African Biological Safety Association (AfBSA)4th Annual Biological Safety Conference, Casablanca,

Morocco

March 23rd to 25th, 2015

Promoting Biosafety and Biosecurity as a Scientific Discipline in the African Continent

*Abiodun A. Denloye, Oladele T. Ojuromi, Kingsley Ochei and Elizabeth A. Ade-Serrano

Abiodun A. Denloye, PhDDepartment of Zoology and Environmental BiologyLagos State University Ojo, Lagos, Nigeria.www. denloye.com

FOR TRUTH AND SERVICE

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Promoting Biosafety and Biosecurity as a Scientific Discipline in the African continent

» Introduction and Background to Study» Objectives» Materials and Methods

˃ Evaluation of biosafety knowledge and waste disposal practices of Health Care Establishments (HCEs) in Abuja and Lagos

˃ Sample examination and identification of intestinal parasites+ Collection of stool and urine samples from HCEs+ Analyses of stool and urine samples from HCEs

» Results˃ Biosafety knowledge of HCE workers Types of HCEs˃ Waste Specimen Characterization˃ Waste treatment before disposal˃ Intestinal Parasites in Medical wastes

» Discussion » Conclusion and Recommendations

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Promoting Biosafety and Biosecurity as a Scientific Discipline in the African continent

» Biosafety is “the discipline addressing the safe handling and containment of infectious microorganisms and hazardous biological materials” (CDC, 2010).

» Biosafety is very important in HCEs, which handle, analyze and dispose of various pathogenic organisms as wastes.

» These wastes have potentials for negative impact on humans, livestock, pets and the environment. Stephen and Elijah (2011) studied Health Care Waste Management in a teaching hospital in Edo State, Nigeria. However, the level of biosafety awareness is not known especially among workers in HCEs, neither have the pathogenic organisms in the wastes identified. Studies were therefore carried out to address the foregoing and the results are presented here.

» This presentation highlights the level of biosafety awareness and the biomedical waste disposal practices in selected HCEs in Abuja and Lagos respectively. It also identifies parasites from HCE wastes in Lagos prior to final disposal.

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Promoting Biosafety and Biosecurity as a Scientific Discipline in the African continent

Objectives of Study

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Promoting Biosafety and Biosecurity as a Scientific Discipline in the African continent

Materials and Methods

Questionnaires were administered in Lagos and Abuja, Nigeria to:1.Evaluate the biosafety knowledge of HCE workers 2.How wastes from HCEs were disposed of

Figure 1: Left: Map of Nigeria with Abuja and Lagos Highlighted. Right; distribution of questionnaires

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Promoting Biosafety and Biosecurity as a Scientific Discipline in the African continent

Figure 3: Summary of Analyses of Stool and Urine Samples from HCEs in Lagos3/

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Promoting Biosafety and Biosecurity as a Scientific Discipline in the African continent

» Collection: Fresh Stool and urine samples were collected using universal sample bottles with tight fitting lids.

» Maintenance of Urine: Urine samples were transported to the laboratory in ice-chest and the samples maintained in a deep freezer at temperature of about -20 oC before examination. Each sample was labeled for type, age, sex and date of collection

» Centrifugation: The sample tube was half-filled and saline solution added. Centrifugation was at 2000 rpm for 2 mins. Supernatant was decanted and sediment on glass slide. Cover slip was placed and then examined under compound light microscope.

» Visual Examination: Stool samples were visually examined under the microscope to note the consistency, presence of abnormal features, weather water watery, bloody or mucous.

» Sedimentation: Fresh stool in 10 ml of 10% formalin mixed thoroughly, and allowed to stand for 30 minutes was strained through two layers of gauze placed in funnel into 15 ml centrifuge tube was centrifuged for two minutes at 1, 500 rpm after adding saline solution. Re-suspended sediment was decanted into 10% formalin, 3 mls of di-ethyl ether added, then centrifuged again. Sediment was pippeted, a drop placed on microscope slide. This was to detect ova and cyst too small for visibility in unprocessed smears.

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Promoting Biosafety and Biosecurity as a Scientific Discipline in the African continent

» 1. Biosafety Awareness of HCE workers» Respondents to questionnaires in the two study centres were drawn from

hospitals, clinics, diagnostic labs and others (pharmaceutical stores)

(Figure 4)

» Figure 4: Composition of HCE Respondents 3/24

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Promoting Biosafety and Biosecurity as a Scientific Discipline in the African continent

» Biosafety Knowledge of respondents

» More HCE workers from Lagos had biosafety training than those from Abuja (Figure 5a).

