses are frequently involved in invasive procedures and direct patient care (4,8,13). This trend is further supported by a national study in China, which found that over 52% of registered nurses had experienced occupational exposure to blood or body fluids, with higher risks among those working extended hours and lacking adequate PPE provision(21). In our study, most BEAs occurred in general services and obstetrics, reflecting patterns observed by Mekonnin et al. (22). These departments are characterized by high patient turnover and frequent use of needles and sharp instruments. However, other studies have identified surgical departments as high-risk areas. For instance, a study conducted in Tunisia revealed that 63.1% of operating room nurses had experienced at least one BEA, with needle pricks (81%) and cuts (37%) being the most common types of exposure Unsafe practices such as needle recapping and improper disposal of medical waste were the leading causes.(23) Similarly, research from Addis Ababa highlighted elevated exposure rates among nurses in emergency and intensive care units, with 76% reporting lifetime exposure and 64% within the past year. Contributing factors included inconsistent PPE use, lack of handwashing facilities, and inadequate training.(24) These findings suggest that exposure risk is not solely department dependent but is also shaped by systemic factors such as infrastructure, workload, and compliance with safety protocols. Tailored interventions such as department specific training, improved waste management, and consistent PPE provision are essential to mitigate BEA risks across diverse clinical settings. While most participants had ≥ 5 years of experience, other studies have shown that less experienced staff may be more vulnerable, particularly in primary-level facilities (2,14,25). This contrast highlights the importance of considering both experience and institutional context when assessing risk. A longitudinal study conducted in university hospitals in France identified younger age, irregular work schedules, and rotating shifts as significant individual-level predictors of BEA(19). These findings suggest that professional maturity alone does not guarantee lower risk; rather, the nature of the work environment and support systems play a crucial role. Studies have shown that younger healthcare workers, those with less experience, and those working irregular or rotating shifts are more susceptible to accidental exposure(19). In Cameroon, a study at the Ngaoundere Regional Hospital revealed that despite an average professional longevity of 9.14 years, 62.8% of healthcare workers had experienced at least one BEA, with needle-stick injuries being the most common (87.5%)(1). This suggests that even experienced staff remain vulnerable in settings where preventive knowledge and practices are insufficiently reinforced. These insights reinforce the importance of integrating continuous professional development, institutional safety culture, and adequate resource allocation into BEA prevention strategies. Experience must be contextualized within the broader framework of facility-level preparedness and staff support. The low rate of formal BEA reporting (36.1%) is concerning. The most cited reason perceiving the incident as “not risky” reflects a widespread underestimation of occupational hazards and a lack of institutional culture around incident reporting. Similar patterns have been observed in Cameroon and Ethiopia, where underreporting is linked to fear of blame, lack of follow-up, and unclear protocols (1,5). A study in Portugal found that underreporting was particularly high for mucocutaneous injuries (80.9%), with physicians being the least likely to report such incidents. The main barriers included excessive bureaucracy and underestimation of transmission risk(26). French university hospitals also reported high non-reporting rates, particularly among younger staff and surgical teams, who often cited complex procedures and lack of feedback as deterrents(27). These findings underscore that underreporting compromises surveillance systems, delays access to post-exposure prophylaxis (PEP), and hinders institutional learning. Although 73.4% of participants expressed a favorable attitude toward PEP, actual uptake and institutional support were not assessed an area warranting further investigation. A longitudinal study in France emphasized that organizational factors such as lack of supervisory support and reliance on external staff significantly increase BEA risk and reduce reporting compliance.(19) Addressing these gaps requires not only simplifying reporting procedures but also fostering a non-punitive culture of safety and accountability. The gap between self-reported compliance with standard precautions (76.6%) and actual practices such as hand hygiene (25%) and PPE use (19.6%) illustrates a “compliance gap” frequently documented in the literature (2,8). This phenomenon is not unique to Kalemie. A meta-analysis of 46 studies in LMICs found that actual adherence to standard precautions averaged only 53%(28). Systemic barriers such as workload pressure, PPE shortages, and lack of accountability mechanisms often explain this gap. In northeastern Ethiopia, a study revealed that actual compliance with standard precautions was as low as 19.2%, with poor infrastructure, negative attitudes, and limited experience significantly associated with non-compliance(29). Bridging this gap requires more than awareness campaigns. It demands consistent access to PPE, improved infrastructure such as reliable water supply and a robust safety culture supported by clear protocols and active supervision. Needle recapping, reported by 27.8% of participants, remains a persistent risk despite global recommendations against it. This practice continues to be a major contributor to needle-stick injuries (NSIs), exposing healthcare workers to bloodborne pathogens such as HIV, HBV, and HCV. A meta-analysis of 13 studies across Africa and Asia revealed that healthcare personnel who engaged in needle recapping were more than twice as likely to experience NSIs compared to those who did not (adjusted Odds Ratio = 2.04; 95% CI: 1.50–2.78; p < 0.001).(30) Studies from Ethiopia and Malaysia confirm that recapping significantly increases the likelihood of needle-stick injuries and should be actively discouraged (8,15). In a tertiary hospital in Somalia, hypodermic needles were the most common instruments involved in NSIs (81.1%), with operation theaters and inpatient care units being the most frequent sites of injury.(31) These data reinforce the urgency of strengthening training on safe injection practices, ensuring the availability of sharps disposal containers, and instituting strict monitoring. Institutional policies must go beyond technical directives and foster behavioral change through continuous education and accountability. Interestingly, multivariate analysis showed that working in secondary-level facilities was protective (AOR = 0.31), contrary to findings from other studies that reported higher exposure rates in hospitals due to procedural complexity (7,32). This divergence suggests that facility type alone may not be a sufficient predictor of blood exposure risk. Instead, contextual factors such as supervision quality, safety culture, and resource management appear to play a more decisive role. A longitudinal study conducted in university hospitals in France identified organizational predictors such as lack of supervisory support and reliance on external staff as significant contributors to accidental blood exposure, regardless of facility level.(19) Similarly, the World Health Organization emphasizes that successful implementation of universal precautions and infection control strategies depends on institutional commitment, staff training, and the availability of protective equipment not merely the level of care provided.(3) Moreover, secondary-level facilities may benefit from tighter team cohesion, more consistent supervision, and less procedural turnover, which can foster safer practices. These findings underscore the importance of assessing facility-level dynamics holistically. Rather than assuming higher risk based on institutional tier, future interventions should focus on strengthening safety culture, improving staff management, and ensuring adequate resource allocation across all levels of care. Finally, the lack of recent training on standard precautions reported by 70.68% of participants is a major concern. The last documented session occurred three years prior and targeted only a limited number of staff. This gap in continuing education echoes findings from Yenesew & Fekadu (8), Belachew et al. (13), and Yasin et al.(14), who emphasize the importance of regular, inclusive, and context-specific training programs. Recent studies reinforce this concern. In northeastern Ethiopia, only 19.2% of healthcare workers complied with standard precautions, with lack of training, absence of continuous water supply, and negative attitudes significantly associated with poor compliance (AOR = 2.51; 95% CI: 1.07–5.89)(29). In Cameroon, a study conducted in the obstetrics-gynecology department of a referral hospital revealed that although 82% of paramedical staff had received hand hygiene training during their initial education, gaps in ongoing training and low vaccination coverage contributed to high occupational exposure rates(33). Furthermore, a meta-analysis of 46 studies across low- and middle-income countries (LMICs) found that the pooled prevalence of standard precaution practices was only 53%, with training identified as a key determinant of compliance. The review emphasized that many institutions lacked structured refresher programs, and that systemic barriers such as time constraints, resource shortages, and unclear protocols undermined adherence even among knowledgeable staff.