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Sabery M, Adib-Hajbaghery M, Ghadirzade Z, Nematian F. Investigation of knowledge, attitudes, and practice of nursing, midwifery, and surgical technology students regarding standard precautions and self-protection in the clinical setting. INTERNATIONAL ARCHIVES OF HEALTH SCIENCES 2021. [DOI: 10.4103/iahs.iahs_130_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Sahiledengle B, Tekalegn Y, Woldeyohannes D, Quisido BJE. Occupational exposures to blood and body fluids among healthcare workers in Ethiopia: a systematic review and meta-analysis. Environ Health Prev Med 2020; 25:58. [PMID: 33010808 PMCID: PMC7533038 DOI: 10.1186/s12199-020-00897-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 09/23/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Occupational exposure to blood and body fluids is a major risk factor for the transmission of blood-borne infections to healthcare workers. There are several primary studies in Ethiopia yet they might not be at the national level to quantify the extent of occupational blood and body fluid exposures (splash of blood or other body fluids into the eyes, nose, or mouth) or blood contact with non-intact skin among the healthcare workers. This systematic review and meta-analysis aimed to estimate the pooled prevalence of occupational blood and body fluid exposure of healthcare workers in Ethiopia. METHODS PubMed, Science Direct, Hinari, Google Scholar, and the Cochrane library were systematically searched; withal, the references of appended articles were also checked for further possible sources. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the included studies. A random-effects meta-analysis model was used to estimate the lifetime and 12-month prevalence of occupational exposure to blood and body fluids among healthcare workers in Ethiopia. RESULTS Of the 641 articles identified through the database search, 36 studies were included in the final analysis. The estimated pooled lifetime and 12-month prevalence on occupational exposure to blood and body fluids among healthcare workers were found to be at 54.95% (95% confidence interval (CI), 48.25-61.65) and 44.24% (95% CI, 36.98-51.51), respectively. The study identified a variation in healthcare workers who were exposed to blood and body fluids across Ethiopian regions. CONCLUSION The finding of the present study revealed that there was a high level of annual and lifetime exposures to blood and body fluids among healthcare workers in Ethiopia.
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Affiliation(s)
- Biniyam Sahiledengle
- Department of Public Health, Madda Walabu University Goba Referral Hospital, P.O. Box: 76, Bale Goba, Ethiopia.
| | - Yohannes Tekalegn
- Department of Public Health, Madda Walabu University Goba Referral Hospital, P.O. Box: 76, Bale Goba, Ethiopia
| | - Demelash Woldeyohannes
- Department of Public Health, College of Medicine and Health Science, Wachemo University, Hosanna, Ethiopia
| | - Bruce John Edward Quisido
- Department of Nursing, College of Health Science, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
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Matsubara C, Sakisaka K, Sychareun V, Phensavanh A, Ali M. Anxiety and perceived psychological impact associated with needle stick and sharp device injury among tertiary hospital workers, Vientiane, Lao PDR. INDUSTRIAL HEALTH 2020; 58:388-396. [PMID: 32074514 PMCID: PMC7417503 DOI: 10.2486/indhealth.2019-0088] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 02/13/2020] [Indexed: 06/10/2023]
Abstract
Occupational needle stick and sharp injuries (NSSIs) affect healthcare workers' (HCWs') mental health, however, limited evidence is available on the psychological impact of NSSIs, especially in developing countries where most of NSSIs have been reported. A cross-sectional study was conducted to evaluate the anxiety and psychological impact regarding NSSIs among HCWs at tertiary hospitals in Lao PDR. In this study, four among seven items of anxiety scale in Hospital Anxiety and Depression Scale (HADS) (Cronbach's α=0.80) was applied. Participants who experienced NSSIs in the past 6 months showed significantly higher anxiety scores than those who did not experienced (p=0.004) and the average anxiety scores was high shortly after the NSSI. The 42.7% of them were more afraid of needles and sharp devices in the 2 wk after the NSSI than the time of the interview. The results encourage developing countries to adapt a comprehensive NSSI management policy including not only to take adequate precaution measures but psychological support and treatment for HCWs from immediately after NSSIs to improve safety for HCWs and patients. Further studies are needed to develop normative psychiatric scales with cultural adaptation in developing countries which provide convenient mental disorder assessment after NSSIs.
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Affiliation(s)
- Chieko Matsubara
- National Center for Global Health and Medicine, Japan
- Graduate School of Medicine, The University of Tokyo, Japan
| | - Kayako Sakisaka
- Graduate School of Medicine, The University of Tokyo, Japan
- Teikyo University Graduate School of Public Health, Japan
- National Center of Neurology and Psychiatry, National Institute of Mental Health, Japan Support Center for Suicide Countermeasures, Japan
| | | | | | - Moazzam Ali
- Reproductive Health and Research, World Health Organization, Switzerland
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Incidence of sharps injuries in surgical units, a meta-analysis and meta-regression. Am J Infect Control 2019; 47:448-455. [PMID: 30502112 DOI: 10.1016/j.ajic.2018.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/05/2018] [Accepted: 10/05/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Sharps injuries occur often among surgical staff, but they vary considerably. METHODS We searched PubMed and Embase for studies assessing the incidence of sharps injuries. We combined the incidence rates of similar studies in a random effects meta-analysis and explored heterogeneity with meta-regression. RESULTS We located 45 studies of which 11 were randomized control trials, 15 were follow-up studies, and 19 were cross-sectional studies. We categorized injuries as self-reported, glove perforations, or administrative injuries. We calculated the population at risk as person-years and as person-operations (po). Meta-analysis of the incidence rate based on the best outcome measure resulted in 13.2 injuries per 100 time-units (95% confidence interval [CI], 4.7-37.1; I2 = 100%). Per 100 person-years, the injury rate was 88.2 (95% CI, 61.3-126.9; 21 studies) for self-reported injuries, 40.0 for perforations (95% CI, 19.2-83.5; 15 studies), and 5.8 for administrative injuries (95% CI, 2.7-12.2; 5 studies). Per 100 po, the respective figures were 2.1 (95% CI, 0.8-5.0; 4 studies), 11.1 (95% CI, 6.6-18.9, 15 studies), and 0.1 (95% CI, 0.05-0.21). I2 values were all above 90%. Meta-regression indicated lower incidence rates in studies that used perforations per po. CONCLUSIONS A surgeon will have a sharps injury in about 1 in 10 operations . Reporting of sharps injuries in surgical staff should be standardized per 100 po and be assessed in prospective follow-up studies.