» More HCE workers from Abuja had no understanding of biosafety than those from Lagos (Figure 5b).

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Promoting Biosafety and Biosecurity as a Scientific Discipline in the African continent

» Waste Specimen Characterization and disposal practices of HCEs in Abuja and Lagos

» Lagos HCEs have higher percent of each waste category than Abuja

(Figure 6).

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Promoting Biosafety and Biosecurity as a Scientific Discipline in the African continent

» Waste Storage Practices by HCEs

» Wastes are sorted out in HCEs in Nigeria (Figure 7).» Lagos has more waste sorting than Abuja

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Promoting Biosafety and Biosecurity as a Scientific Discipline in the African continent

» Disposal Methods of Medical Wastes

» HCEs in Abuja mostly use incineration method while most in Lagos employ the services of the Lagos State Waste Management Authority (LAWMA) (Figure 8)

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Promoting Biosafety and Biosecurity as a Scientific Discipline in the African continent

» Frequency of Waste Disposal

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» Most Abuja HCEs dispose of wastes daily; Most Lagos HCEs dispose of wastes weekly (Figure 9).

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Promoting Biosafety and Biosecurity as a Scientific Discipline in the African continent

» Parasites in Urine and Stool Samples˃ Only one of the urine samples tested positive for parasites˃ Stool samples tested positive for four Protozoans, one flatworm and two roundworms

among the samples (Figure 10).

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Promoting Biosafety and Biosecurity as a Scientific Discipline in the African continent

» Prevalence of Parasites in stool samples among males and females

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Promoting Biosafety and Biosecurity as a Scientific Discipline in the African continent

» The involvement of LAWMA in biomedical waste disposal (eg use of designated trucks and distribution of coloured boxes) may be the reason for more Lagos HCE workers understanding of biosafety matters more than Abuja. This agrees with Ohakwe (2011)

» Wastes from HCEs were not treated before final disposal. This has large environmental impact including pollution of water bodies (Stephen and Elijah, 2011).

» The presence of parasites shows that the handling of wastes from the HCEs is unsustainable and cannot be relied upon for the protection of human health and environmental integrity. This agrees with the findings and position of Mordi and Ngwodo (2007).

Plate1: Brown, yellow and red coloured disposal bags for colour coding from source (Top); Sharps disposal box (Middle) and Medical waste disposal truck (Bottom) used in Lagos State

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Promoting Biosafety and Biosecurity as a Scientific Discipline in the African continent

» Although a large number of HCE workers sampled have knowledge of biosafety, they showed little understanding and practice of biosafety. It is recommended that HCEs and governments should engage in personnel training and retraining.

» Study shows use of improper waste disposal methods. Enactment of waste disposal regulations and commitment of the appropriate arm(s) of government in the Federal Capital Territory, Abuja as is done in Lagos are recommended.

» This study pinpoint the non-treatment of waste of different HCEs in both Abuja and Lagos. It is recommended that HCEs be compelled to treat all their biomedical wastes before final disposal.

» Indiscriminate urination and defecation by men and women in unauthorized places must be discouraged. Women should be educated on the dangers of squatting in places where wastes are held temporarily before final disposal.

» Biosafety sensitization workshop must be arranged for HCEs and residents of the vicinity of HCEs. 3/

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Promoting Biosafety and Biosecurity as a Scientific Discipline in the African continent

» Centres for Disease Control and Prevention (2010). Biosafety in Microbiological and Biomedical Laboratories. US Department of Health and Human Services. National Institutes of Health. Fifth Edition. 415pp.

» Mordi, R. M and Ngwodo, P. O. A. (2007). A study of blood and gastro-intestinal parasites in Edo State. African Journal of Biotechnology 6 (19): 2201- 2207.

» Ohakwe, O. Johnson (2011). A Statistical Analysis of Medical Waste Generation, Management and the Health Implications: A Case Study of Enugu

Metropolis, Enugu State, Nigeria. Continental J. Applied Sciences, Vol. 6, No. 1. (June 2011), pp. 25-30.

» Stephen O. A and Elijah, I. O (2011). Healthcare waste management in Nigeria: A case study. Journal of Health and Epidemiology, Vol.3(3): 99-110 .

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Promoting Biosafety and Biosecurity as a Scientific Discipline in the African continent

THANK YOU

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