Strategies to combat Nosocomial Infections at CBCA Virunga General hospital and Charité Maternelle : A Contextualized Model in Goma, replicable in the Democratic Republic of Congo

Abstract

Introduction: A study was conducted on strategies to combat nosocomial infections at CBCA‑Virunga General Referral Hospital and Charité Maternelle in Goma, Democratic Republic of Congo, from July 1 to September 25, 2025 (approximately two months). Nosocomial infections remain a major public health problem worldwide, in Africa, and in the DRC. Several countries, such as Senegal, Benin, and Cameroon, have established hospital committees for the control of nosocomial infections (CLIN). In Goma, particularly in the two general referral hospitals CBCA‑Virunga and Charité Maternelle, nosocomial infections are present but poorly documented due to the absence of a structured epidemiological surveillance system, highlighting the urgent need for a response strategy.

Material and Methods : This was a cross-sectional and analytical study with an operational objective, integrating a mixed-methods approach (quantitative and qualitative). It included a documentary review, direct observations, and interviews with managers of the CBCA-Virunga and Charité Maternelle referral hospitals, as well as focus group discussions with healthcare workers on nosocomial infection surveillance according to their professional departments. Based on the data collected, a contextual surveillance model for nosocomial infections was designed, taking into account local resources and existing constraints.

Results: The study revealed a lack of data on nosocomial infections in the targeted hospitals and the absence of strategies for their control. Epidemiological surveillance of nosocomial infections is currently non‑existent, with no standardized protocols, no dedicated infection control committee, no systematic reporting system, limited staff training in infection surveillance, lack of functional bacteriology services for microbiological confirmation, and absence of epidemiological indicators for monitoring.

Conclusion : The implementation of a strategy based on nine pillars is recommended: 1. conducting a situational analysis of nosocomial infections in each targeted hospital, including CBCA-Virunga and Charité Maternelle, to determine prevalence, risk factors, etiology, and KAP (Knowledge, Attitudes, and Practices) study; 2. presenting and disseminating survey results to healthcare workers and developing an operational action plan; 3. training healthcare staff on nosocomial infections and epidemiological surveillance mechanisms; 4. establishing a Hospital Infection Control Committee (CLIN) in each targeted hospital; 5. coordinating the nosocomial infection control program at the national level; 6. digitalizing the program; 7. promoting community ownership; 8. establishing a legal framework through the adoption of a law on the control of nosocomial infections; 9. integrating Infection Prevention and Control (IPC) into the national curriculum for health sciences education in the DRC. This model is also replicable in other hospitals across the Democratic Republic of the Congo