Social and cultural dimensions of hygiene in Cambodian health care facilities

<p>Abstract</p> <p>Background</p> <p>The frequency of bloodborne pathogen healthcare-associated infections is thought to be high in developing Southeast Asian Countries. The underlying social-cultural logics contributing to the risks of transmission are rarely studied. This report provides some insights on the social and cultural factors that shape hygiene practices in Cambodian health care settings.</p> <p>Methods</p> <p>We conducted qualitative surveys in various public and private health facilities in Phnom Penh, the capital city and in provinces. We observed and interviewed 319 participants, health care workers and patients, regarding hygiene practices and social relationships amongst the health care staff and with patients. We also examined the local perceptions of hygiene, their impact on the relationships between the health care staff and patients, and perceptions of transmission risks. Data collection stem from face to face semi-structured and open-ended interviews and focus group discussions with various health care staffs (i.e. cleaners, nurses, midwives and medical doctors) and with patients who attended the study health facilities.</p> <p>Results</p> <p>Overall responses and observations indicated that hygiene practices were burdened by the lack of adequate materials and equipements. In addition, many other factors were identified to influence and distort hygiene practices which include (1) informal and formal social rapports in hospitals, (2) major infection control roles played by the cleaners in absence of professional acknowledgment. Moreover, hygiene practices are commonly seen as an unessential matter to be devoted to low-ranking staff.</p> <p>Conclusion</p> <p>Our anthropological findings illustrate the importance of comprehensive understanding of hygiene practices; they need to be considered when designing interventions to improve infection control practices in a Cambodian medical setting.</p

Oral candidosis and associated Candida species in HIV-infected Cambodians exposed to antimycotics

Although human immundeficiency virus (HIV) infection is endemic in Southeast Asia, data on oral mycotic flora in this disease in Asians are sparse. The aim of this study was to determine the prevalence of Candida species in HIV-infected Cambodians with oral candidosis, unexposed (group 1) and exposed to antimycotics (group 2) and a healthy population (group 3). In 161 HIV patients with oral candidosis (group 1: 121 pts; group 2: 40 pts) and in 81 controls (group 3) swab samples of tongue and palate were obtained. Oral candidosis was detected in 100 and 70% of groups 1 and 2 respectively. Candida spp. were isolated from 91 and 100% of groups 1 and 2, respectively, and from 79% of controls. Candida albicans was the most common, with non-albicans species such as C. tropicalis and C. krusei being notable. Our data indicate that variants of oral candidal infections in HIV disease are similar to those seen in the pre-HAART era. The particularly high rate of C. krusei isolation in all groups is noteworthy.link_to_subscribed_fulltex