(28) These findings suggest that training must be not only regular but also tailored to the realities of each facility. One-off sessions targeting select staff are insufficient to foster a sustainable safety culture. Instead, institutions should implement continuous professional development programs, integrate infection prevention into onboarding and supervision, and ensure that all cadres including support staff are included. In summary, this study highlights the multifactorial nature of BEAs and the urgent need for systemic interventions. Addressing both individual behaviors and institutional barriers is essential to reduce occupational exposure and protect the health workforce in Kalemie and similar settings. Strengths and Limitations of the Study This study presents several limitations. The cross-sectional design does not allow for causal inference between the identified factors and the occurrence of blood exposure accidents (BEAs). Exposure data were collected through self-reporting, which may have introduced recall bias. Furthermore, the absence of qualitative data limits the ability to explore in depth the organizational and behavioral determinants underlying poor adherence to standard precautions. Nevertheless, the principal strength of this study lies in its status as the first investigation assessing occupational exposure to blood-related accidents and associated factors within the study area. In addition, the random selection of participants and the inclusion of both public and private health facilities, spanning primary and secondary levels of care, contribute to the adequate representativeness of the findings. Conclusion This study highlights the high prevalence of blood exposure accidents (BEAs) among healthcare providers in Kalemie, with nearly two-thirds of participants reporting incidents within the past year. The findings underscore the persistent occupational risks faced by frontline workers, particularly in environments with limited resources and inconsistent adherence to safety protocols. Key factors associated with BEA occurrence include non-compliance with standard precautions, needle recapping practices, and inadequate use of personal protective equipment (PPE). Conversely, working in secondary-level facilities was found to be protective, suggesting that institutional structure and supervision may play a critical role in mitigating exposure risks. Despite widespread awareness of blood exposure accidents (BEAs), knowledge levels among healthcare providers remain low, and preventive practices are inconsistently applied. The gap between intention and behavior particularly regarding hand hygiene, use of personal protective equipment (PPE), and incident reporting reflects systemic challenges that require coordinated interventions. These findings underscore the need for targeted health policy measures, including the institutionalization of continuous training programs, reinforcement of supervision mechanisms, and integration of BEA prevention into routine quality assurance frameworks. Moreover, policies should prioritize resource allocation for PPE availability, promote a non-punitive culture of incident reporting, and establish accountability structures at facility level to ensure adherence to standard precautions. Addressing these gaps is essential to reduce occupational risks and strengthen infection prevention and control (IPC) across all levels of the health system. These measures are essential to protect healthcare providers, improve quality of care, and strengthen the resilience of the health system in Kalemie and beyond. Declarations Ethics approval and consent to participate Ethical approval was obtained from the Ethics Committee of the School of Public Health, University of Kinshasa (Ref: ESP/ESP/38/2024). Written informed consent was obtained from all participants prior to their inclusion in the study. Participation was entirely voluntary, and no financial compensation was provided. Confidentiality of personal data was strictly maintained throughout the study, and all data were used solely for research purposes. All procedures involving human participants were conducted in accordance with ethical standards of the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Consent for publication Not applicable. No identifiable personal data were published in this study. All information presented is anonymous and aggregated, ensuring that individual participants can be identified. Data availability All data generated or analyzed during this study are included in this published article. Original data are available from the corresponding author upon reasonable request. Conflicts of Interest The authors declare no conflicts of interest related to this study. Funding This research received no external funding. All data collection and analysis activities were supported by the authors’ institutions. Authors’ Contributions JDK : Conceptualization, study design, data collection supervision, statistical analysis, manuscript drafting and revision. DMM : Conceptualization, study design, Critical revision of the manuscript for intellectual content. MML: statistical analysis, revision of the manuscript , OM: Critical revision of the manuscript All authors have read and approved the final version of the manuscript. Acknowledgements The authors wish to thank the Provincial Health Division of Tanganyika for administrative support, the managers of participating health facilities for their collaboration, and the healthcare providers who generously contributed their time and insights to this study. References Karyom DAN, Bong-Akee S, Honore ER, Gael OM, Collins BN, Yanick DN, et al. Blood Exposure Accidents among Health Care Personnel at the Ngaoundere Regional Hospital in Northern Cameroon: Knowledge, Practical Attitudes, and Means of Prevention. 2022;10(6). Feyissa Regassa S, Deneke Wolde, Merga Belina, Kehabtimer Shiferaw Kotiso, Girmay Medhin, Wondwossen Amogne, et al. Compliance with infection prevention and control standard precautions and factors associated with noncompliance among healthcare workers working in public hospitals in Addis Ababa, Ethiopia. Antimicrobial Resistance & Infection Control. 2024;(13:32):12. World Health Organization. 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Mekonnin T, Tsegaye A, Berihun A, Kassachew H, Sileshi A. Occupational Exposure to Blood and Body Fluids among Health Care Workers in Mizan Tepi University Teaching Hospital, Bench Maji Zone, South West Ethiopia. Med Saf Glob Health [Internet]. 2018 [cité 18 nov 2024];07(02). Disponible sur: https://www.omicsonline.org/open-access/occupational-exposure-to-blood-and-body-fluids-among-health-care-workers-in-mizan-tepi-university-teaching-hospital-bench-maji-zon-2574-0407-1000146-106695.html Belgacem A, Neffati A, Atfi S, Hammemi N, Soussi S, Ghali H. Descriptive correlational study of knowledge, attitudes and practices related to blood exposure accidents among operating room nurses in the two university hospitals of Sousse. LA TUNISIE MEDICALE. 2023;Vol 10(1 (12)):891‑8. Adal O, Abebe A. Occupational Exposure to Blood and Body Fluids Among Nurses in Public Hospitals of the Emergency Department and Intensive Care Unit, Addis Ababa, Ethiopia: Cross-sectional Study [Internet]. In Review; 2022 [cité 13 nov 2024]. Disponible sur: https://www.researchsquare.com/article/rs-1272527/v1 Abere G, Yenealem DG, Wami SD. Occupational Exposure to Blood and Body Fluids among Health Care Workers in Gondar Town, Northwest Ethiopia: A Result from Cross-Sectional Study. Journal of Environmental and Public Health. 15 mai 2020;2020:1‑9. Vieira C, Góis J, Laranjeira P, Pinho P, Norton P. Underreporting of work accidents associated with blood-borne risk factors. La Medicina del Lavoro. 28 juin 2022;113(3):e2022028. Battail T, Fort E, Denis MA, Fassier JB, Bonneterre V, Dutheil F, et al. Underreporting of occupational blood and body fluid exposure in French university hospitals in 2017. WORK. 13 déc 2022;73(4):1393‑403. Yilma M, Taye G, Abebe W. Magnitude of standard precautions practices among healthcare workers in health facilities of Low and Middle Income Countries: A systematic review and meta-analysis. PLoS ONE [Internet]. April;2024(19(4): e0302282.). Disponible sur: https://doi.org/10.1371/journal.pone.0302282 Keleb A, Lingerew M, Adema A, Berihun G, Sisay T, Adanel M. The magnitude of standard precautions practice and its associated factors among healthcare workers in governmental hospitals of northeastern Ethiopia. Frontiers in in Health Services. Andriyani S, Demartoto A, Murti B. Meta-analysis: Effect of training and needle recapping on needle stick injury in health workers. Journal of Health Policy and Management. 2024;9(2):1‑10. Mohamud RYH, Mohamed N, Doğan A, Hilowle F, Isse S, Hassan M, et al. Needlestick and Sharps Injuries Among Healthcare Workers at a Tertiary Care Hospital: A Retrospective Single-Center Study. RMHP. nov 2023;Volume 16:2281‑9. Lemessa D, Solomon T. Occupational Exposure of Health-Care Workers to Blood and Body Fluids in West Shewa Zone, Ethiopia, 2018: A Cross-Sectional Study. A. Al-Khatib I, éditeur. Journal of Environmental and Public Health. 31 déc 2021;2021:1‑7. Cheuyem L, Zobel F, Enjema LE, Innocent T. Standard precautions perception and practice among health workers in the obstetrics- gynecology department of a referral hospital in Cameroon. BMC Health Services Research. 2025;25(1165). Additional Declarations No competing interests reported. Supplementary Files Datacollectiontool.pdf Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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this study adds:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBEAs remain highly prevalent in Kalemie, DRC, particularly among nurses and general service staff.\u003c/p\u003e\n\u003cp\u003eNon-compliance with standard precautions and needle recapping are key risk factors.\u003c/p\u003e\n\u003cp\u003eWorking in secondary-level facilities may offer protective institutional advantages.\u003c/p\u003e"},{"header":"1. Introduction","content":"\u003cp\u003eOccupational exposure to blood and infectious body fluids remains a major public health concern, particularly for healthcare workers in low-resource settings. Blood exposure accidents (BEAs) refer to any accidental percutaneous or mucocutaneous contact with blood or biological fluids potentially contaminated by pathogens such as bacteria, viruses, parasites, or fungi(1,2). These exposures typically occur through needle-stick injuries, cuts, or splashes during clinical procedures.\u003c/p\u003e\u003cp\u003eIn addition to blood, other biological fluids including cerebrospinal fluid, synovial fluid, amniotic fluid, and genital secretions may also pose a risk of infection, even when not visibly contaminated with blood(2). According to the World Health Organization (WHO), approximately 3 out of 35\u0026nbsp;million healthcare workers are exposed to bloodborne pathogens annually, with the majority of these exposures occurring in developing countries (6,11).