Hospital exposure to body fluids and vaccination status of caregivers: a cross-sectional study in public hospitals of Yaoundé-Cameroon
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Background
In many Sub-Saharan African countries, structural health system challenges lead to a heavy reliance on informal caregivers to provide basic patient care in hospitals. These caregivers are frequently exposed to blood and body fluids (BBF), placing them at high risk of infections like hepatitis B, COVID-19, and cholera. This study aimed to assess the prevalence and determinants of BBF exposure and vaccination coverage among informal caregivers in public hospitals in Yaoundé, Cameroon.
Methods
A cross-sectional study was conducted between April and July 2025 at two public reference hospitals in Yaoundé. A total of 327 caregivers, aged ≥21 and caring for a hospitalized patient for ≥48 hours, were enrolled using a non-probabilistic convenience sampling technique. Data on sociodemographics, hospital experiences, BBF exposure, and vaccination status were collected via face-to-face interviews using a pre-tested questionnaire. Multivariate binary logistic regression was used to identify factors associated with full vaccination and exposure to BBF.
Results
A high proportion (57.49%) reported exposure to BBF, most commonly to urine (87%), expectoration (38%), and vomit (21%). Vaccination coverage was critically low: only 10.40% were fully vaccinated against hepatitis B, 6.12% against COVID-19, and 3.98% against cholera. Furthermore, 67.59% had not received any of the three vaccines. Multivariate analysis revealed female caregivers were significantly less likely to be fully vaccinated against COVID-19 (aOR=6.27), hepatitis B (aOR=2.98), and cholera (aOR=3.36) compared to males. Higher education level was associated with lower COVID-19 vaccine uptake (aOR=29.7), and unemployed caregivers were less likely to be vaccinated against hepatitis B than public sector workers (aOR=6.43). Caregivers who performed tasks had seventeen-fold increased odds of BBF exposure (aOR=17.1). Those with prior caregiving experience were three times more likely to be exposed (aOR=2.98). Married status and reporting difficulty sleeping were also significantly associated with higher exposure risk to BBF.
Conclusion
Informal caregivers in Cameroonian hospitals face high exposure to blood and body fluids, coupled with low vaccination coverage against key infectious diseases. These results underscore an urgent need for public health policies to recognize and protect them, including integrating them into infection prevention programs and implementing targeted vaccination campaigns within healthcare facilities.
