Hospital Stakeholders’ Perception on Environmental Effects Related to Biomedical Waste in Togo’s University Hospitals (UHC) in 2021

Introduction: Given its effects, hospital waste is an environmental concern and a threat to health personnel, users of health services and neighboring populations. Our objective was to assess the perception of health care stakeholders on the environmental effects related to biomedical waste produced in Teaching Hospitals (CHU) in Togo in 2021. Methods: This was a cross-sectional study held from June 24 to August 28, 2021. It targeted three university hospitals, 340 health care providers and services selected by a probabilistic method with a simple random technique in 25 services, 72 directors, deputy directors, supervisors and heads of services, 27 collection and incineration agents selected by a non-probabilistic method with a reasoned choice technique, 44 patients and attendants and 36 householders of neighboring residents selected by a non-probabilistic method with an accidental choice technique. Variables such as the spreading of disease vectors, soil, air and water contamination, the presence of unpleasant odors and unsightly living conditions were assessed. Results: According to the respondents, biomedical waste causes the proliferation of vectors (55.3%), an unsightly environment inside the hospital (47.1%), and unpleasant odors (61.2%). Incineration operations disturb hospital residents (52.8%), according to the householders of the residents. During observation, we note deposits of waste that have not been destroyed and wastewater flowing in some places. Conclusion: Biomedical waste in Togo’s university hospitals generates environmental effects and therefore potentially high risks for human health. Improving their management should be a concern for all hospital actors.

Comparison of microwave and autoclave treatment for biomedical waste disinfection

As the world is facing a Covid-19 pandemic,this virus teaches a lesson about the importance of on-site disinfection.On-site disinfection/sterilization with real-time monitoring of biomedical waste generated from the medical facilities is mandatory to prevent hospital-acquired infection(HAI).In this study,the life cycle assessment of two technologies,i.e.,microwave(radiation-based)and autoclave(steam-based)were performed to summarize the inside-out evaluation of both technologies in terms of efficiency,efficacy,and cost-effectiveness.The results of disinfection efficacy indicated a log 10 reduction(almost 100%)in the vegetative load of microorganisms compared to the control,showing a similar level of disinfection efficacy of both strategies.Additionally,both technologies were compared on several parameters,and it was discovered that the autoclave uses more time and resources than the microwave.The total cost of an autoclave to the government is approximately double that of a microwave,while the operational cost of an autoclave is more than double that of a microwave.The findings from this study indicate that MACS may be used as a dry technique of biomedical disinfection,and its portability,tunability,and compactness make it a suitable alternative for biomedical disinfection and sterilization.

Assessing Biomedical Solid and Liquid Waste Management in University Hospital Centers (CHU) in Togo, 2021

Introduction. Biomedical waste represents an environmental concern and a risk to healthcare workers, users of healthcare services, and the surrounding population. This study aimed to assess the management of solid and liquid biomedical waste in University Hospitals Centers (UHC) in Togo in 2021. Methods. This is a cross-sectional, evaluative and analytical study undertaken in 2021. It involved 3 UHCs, 25 departments, 340 care providers and departments randomly selected, 72 directors or deputies, supervisors and heads of departments, 27 collection and incineration agents selected by a reasoned choice technique, and 44 patients and attendants selected by an accidental choice technique. Data analysis was done using Pearson’s Chi2 statistical test for comparing proportions and logistic regression. Results. Solid and liquid waste management was “poor” due to non-use of waste management guidelines (ORa = 3.50;p = 0.0000), insufficient training of healthcare providers and collection agents (ORa = 6.55;p = 0.0000 and ORa = 6.08;p = 0.0000 respectively), insufficient user awareness sessions (ORa = 4.04;p = 0.0001), insufficient coordination of activities (ORa = 5.07;p = 0.0002), insufficient supervision of service providers and collection agents (ORa = 2.34;p = 0.0000), insufficient monitoring and follow-up of activities (ORa = 20.40;p = 0.0000). The sorting was not systematic (74.1%), and the Biochemical Oxygen Demand (BOD) and Chemical Oxygen Demand (COD) of the effluents were relatively high. Conclusion. Managing solid and liquid biomedical waste is insufficient in Togo’s university hospitals and represents a potential risk to human health and the environment.