\u003c/p\u003e\u003cp\u003eBEAs carry a substantial risk of transmitting serious infections such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). The likelihood of transmission varies depending on the pathogen and the nature of the exposure. For instance, the risk of HBV transmission following a needle-stick injury ranges from 10% to 40%, while the risk for HCV is approximately 2.1%, and 0.32% for HIV(3).\u003c/p\u003e\u003cp\u003eThe consequences of such infections can be severe, leading to chronic illness, permanent disability, or even death among healthcare workers(4,5). WHO estimates that nearly two million needle-stick injuries occur annually among healthcare workers; 40\u0026ndash;60% of HBV and HCV infections in this population are occupationally acquired (5,6)\u003c/p\u003e\u003cp\u003eMultiple factors contribute to the occurrence of BEAs, including lack of infection prevention training, inadequate availability of personal protective equipment (PPE), poor compliance with standard precautions, absence of infection control committees, improper handling of surgical instruments, and overcrowded or poorly designed workspaces (2,7,8).\u003c/p\u003e\u003cp\u003eHigh-income countries have implemented surveillance systems and preventive measures to mitigate occupational exposure risks, including continuous staff training, routine use of PPE, and strict adherence to standard precautions (8). However, in many African countries, occupational exposure remains frequent, underreported and poorly documented (5,9).\u003c/p\u003e\u003cp\u003eIn West Africa, studies have reported BEAs prevalence rates as high as 72% (4), while in Lubumbashi, Democratic Republic of the Congo (DRC), 73.2% of healthcare workers have experienced BEAs (10). These exposures frequently occur in operating rooms and during suturing procedures, with needle-stick injuries being the most common mechanism (10,11).\u003c/p\u003e\u003cp\u003eAlthough studies in the DRC suggest that nearly 50% of BEAs could be prevented through simple measures (16), implementation remains limited. In resource-constrained settings such as Kalemie, healthcare facilities often lack sufficient PPE and training programs. While some initiatives were introduced during the COVID-19 pandemic, support has since declined, leaving many facilities with inadequate capacity to sustain prevention efforts.\u003c/p\u003e\u003cp\u003eMoreover, the absence of BEA surveillance systems, understaffing in primary care centers compared to hospitals, and insufficient data on prevention practices contribute to elevated occupational risks. This study aims to determine the prevalence of BEAs among healthcare providers in Kalemie and to identify the factors associated with these exposures.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1 Study Design and Setting\u003c/h2\u003e\u003cp\u003eA cross-sectional study was conducted in March 2024 among healthcare providers working in health facilities of Kalemie, Tanganyika Province, eastern Democratic Republic of Congo (DRC). Kalemie comprises two health zones Kalemie and Nyemba covering 11 health areas and a total of 45 public, private, and faith-based health facilities.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2 Sample Size and Sampling Technique\u003c/h2\u003e\u003cp\u003eThe sample size was calculated using the single population proportion formula:\u003c/p\u003e\u003cp\u003e\u003cem\u003en = [(zα/2)\u0026sup2; \u0026times; p (1\u0026thinsp;\u0026minus;\u0026thinsp;p)] / d\u0026sup2;\u003c/em\u003e, where \u003cem\u003ez\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.96 (for 95% confidence), \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;73.2% (estimated BEA prevalence from Malonga \u0026amp; Mbutshu, 2018), and \u003cem\u003ed\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.05 (margin of error). After accounting for a 10% non-response rate, the final sample size was set at 335 participants.\u003c/p\u003e\u003cp\u003eA two-stage random sampling technique was applied. First, 34 health facilities were selected from the SNIS database. At the second stage, proportional allocation was used to distribute the sample across facilities, we first enumerated the healthcare providers within each health facility using declarative lists. The proportion of healthcare providers per facility was then calculated to determine the relative weight of each facility, using the following formula:\u003c/p\u003e\u003cp\u003e\u003cb\u003eProportion per facility\u003c/b\u003e = (Number of healthcare providers in the facility) / (Total number of healthcare providers across all facilities) \u0026times; 100\u003c/p\u003e\u003cp\u003eBased on this, the number of healthcare providers to be selected per facility was determined using the formula:\u003c/p\u003e\u003cp\u003e\u003cb\u003eNumber of healthcare providers to be selected per facility\u003c/b\u003e\u0026thinsp;=\u0026thinsp;Proportion of healthcare providers per facility \u0026times; Total number of healthcare providers to be selected.\u003c/p\u003e\u003cp\u003eAnd healthcare providers were randomly selected using a random number generator based on staff rosters\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3 Inclusion and Exclusion Criteria\u003c/h2\u003e\u003cp\u003e\u003cb\u003eInclusion criteria\u003c/b\u003e:\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eHealthcare providers (nurses, physicians, midwives, laboratory technicians) with direct contact with blood or body fluids.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eExclusion criteria\u003c/b\u003e:\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eProviders with less than one month of professional experience, to ensure familiarity with workplace procedures and reduce onboarding variability.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e2.4 Data Collection Tools and Procedures\u003c/h2\u003e\u003cp\u003eData were collected using a structured questionnaire adapted from validated tools (5,17,18). The questionnaire included closed-ended items covering sociodemographic characteristics, BEA knowledge, attitudes, compliance with standard precautions, and exposure history.\u003c/p\u003e\u003cp\u003eFace-to-face interviews were conducted using KoboCollect on tablets. Seven trained data collectors and one supervisor were recruited locally and trained over two days. Internal reliability was assessed using Cronbach\u0026rsquo;s alpha (α\u0026thinsp;=\u0026thinsp;0.766). A pilot test was conducted at Baraka Health Post and Shalom Polyclinic.\u003c/p\u003e\u003cp\u003eEach data collector interviewed approximately 10 healthcare providers per day over five days. Appointments were scheduled in advance with facility managers to ensure availability and minimize disruption.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003e2.5 Variables\u003c/h2\u003e\u003cp\u003e\u003cb\u003eDependent variable\u003c/b\u003e :\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eOccupational exposure to blood within the past 12 months, defined as percutaneous or mucocutaneous contact with blood or biological fluids.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eIndependent variables\u003c/b\u003e :\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eType of health facility: General Referral Hospital (GRH)/Referral Health Center (RHC)/Polyclinic vs Health Center (HC)/Health Post (HP)/Dispensary\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eSex, age, marital status\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eProfessional category (nurse, midwife, physician, lab technician)\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eService area (surgery, obstetrics, laboratory, internal medicine, pediatrics, general services, emergency)\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eYears of experience\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eDaily working hours\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eTraining on standard precautions\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eCompliance with standard precautions\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eNeedle recapping practices\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eAvailability and use of PPE\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eSyringe reuse\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e2.6 Data Analysis\u003c/h2\u003e\u003cp\u003eData were verified, cleaned, and exported from KoboCollect to Excel 2016, then analyzed using SPSS version 25.0. Descriptive statistics summarized participant characteristics. Continuous variables (age, experience, working hours) were tested for normality using the Kolmogorov\u0026ndash;Smirnov test and presented as medians with interquartile ranges (IQR). Knowledge scores were calculated from 31 items. Correct answers\u0026thinsp;=\u0026thinsp;1 point; incorrect\u0026thinsp;=\u0026thinsp;0. Scores were classified as: optimal (\u0026gt;\u0026thinsp;85%), moderate (70\u0026ndash;85%) or poor (\u0026lt;\u0026thinsp;70%), as per Feyissa et al.(2)\u003c/p\u003e\u003cp\u003eBivariate associations were assessed using Chi-square tests. Variables with \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026le;\u0026thinsp;0.20 were included in a multivariate logistic regression model. Adjusted odds ratios (ORs) and 95% confidence intervals (CI) were reported. Statistical significance was set at \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e2.7 Ethical Considerations\u003c/h2\u003e\u003cp\u003e\u003cstrong\u003eEthical approval\u003c/strong\u003e\u003cp\u003e was obtained from the Ethics Committee of the School of Public Health, University of Kinshasa (Ref: ESP/CE/38/2024). Written informed consent was obtained from all participants. Confidentiality was maintained, and no financial compensation was provided.\u003c/p\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003e3.1 Sociodemographic and Professional Characteristics\u003c/h2\u003e\u003cp\u003eOut of 316 healthcare providers surveyed, the majority (81.0%) worked in secondary-level health facilities (GRH, RHC, polyclinics); most were female (56.6%), married (72.8%), and aged 40 years or older (40.5%). Nurses represented the largest professional category (78.2%), followed by physicians (9.5%), laboratory technicians (6.6%), and midwives (5.7%) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eRegarding service assignment, 37.0% worked in general services, 19.3% in obstetrics and gynecology, and 12.7% in internal medicine. Most respondents had\u0026thinsp;\u0026ge;\u0026thinsp;5 years of professional experience (78.8%) and reported working\u0026thinsp;\u0026le;\u0026thinsp;8 hours per day (66.1%) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSociodemographic and Professional Characteristics of Healthcare Providers\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategories\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003en\u0026thinsp;=\u0026thinsp;316\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eType of Health Facility\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGeneral/Referral Hospital/Polyclinic\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e256\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e81.