Page 195 - GHES-3-3

Global Health Economics and
Sustainability
Blood exposure in Cameroon healthcare workers

2.3. Eligibility criteria including the name of the primary author, study year,

This review included cross-sectional studies that reported region, study design, setting, study population, sample
on the lifetime and/or 12-month prevalence of occupational size, response rate, 12-month and lifetime prevalence of
exposure to BBFs through contact with mucous membranes exposure to BBFs among HCWs, and reporting rate. Three
and injured skin. To be included, studies had to provide reviewers critically assessed each article for relevance
quantitative outcomes and investigate occupational and quality. Any disagreement between the reviewers
exposure to BBFs as the dependent variable. Only full- was resolved by discussion. The quality of the selected
text articles published in English with clear objectives and studies was assessed using the Joanna Briggs Institute’s
methods were chosen for this review. For the narrative quality assessment tool for prevalence studies (“JBI
review, additional studies investigating the risk factors of Critical Appraisal Tools,” 2017). Nine parameters were
occupational exposure to BBFs were also included. This used to assess the risk of bias for each study, including the
review focused on studies involving HCWs in different appropriateness of sampling frame, appropriate sampling
departments of private and public healthcare settings. technique, adequate sample size, description of study
Specifically, the review included studies involving doctors, subjects and setting, sufficient data analysis, use of valid
nurses, midwives, assistant nurses, laboratory technicians, methods for identified conditions, valid measurement
medical students, and cleaners. No restriction was applied for all participants, use of appropriate statistical analysis,
on the publication date, since there was no prior systematic and adequate response rate (≥60%). Each parameter was
review that investigated occupational exposure to BBFs scored as 0 (yes) or 1 (no). Risk of bias was classified as low
among HCWs in the country. (0 – 2), moderate (3 – 4), or high (5 – 9).

2.4. Article searching strategy 2.6. Outcome of measurement
A comprehensive review of various literature sources was The primary outcomes of this study were the 12-month
conducted, including both published and unpublished and lifetime prevalence of occupational exposure to BBFs
studies, based on predetermined eligibility criteria. among HCWs. These prevalence rates were calculated
A systematic search using electronic databases, such as by dividing the number of HCWs who experienced
PubMed, Google Scholar, Cochrane Library, and Science occupational exposure to BBFs by the total number of
Direct, was performed to identify published studies. The HCWs enrolled in the study and at risk of such exposures.
search strategy involved analyzing the text contained in the Similarly, the reporting rate was calculated by dividing the
title and abstract of each study. A combination of keywords number of cases reported or managed by the hospital focal
and medical subject headings terms was used by employing point by the total number of cases reported by the study
Boolean logic operators (e.g., “AND” and “OR”) to refine participants.
the search. The keywords and medical subject headings 2.7. Operational definition
terms included: “prevalence,” “occupation,” “accidental
exposure,” “magnitude,” “exposure,” “occupational disease,” Occupational exposure to BBFs in this report includes
“accident,” “occupational exposure,” “cross-infection,” any splash of BBFs into the eyes, nose, or mouth, contact
“occupational hazard,” “body fluid,” “blood spill,” “blood,” with non-intact skin, and exposure through percutaneous
“blood-borne pathogens,” “reporting,” “management,” injuries.
“post-exposure prophylaxis,” “blood-borne infection,”
“healthcare workers,” “health workers,” “health-care 2.8. Statistical analysis
workers,” “health personnel,” “risk factor,” “circumstance,” The estimated pooled prevalence of BBF exposure was
“factor favoring,” “medical personnel,” and “Cameroon.” performed using common- and random-effects meta-
To ensure a comprehensive search, manual searching was analysis models based on the Der Simonian and Laird
conducted to identify additional published articles that approach. The existence of heterogeneity among the studies
2
were not indexed in electronic databases. Unpublished was assessed using the I test statistic. Three categories were
studies were retrieved from the University of Yaoundé used to classify the degree of heterogeneity (I index). These
2
1 library. Furthermore, the reference lists of identified categories were either low (<25%), moderate (25 – 75%),
studies were scanned to achieve literature saturation. The or high (>75%) heterogeneity. The subgroup analysis was
last search was conducted on November 1, 2024. performed based on the study year, region, sample size,
and hospital level. The random-effects model is preferred if
2.5. Data extraction and quality assessment a significant heterogeneity is observed between the studies
A standardized form in Microsoft Office Excel 2019 was on the prevalence estimates of 12-month and lifetime BBF
used to extract all relevant data from the selected studies, exposure.

Volume 3 Issue 3 (2025) 187 https://doi.org/10.36922/GHES025090016