This study aimed to provide a descriptive overview and identify the determinants of exposure to blood and body fluids (BBF) among caregivers, as well as to assess their vaccination status. The results reveal that caregivers are highly exposed to these fluids in the hospital setting, despite very low vaccination coverage.

The majority of participants were female and over 41 years old. Similar results were found in a study conducted in Iran, which could be explained by the fact that as women get older, they are more likely to care for their relatives without necessarily considering the risks of exposure [25]. Half of the participants were either unemployed or self-employed and had a monthly income of less than 50,000 CFA francs. Indeed, due to the long hospital stays required, families tend to assign the most available person to stay by the patient’s side [17].

Among participants who had previously been patient attendants, over 25% had contracted an illness during their hospital stay. This concerning figure corroborates the findings of a Cameroonian study documenting the precarious living conditions of these caregivers [17,26]. Due to a lack of suitable accommodation, they are often compelled to sleep on benches, in corridors, or in the open air, which significantly increases their risk of exposure to pathogens. This situation calls for urgent action from policymakers to guarantee the health and well-being of this vulnerable population by creating safe and suitable reception areas within healthcare facilities.

Just under a quarter of the caregivers surveyed had received a complete COVID-19 vaccination schedule, a finding similar to that observed in Congo [27]. This low coverage is mainly explained by vaccine hesitancy, fueled by doubts about the vaccines’ efficacy and safety, a lack of information, and widespread mistrust [28,29]. To promote uptake, vaccination strategies must therefore imperatively target the specific factors underlying this hesitancy within the population [30].

A higher level of education was significantly associated with COVID-19 vaccination. This trend was also observed in a study conducted in the United States [31]. Caregivers with a higher level of education are indeed more likely to adopt health-promoting behaviors, including preventive measures against infectious diseases like COVID-19. Furthermore, they generally benefit from better access to health resources, particularly information on disease prevention [32]. These results underscore the need to strengthen vaccination awareness, specifically targeting less educated populations. To effectively reach these groups, including in the most remote areas, it is essential to use widely accessible communication channels, such as media (television, radio), social networks, and health facilities.

Regarding hepatitis B, only 10.40% of caregivers had received a complete vaccination. This insufficient vaccination coverage worsens the burden of this preventable disease [33]. This result is lower than that observed in another Cameroonian study, a discrepancy that could be explained by differences in the study populations [7].

Studies have identified several barriers that could explain this low vaccination coverage, including the high cost of the vaccine, lack of time to get vaccinated, neglect, and vaccine unavailability [7,34]. To reduce the incidence of infection, the policy of free vaccination for newborns of infected mothers must be reinforced by intensive behavior change campaigns aimed at promoting preventive behaviors within the population [35].

Unemployed caregivers and those not vaccinated against cholera were respectively six and eight times more likely to be vaccinated against hepatitis B. This trend, which contrasts with data from an Ethiopian study, could reveal a unique opportunity to target these groups in future awareness and vaccination strategies [36].

Less than 5% of caregivers were fully vaccinated against cholera, with a lack of awareness of the vaccine’s existence identified as a major barrier [14]. Consequently, it is crucial to intensify awareness campaigns focused on communities and to adjust public health strategies to better meet the specific needs of this population [37].

Over 50% of caregivers were exposed to body fluids, a result similar to that observed in Bangladesh [8]. Most of the exposed caregivers were not fully vaccinated against hepatitis B, Cholera, and COVID-19. This makes them more vulnerable to infectious diseases, especially if an outbreak appears in the study area [38,39].

These findings corroborate results among healthcare workers in both a district and a referral hospital in Yaoundé. Workers responsible for providing primary care were not fully protected against these diseases, a situation worsened by recurrent shortages of personal protective equipment, poor compliance with standard precautions, and inadequate management of exposure cases in most hospital settings [39–43].

Multivariate analysis revealed that caregivers performing hospital tasks had a 17-fold higher risk of exposure to blood and body fluids, while those with prior caregiving experience had a three-fold higher risk. Paradoxically, these essential care actors receive no training in basic precautions, leaving them defenseless against the growing threat of nosocomial infections [5,44].