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHealth Center/Post/Dispensary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e19.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge (median: 38 years; IQR: 16 years)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e19\u0026ndash;29 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e20.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e30\u0026ndash;39 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e122\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e38.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;40 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e128\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e40.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e137\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e43.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e179\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e56.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e18.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e230\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e72.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCommon-law Union\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWidowed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eProfessional Category\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e247\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e78.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMidwife/Birth Attendant\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLaboratory Technician\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePhysician\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e9.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDepartment of Assignment\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSurgery/Operating Room\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e9.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eObstetrics and Gynecology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e19.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLaboratory\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e9.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInternal Medicine\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e12.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePediatrics\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGeneral Services\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e117\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e37.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEmergency\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eYears of Experience (median: 9 years; IQR: 10 years)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e21.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e249\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e78.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWorkload (median: 8 hours; IQR: 1 hour)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;8 hours\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e209\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e66.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;8 hours\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e107\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e33.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003e3.2 Prevalence and Circumstances of Blood Exposure Accidents (BEAs) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e)\u003c/h2\u003e\u003cp\u003eAmong the participants, 65.8% [95% CI: 60.4\u0026ndash;70.8] reported experiencing a BEA during their career, and 60.4% [95% CI: 54.9\u0026ndash;65.6] within the past 12 months.\u003c/p\u003e\u003cp\u003eThe most frequently cited causes of BEAs were unexpected patient movement (42.4%) and lack of attention (34.6%). BEAs occurred primarily in treatment rooms (33.5%), delivery rooms (17.3%), operating rooms (14.1%), laboratories (11.0%), patient rooms and emergency units (each 9.0%)\u003c/p\u003e\u003cp\u003eThe leading mechanism of exposure was needlestick injury (59.2%), followed by Splash on damaged skin (22.5%), Splash on mucous membranes (9.4%) and Blade injuries (7.3%). Objects most often involved included hollow needles (40.3%), defective surgical equipment (25.7%), catheters (15.2%), suture needles (12.6%) and blades (6.3%). Risky procedures included intramuscular injection (32.5%), suturing (14.1%), needle insertion/removal (11.5%) and blood sampling (11.0%)\u003c/p\u003e\u003cp\u003eOnly 36.1% of BEAs were formally reported. The main reason for non-reporting was the perception that the incident was not risky (57.4%).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDistribution of Healthcare Providers by Characteristics of Blood Exposure Accidents (BEA), Kalemie, March 2024\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003en\u0026thinsp;=\u0026thinsp;191\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBEA occurrence during professional career\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e108\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e34.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e208\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e64.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eBEA occurrence in the past 12 months\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e125\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e39.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e191\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e60.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCause of BEA\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUnexpected patient movement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e42.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLack of attention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e34.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLack of safety devices\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWork context (stress, overload)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLack of practical experience\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRestricted workspace\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLocation of occurrence\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTreatment room\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e33.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDelivery room\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e17.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOperating room\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLaboratory\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePatient room\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmergency room\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOther\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVaccination session\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMechanism of occurrence\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNeedle stick\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e113\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e59.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSplash on damaged skin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSplash on mucous membrane\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBlade injury\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e7.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOther\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIncriminated object\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHollow needle (syringe)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDefective surgical equipment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e25.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCatheter\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSuture needle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBlade\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eRisky procedure responsible for BEA\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIntramuscular injection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e32.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSuturing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNeedle insertion/removal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBlood sampling\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOther\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSurgical procedure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e7.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDelivery management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePuncture\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRecapping used needle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003e3.3 Knowledge, Attitudes, and Practices\u003c/h2\u003e\u003cp\u003eNearly all participants (97.8%) had heard of BEAs, mainly through formal education (40.5%) and training (40.5%). However, 72.8% had never received specific training on standard precautions, and 94.3% demonstrated poor knowledge levels (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAttitudes toward BEA prevention were mixed, 48.4% strongly agreed on the importance of reporting BEAs, 72.2% emphasized knowing the serological status of the source patient, 69.0% considered it important to know their own status and 73.4% expressed willingness to initiate post-exposure prophylaxis (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn practice, 76.6% claimed to always follow standard precautions, only 25.0% consistently washed hands before and after patient contact, 27.8% practiced needle recapping, 19.6% reported always using PPE during procedures and 16.5% admitted to reusing syringes (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eKnowledge of Healthcare Providers on Blood Exposure Accidents, Kalemie, March 2024\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003en\u0026thinsp;=\u0026thinsp;316\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHas information about BEA\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e309\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e97.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSource of information\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSchool/University\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e125\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRadio\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eColleague\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTraining\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e125\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOfficial memo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOther sources\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTraining on standard precautions\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e230\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e72.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e27.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLevel of knowledge on BEA\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e298\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e94.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eModerate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOptimal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eImportance of reporting BEA\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStrongly disagree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSlightly agree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAgree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e106\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e33.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStrongly agree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e153\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e48.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDon\u0026rsquo;t know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eImportance of knowing patient\u0026rsquo;s serostatus\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStrongly disagree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSlightly agree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAgree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e21.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStrongly agree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e228\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e72.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDon\u0026rsquo;t know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eImportance of knowing own serostatus\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStrongly disagree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSlightly agree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAgree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e25.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStrongly agree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e218\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e69.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDon\u0026rsquo;t know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eImportance of PPE use in BEA prevention\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStrongly disagree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSlightly agree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e21.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAgree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e139\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e44.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStrongly agree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e25.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePost-exposure prophylaxis consideration\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e26.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e232\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e73.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCompliance with standard precautions\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNever\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRarely\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUsually\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlways\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e242\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e76.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eHand hygiene\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNever\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRarely\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e21.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUsually\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e156\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e49.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlways\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e25.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNeedle recapping\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNever\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRarely\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUsually\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlways\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e27.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMouth pipetting\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNever\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e182\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e57.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRarely\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUsually\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot applicable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e116\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e36.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAvailability of PPE\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRarely\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e31.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUsually\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e137\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e43.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlways\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e25.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eUse of PPE\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNever\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRarely\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e29.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUsually\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e161\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e50.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlways\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e19.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eReuse of syringes\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e264\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e83.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003ea. Factors Associated with BEAs\u003c/em\u003e\u003c/p\u003e\u003cp\u003eBivariate analysis identified six factors significantly associated with BEA occurrence: Type of health facility, daily working hours, compliance with standard precautions, needle recapping practices, PPE usage, PPE availability.\u003c/p\u003e\u003cp\u003eHealthcare providers in secondary-level facilities were significantly more likely to experience blood exposure accidents (BEAs) compared to those in primary-level settings (OR\u0026thinsp;=\u0026thinsp;3.07; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Those working\u0026thinsp;\u0026gt;\u0026thinsp;8 hours/day were also associated with increased risk (OR\u0026thinsp;=\u0026thinsp;2.23; p\u0026thinsp;=\u0026thinsp;0.001). Non-compliance with standard precautions markedly elevated the likelihood of BEAs (OR\u0026thinsp;=\u0026thinsp;2.92; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), while the practice of needle recapping was independently linked to a 2.59-fold increase in risk (aOR\u0026thinsp;=\u0026thinsp;2.59; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eMultivariate logistic regression confirmed two independent predictors: Working in secondary-level facilities was protective (AOR\u0026thinsp;=\u0026thinsp;0.31; 95% CI: 0.14\u0026ndash;0.67; p\u0026thinsp;=\u0026thinsp;0.003) and non-compliance with standard precautions significantly increased risk (AOR\u0026thinsp;=\u0026thinsp;2.92; 95% CI: 1.50\u0026ndash;5.68; p\u0026thinsp;=\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eBivariate and Multivariate Analysis of Factors Associated with Blood Exposure Accidents (BEA) Among Healthcare Providers in Kalemie, March 2024\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eBEA Occurrence\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eBivariate Analysis\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u003cp\u003eMultivariate Analysis\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo (n\u0026thinsp;=\u0026thinsp;125)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eYes (n\u0026thinsp;=\u0026thinsp;191)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eOR (95% CI)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eAdjusted OR (95% CI)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eType of Health Facility\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGeneral/Referral Hospital/Polyclinic\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e168\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3.071 [1.718\u0026ndash;5.490]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.310 [0.144\u0026ndash;0.670]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e0.003*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHealth Center/Post/Dispensary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (ref)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1 (ref)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.815 [0.517\u0026ndash;1.284]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.377\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e112\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (ref)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge Group\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e19\u0026ndash;29 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.681 [0.374\u0026ndash;1.240]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.209\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e30\u0026ndash;39 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.178 [0.704\u0026ndash;1.969]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.533\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;40 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (ref)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eProfessional Category\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMidwife\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.179 [0.327\u0026ndash;4.250]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.802\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e101\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e146\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.084 [0.440\u0026ndash;2.669]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.860\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePhysician\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.062 [0.631\u0026ndash;6.739]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.231\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLab Technician\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (ref)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDepartment of Assignment\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSurgery/Operating Room\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.206 [0.663\u0026ndash;7.344]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.197\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.458 [0.130\u0026ndash;1.613]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.224\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eObstetrics \u0026amp; Gynecology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.085 [0.412\u0026ndash;2.859]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.868\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.521 [0.171\u0026ndash;1.589]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.252\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLaboratory\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.565 [0.193\u0026ndash;1.649]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.296\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.735 [0.314\u0026ndash;9.593]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.528\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInternal Medicine\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.647 [0.233\u0026ndash;1.795]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.403\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.352 [0.463\u0026ndash;3.944]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.581\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGeneral Services\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.577 [0.238\u0026ndash;1.398]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.223\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.988 [0.370\u0026ndash;2.641]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.982\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmergency\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.765 [0.518\u0026ndash;43.798]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.168\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.282 [0.030\u0026ndash;2.680]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.270\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePediatrics\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (ref)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1 (ref)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eYears of Experience\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.822 [0.476\u0026ndash;1.420]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.483\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e153\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (ref)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWorkload\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;8 hours\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.228 [1.383\u0026ndash;3.588]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.001*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.627 [0.359\u0026ndash;1.093]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.100\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;8 hours\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (ref)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1 (ref)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTraining on Standard Precautions\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e135\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.761 [0.455\u0026ndash;1.274]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.300\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (ref)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCompliance with Standard Precautions\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot always\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.915 [1.707\u0026ndash;4.980]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001**\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.921 [1.503\u0026ndash;5.677]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e0.001*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlways\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e111\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e153\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (ref)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1 (ref)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNeedle Recapping\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlways/Usually/Rarely\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.598 [1.573\u0026ndash;4.292]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001**\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.884 [0.459\u0026ndash;1.703]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.713\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNever\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e152\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (ref)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1 (ref)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAvailability of PPE\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot always\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e151\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.563 [0.337\u0026ndash;0.940]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.028*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.760 [0.397\u0026ndash;1.458]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.409\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlways\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (ref)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1 (ref)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eUse of PPE during procedures\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot always\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.362 [1.344\u0026ndash;4.152]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.003*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.546 [0.263\u0026ndash;1.135]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.105\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlways\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e137\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (ref)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1 (ref)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003cb\u003eSignificance codes\u003c/b\u003e:\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u0026bull; *p\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u0026bull; **p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThis study revealed a high prevalence of blood exposure accidents (BEAs) among healthcare providers in Kalemie, with 65.8% [95% CI: 60.4\u0026ndash;70.8] reporting at least one incident during their career and 60.4% [95% CI: 54.9\u0026ndash;65.6] within the past 12 months. These findings confirm that occupational exposure to blood remains a persistent risk in low-resource settings and align with studies conducted in Ethiopia, China, and Morocco, where BEA rates range from 56.2% to 65.3% (6,12,13).\u003c/p\u003e\u003cp\u003eHowever, the prevalence observed in Kalemie is lower than that reported in Lubumbashi (73.2%) and Southeast Ethiopia (78.3%) (10,14), yet significantly higher than rates documented in Malaysia (25.1%), Nigeria (34%), Iran (57.5%), Benin (14%), and Serbia (39%) (7,9,15\u0026ndash;17). These disparities may reflect differences in training, infrastructure, supervision, and access to personal protective equipment (PPE).\u003c/p\u003e\u003cp\u003eMoreover, a systematic review across sub-Saharan Africa reported lifetime needlestick injury prevalence ranging from 22% to 95%, with one-year rates between 39% and 91%. The review emphasized that poor training, limited access to PPE, and unsafe practices such as needle recapping were prevalent across all experience levels.(18)\u003c/p\u003e\u003cp\u003eBeyond structural factors, individual and organizational predictors play a critical role in shaping BEA risk. Studies have shown that the lack of supervisory support and reliance on external or temporary staff have been associated with increased incidence rates(19).\u003c/p\u003e\u003cp\u003eWorkload intensity also emerges as a significant determinant: healthcare workers clocking more than 40 hours per week are nearly ten times more likely to experience BEAs. Inadequate PPE supply, poor adherence to infection prevention protocols such as recapping used needles and insufficient training in infection control further exacerbate the risk(20).\u003c/p\u003e\u003cp\u003eAddressing these challenges calls for a multifaceted strategy. Structural improvements must be paired with behavioral interventions, including strengthened staff management, reliable PPE supply, and regular infection prevention and patient safety training. Such measures are essential to reduce occupational exposure and foster a safer clinical environment.\u003c/p\u003e\u003cp\u003eThe predominance of nurses among exposed professionals is consistent with findings from West Africa and Ethiopia, where nurses are frequently involved in invasive procedures and direct patient care (4,8,13). This trend is further supported by a national study in China, which found that over 52% of registered nurses had experienced occupational exposure to blood or body fluids, with higher risks among those working extended hours and lacking adequate PPE provision(21).\u003c/p\u003e\u003cp\u003eIn our study, most BEAs occurred in general services and obstetrics, reflecting patterns observed by Mekonnin et al. (22). These departments are characterized by high patient turnover and frequent use of needles and sharp instruments. However, other studies have identified surgical departments as high-risk areas. For instance, a study conducted in Tunisia revealed that 63.1% of operating room nurses had experienced at least one BEA, with needle pricks (81%) and cuts (37%) being the most common types of exposure Unsafe practices such as needle recapping and improper disposal of medical waste were the leading causes.(23)\u003c/p\u003e\u003cp\u003eSimilarly, research from Addis Ababa highlighted elevated exposure rates among nurses in emergency and intensive care units, with 76% reporting lifetime exposure and 64% within the past year. Contributing factors included inconsistent PPE use, lack of handwashing facilities, and inadequate training.(24)\u003c/p\u003e\u003cp\u003eThese findings suggest that exposure risk is not solely department dependent but is also shaped by systemic factors such as infrastructure, workload, and compliance with safety protocols. Tailored interventions such as department specific training, improved waste management, and consistent PPE provision are essential to mitigate BEA risks across diverse clinical settings.\u003c/p\u003e\u003cp\u003eWhile most participants had\u0026thinsp;\u0026ge;\u0026thinsp;5 years of experience, other studies have shown that less experienced staff may be more vulnerable, particularly in primary-level facilities (2,14,25). This contrast highlights the importance of considering both experience and institutional context when assessing risk. A longitudinal study conducted in university hospitals in France identified younger age, irregular work schedules, and rotating shifts as significant individual-level predictors of BEA(19). These findings suggest that professional maturity alone does not guarantee lower risk; rather, the nature of the work environment and support systems play a crucial role.\u003c/p\u003e\u003cp\u003eStudies have shown that younger healthcare workers, those with less experience, and those working irregular or rotating shifts are more susceptible to accidental exposure(19). In Cameroon, a study at the Ngaoundere Regional Hospital revealed that despite an average professional longevity of 9.14 years, 62.8% of healthcare workers had experienced at least one BEA, with needle-stick injuries being the most common (87.5%)(1). This suggests that even experienced staff remain vulnerable in settings where preventive knowledge and practices are insufficiently reinforced.\u003c/p\u003e\u003cp\u003eThese insights reinforce the importance of integrating continuous professional development, institutional safety culture, and adequate resource allocation into BEA prevention strategies. Experience must be contextualized within the broader framework of facility-level preparedness and staff support.\u003c/p\u003e\u003cp\u003eThe low rate of formal BEA reporting (36.1%) is concerning. The most cited reason perceiving the incident as \u0026ldquo;not risky\u0026rdquo; reflects a widespread underestimation of occupational hazards and a lack of institutional culture around incident reporting. Similar patterns have been observed in Cameroon and Ethiopia, where underreporting is linked to fear of blame, lack of follow-up, and unclear protocols (1,5). A study in Portugal found that underreporting was particularly high for mucocutaneous injuries (80.9%), with physicians being the least likely to report such incidents. The main barriers included excessive bureaucracy and underestimation of transmission risk(26). French university hospitals also reported high non-reporting rates, particularly among younger staff and surgical teams, who often cited complex procedures and lack of feedback as deterrents(27).\u003c/p\u003e\u003cp\u003eThese findings underscore that underreporting compromises surveillance systems, delays access to post-exposure prophylaxis (PEP), and hinders institutional learning.\u003c/p\u003e\u003cp\u003e Although 73.4% of participants expressed a favorable attitude toward PEP, actual uptake and institutional support were not assessed an area warranting further investigation. A longitudinal study in France emphasized that organizational factors such as lack of supervisory support and reliance on external staff significantly increase BEA risk and reduce reporting compliance.(19) Addressing these gaps requires not only simplifying reporting procedures but also fostering a non-punitive culture of safety and accountability.\u003c/p\u003e\u003cp\u003eThe gap between self-reported compliance with standard precautions (76.6%) and actual practices such as hand hygiene (25%) and PPE use (19.6%) illustrates a \u0026ldquo;compliance gap\u0026rdquo; frequently documented in the literature (2,8). This phenomenon is not unique to Kalemie. A meta-analysis of 46 studies in LMICs found that actual adherence to standard precautions averaged only 53%(28). Systemic barriers such as workload pressure, PPE shortages, and lack of accountability mechanisms often explain this gap.\u003c/p\u003e\u003cp\u003eIn northeastern Ethiopia, a study revealed that actual compliance with standard precautions was as low as 19.2%, with poor infrastructure, negative attitudes, and limited experience significantly associated with non-compliance(29).\u003c/p\u003e\u003cp\u003eBridging this gap requires more than awareness campaigns. It demands consistent access to PPE, improved infrastructure such as reliable water supply and a robust safety culture supported by clear protocols and active supervision.\u003c/p\u003e\u003cp\u003eNeedle recapping, reported by 27.8% of participants, remains a persistent risk despite global recommendations against it. This practice continues to be a major contributor to needle-stick injuries (NSIs), exposing healthcare workers to bloodborne pathogens such as HIV, HBV, and HCV. A meta-analysis of 13 studies across Africa and Asia revealed that healthcare personnel who engaged in needle recapping were more than twice as likely to experience NSIs compared to those who did not (adjusted Odds Ratio\u0026thinsp;=\u0026thinsp;2.04; 95% CI: 1.50\u0026ndash;2.78; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).(30)\u003c/p\u003e\u003cp\u003eStudies from Ethiopia and Malaysia confirm that recapping significantly increases the likelihood of needle-stick injuries and should be actively discouraged (8,15). In a tertiary hospital in Somalia, hypodermic needles were the most common instruments involved in NSIs (81.1%), with operation theaters and inpatient care units being the most frequent sites of injury.(31)\u003c/p\u003e\u003cp\u003eThese data reinforce the urgency of strengthening training on safe injection practices, ensuring the availability of sharps disposal containers, and instituting strict monitoring. Institutional policies must go beyond technical directives and foster behavioral change through continuous education and accountability.\u003c/p\u003e\u003cp\u003eInterestingly, multivariate analysis showed that working in secondary-level facilities was protective (AOR\u0026thinsp;=\u0026thinsp;0.31), contrary to findings from other studies that reported higher exposure rates in hospitals due to procedural complexity (7,32). This divergence suggests that facility type alone may not be a sufficient predictor of blood exposure risk. Instead, contextual factors such as supervision quality, safety culture, and resource management appear to play a more decisive role.\u003c/p\u003e\u003cp\u003eA longitudinal study conducted in university hospitals in France identified organizational predictors such as lack of supervisory support and reliance on external staff as significant contributors to accidental blood exposure, regardless of facility level.(19) Similarly, the World Health Organization emphasizes that successful implementation of universal precautions and infection control strategies depends on institutional commitment, staff training, and the availability of protective equipment not merely the level of care provided.(3)\u003c/p\u003e\u003cp\u003eMoreover, secondary-level facilities may benefit from tighter team cohesion, more consistent supervision, and less procedural turnover, which can foster safer practices.\u003c/p\u003e\u003cp\u003eThese findings underscore the importance of assessing facility-level dynamics holistically. Rather than assuming higher risk based on institutional tier, future interventions should focus on strengthening safety culture, improving staff management, and ensuring adequate resource allocation across all levels of care.\u003c/p\u003e\u003cp\u003eFinally, the lack of recent training on standard precautions reported by 70.68% of participants is a major concern. The last documented session occurred three years prior and targeted only a limited number of staff. This gap in continuing education echoes findings from Yenesew \u0026amp; Fekadu (8), Belachew et al. (13), and Yasin et al.(14), who emphasize the importance of regular, inclusive, and context-specific training programs. Recent studies reinforce this concern. In northeastern Ethiopia, only 19.2% of healthcare workers complied with standard precautions, with lack of training, absence of continuous water supply, and negative attitudes significantly associated with poor compliance (AOR\u0026thinsp;=\u0026thinsp;2.51; 95% CI: 1.07\u0026ndash;5.89)(29). In Cameroon, a study conducted in the obstetrics-gynecology department of a referral hospital revealed that although 82% of paramedical staff had received hand hygiene training during their initial education, gaps in ongoing training and low vaccination coverage contributed to high occupational exposure rates(33). Furthermore, a meta-analysis of 46 studies across low- and middle-income countries (LMICs) found that the pooled prevalence of standard precaution practices was only 53%, with training identified as a key determinant of compliance. The review emphasized that many institutions lacked structured refresher programs, and that systemic barriers such as time constraints, resource shortages, and unclear protocols undermined adherence even among knowledgeable staff.(28)\u003c/p\u003e\u003cp\u003eThese findings suggest that training must be not only regular but also tailored to the realities of each facility. One-off sessions targeting select staff are insufficient to foster a sustainable safety culture. Instead, institutions should implement continuous professional development programs, integrate infection prevention into onboarding and supervision, and ensure that all cadres including support staff are included.\u003c/p\u003e\u003cp\u003eIn summary, this study highlights the multifactorial nature of BEAs and the urgent need for systemic interventions. Addressing both individual behaviors and institutional barriers is essential to reduce occupational exposure and protect the health workforce in Kalemie and similar settings.\u003c/p\u003e\u003cp\u003e\u003cb\u003eStrengths and Limitations of the Study\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis study presents several limitations. The cross-sectional design does not allow for causal inference between the identified factors and the occurrence of blood exposure accidents (BEAs). Exposure data were collected through self-reporting, which may have introduced recall bias. Furthermore, the absence of qualitative data limits the ability to explore in depth the organizational and behavioral determinants underlying poor adherence to standard precautions.\u003c/p\u003e\u003cp\u003eNevertheless, the principal strength of this study lies in its status as the first investigation assessing occupational exposure to blood-related accidents and associated factors within the study area. In addition, the random selection of participants and the inclusion of both public and private health facilities, spanning primary and secondary levels of care, contribute to the adequate representativeness of the findings.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study highlights the high prevalence of blood exposure accidents (BEAs) among healthcare providers in Kalemie, with nearly two-thirds of participants reporting incidents within the past year. The findings underscore the persistent occupational risks faced by frontline workers, particularly in environments with limited resources and inconsistent adherence to safety protocols.\u003c/p\u003e\u003cp\u003eKey factors associated with BEA occurrence include non-compliance with standard precautions, needle recapping practices, and inadequate use of personal protective equipment (PPE). Conversely, working in secondary-level facilities was found to be protective, suggesting that institutional structure and supervision may play a critical role in mitigating exposure risks.\u003c/p\u003e\u003cp\u003eDespite widespread awareness of blood exposure accidents (BEAs), knowledge levels among healthcare providers remain low, and preventive practices are inconsistently applied. The gap between intention and behavior particularly regarding hand hygiene, use of personal protective equipment (PPE), and incident reporting reflects systemic challenges that require coordinated interventions. These findings underscore the need for targeted health policy measures, including the institutionalization of continuous training programs, reinforcement of supervision mechanisms, and integration of BEA prevention into routine quality assurance frameworks. Moreover, policies should prioritize resource allocation for PPE availability, promote a non-punitive culture of incident reporting, and establish accountability structures at facility level to ensure adherence to standard precautions. Addressing these gaps is essential to reduce occupational risks and strengthen infection prevention and control (IPC) across all levels of the health system. These measures are essential to protect healthcare providers, improve quality of care, and strengthen the resilience of the health system in Kalemie and beyond.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from the Ethics Committee of the School of Public Health, University of Kinshasa (Ref: ESP/ESP/38/2024). Written informed consent was obtained from all participants prior to their inclusion in the study. Participation was entirely voluntary, and no financial compensation was provided. Confidentiality of personal data was strictly maintained throughout the study, and all data were used solely for research purposes.\u003c/p\u003e\n\u003cp\u003eAll procedures involving human participants were conducted in accordance with ethical standards of the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable. No identifiable personal data were published in this study. All information presented is anonymous and aggregated, ensuring that individual participants can be identified.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated or analyzed during this study are included in this published article. Original data are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflicts of interest related to this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no external funding. All data collection and analysis activities were supported by the authors\u0026rsquo; institutions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eJDK\u003c/strong\u003e: Conceptualization, study design, data collection supervision, statistical analysis, manuscript drafting and revision. \u003cstrong\u003eDMM\u003c/strong\u003e: Conceptualization, study design, Critical revision of the manuscript for intellectual content. \u003cstrong\u003eMML:\u0026nbsp;\u003c/strong\u003estatistical analysis, revision of the manuscript\u003cstrong\u003e, OM:\u0026nbsp;\u003c/strong\u003eCritical revision of the manuscript\u003c/p\u003e\n\u003cp\u003eAll authors have read and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors wish to thank the Provincial Health Division of Tanganyika for administrative support, the managers of participating health facilities for their collaboration, and the healthcare providers who generously contributed their time and insights to this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eKaryom DAN, Bong-Akee S, Honore ER, Gael OM, Collins BN, Yanick DN, et al. 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Disponible sur: https://doi.org/10.1371/journal.pone.0302282\u003c/li\u003e\n\u003cli\u003eKeleb A, Lingerew M, Adema A, Berihun G, Sisay T, Adanel M. The magnitude of standard precautions practice and its associated factors among healthcare workers in governmental hospitals of northeastern Ethiopia. Frontiers in in Health Services. \u003c/li\u003e\n\u003cli\u003eAndriyani S, Demartoto A, Murti B. Meta-analysis: Effect of training and needle recapping on needle stick injury in health workers. Journal of Health Policy and Management. 2024;9(2):1‑10. \u003c/li\u003e\n\u003cli\u003eMohamud RYH, Mohamed N, Doğan A, Hilowle F, Isse S, Hassan M, et al. Needlestick and Sharps Injuries Among Healthcare Workers at a Tertiary Care Hospital: A Retrospective Single-Center Study. RMHP. nov 2023;Volume 16:2281‑9. \u003c/li\u003e\n\u003cli\u003eLemessa D, Solomon T. Occupational Exposure of Health-Care Workers to Blood and Body Fluids in West Shewa Zone, Ethiopia, 2018: A Cross-Sectional Study. A. Al-Khatib I, \u0026eacute;diteur. Journal of Environmental and Public Health. 31 d\u0026eacute;c 2021;2021:1‑7. \u003c/li\u003e\n\u003cli\u003eCheuyem L, Zobel F, Enjema LE, Innocent T. Standard precautions perception and practice among health workers in the obstetrics- gynecology department of a referral hospital in Cameroon. BMC Health Services Research. 2025;25(1165). \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Blood exposure accidents, associated factors, healthcare workers, Kalemie","lastPublishedDoi":"10.21203/rs.3.rs-7616605/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7616605/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e\u003cp\u003eBlood exposure accidents (BEAs) represent a major occupational hazard for healthcare workers, particularly in low-resource settings. In Kalemie, Democratic Republic of Congo, limited access to protective equipment and inconsistent adherence to safety protocols increase the risk of exposure to blood and body fluids.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e\u003cp\u003eA cross-sectional study was conducted in March 2024 among 316 healthcare providers working in various health facilities in Kalemie. Data were collected using a structured questionnaire and analyzed with SPSS version 26. Descriptive statistics, bivariate analysis, and multivariate logistic regression were used to identify factors associated with BEA occurrence.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e\u003cp\u003eAmong participants, 64.8% [95% CI: 60.4\u0026ndash;70.8] reported experiencing a BEA during their professional career, and 60.4% [95% CI: 54.9\u0026ndash;65.6] within the past 12 months. The most common causes were unexpected patient movement (42.4%) and lack of attention (34.6%). In multivariate analysis, working in secondary-level facilities (AOR\u0026thinsp;=\u0026thinsp;0.31; 95% CI: 0.14\u0026ndash;0.67; p\u0026thinsp;=\u0026thinsp;0.003) and inconsistent compliance with standard precautions (AOR\u0026thinsp;=\u0026thinsp;2.92; 95% CI: 1.50\u0026ndash;5.68; p\u0026thinsp;=\u0026thinsp;0.001) were significantly associated with BEAs occurrence.\u003c/p\u003e\u003ch2\u003eConclusion:\u003c/h2\u003e\u003cp\u003eBEAs remain highly prevalent among healthcare workers in Kalemie. Strengthening training on standard precautions, improving access to personal protective equipment, and promoting a culture of safety are essential to reduce occupational risks and improve worker protection.\u003c/p\u003e","manuscriptTitle":"Prevalence and factors associated with Blood Exposure Accidents Among Healthcare Workers in Kalemie, Democratic Republic of Congo, March 2024: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-19 10:06:56","doi":"10.21203/rs.3.rs-7616605/v1","editorialEvents":[{"type":"communityComments","content":3}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"33cb4a6a-5e29-4ddf-9ac1-b3abafe1a16c","owner":[],"postedDate":"November 19th, 2025","published":true,"recentEditorialEvents":[{"type":"decision","content":"Withdrawn","date":"2026-05-06T11:33:57+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-05-06T11:42:34+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-19 10:06:56","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7616605","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7616605","identity":"rs-7616605","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}