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Auta A, Adewuyi EO, Tor-Anyiin A, Aziz D, Ogbole E, Ogbonna BO, Adeloye D. Health-care workers' occupational exposures to body fluids in 21 countries in Africa: systematic review and meta-analysis. Bull World Health Organ 2017; 95:831-841F. [PMID: 29200524 PMCID: PMC5710084 DOI: 10.2471/blt.17.195735] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 09/15/2017] [Accepted: 09/16/2017] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To estimate the lifetime and 12-month prevalence of occupational exposure to body fluids among health-care workers in Africa. METHODS Embase®, PubMed® and CINAHL databases were systematically searched for studies published between January 2000 and August 2017 that reported the prevalence of occupational exposure to blood or other body fluids among health-care workers in Africa. The continent-wide prevalence of exposure was estimated using random-effects meta-analysis. FINDINGS Of the 904 articles identified, 65 studies from 21 African countries were included. The estimated pooled lifetime and 12-month prevalence of occupational exposure to body fluids were 65.7% (95% confidence interval, CI: 59.7-71.6) and 48.0% (95% CI: 40.7-55.3), respectively. Exposure was largely due to percutaneous injury, which had an estimated 12-month prevalence of 36.0% (95% CI: 31.2-40.8). The pooled 12-month prevalence of occupational exposure among medical doctors (excluding surgeons), nurses (including midwives and nursing assistants) and laboratory staff (including laboratory technicians) was 46.6% (95% CI: 33.5-59.7), 44.6% (95% CI: 34.1-55.0) and 34.3% (95% CI: 21.8-46.7), respectively. The risk of exposure was higher among health-care workers with no training on infection prevention and those who worked more than 40 hours per week. CONCLUSION The evidence available suggests that almost one half of health-care workers in Africa were occupationally exposed to body fluids annually. However, a lack of data from some countries was a major limitation. National governments and health-care institutions across Africa should prioritize efforts to minimize occupational exposure among health-care workers.
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Affiliation(s)
- Asa Auta
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Fylde Road, Preston, PR1 2HE, England
| | - Emmanuel O Adewuyi
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Amom Tor-Anyiin
- School of Health Sciences, Walden University, Minneapolis, United States of America
| | - David Aziz
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Fylde Road, Preston, PR1 2HE, England
| | - Esther Ogbole
- Biochemistry and Chemotherapy Division, Nigerian Institute for Trypanosomiasis Research, Vom, Nigeria
| | - Brian O Ogbonna
- Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Nigeria
| | - Davies Adeloye
- Department of Demography and Social Statistics, Covenant University, Ota, Nigeria
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Matsubara C, Sakisaka K, Sychareun V, Phensavanh A, Ali M. Prevalence and risk factors of needle stick and sharp injury among tertiary hospital workers, Vientiane, Lao PDR. J Occup Health 2017; 59:581-585. [PMID: 28904259 PMCID: PMC5721280 DOI: 10.1539/joh.17-0084-fs] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 08/04/2017] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Health care workers (HCWs) face risks of needle stick and sharp injuries (NSIs). Most NSIs occur in developing countries, however, no epidemiological study on NSIs is publicly available in Lao PDR. The objective of this study is to identify the prevalence and risk factors of NSIs among HCWs in Lao PDR. METHODS This cross-sectional study was designed to determine the prevalence and risk factors of NSIs among four tertiary hospitals in Vientiane, Lao People's Democratic Republic. RESULTS Six months before the survey, 11.4% (106/932) of hospital staff had experienced NSIs, while 42.1% did in their entire career. Key protective factors of NSIs among nurses included adequate availability of needles, syringes, and sharp equipment (p = 0.042; odds ratio [OR], 0.47) and attendance to educational or refresher courses on safety regarding NSIs (p = 0.038; OR, 0.50). As an on-site practice, single-handed recapping was prevalent (46.7%, 257/550) among participants. CONCLUSIONS The result showed that high rates of NSIs persist among HCWs. The findings of this research call for comprehensive health and injection safety programs for HCWs involved in clinical practice.
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Affiliation(s)
- Chieko Matsubara
- National Center for Global Health and Medicine
- Graduate School of Medicine, The University of Tokyo
| | - Kayako Sakisaka
- Graduate School of Medicine, The University of Tokyo
- Teikyo University Graduate School of Public Health
| | | | | | - Moazzam Ali
- Reproductive Health and Research, World Health Organization
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Accidental exposures to blood and body fluids among health care workers in a Referral Hospital of Cameroon. BMC Res Notes 2016; 9:94. [PMID: 26879949 PMCID: PMC4753641 DOI: 10.1186/s13104-016-1923-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 02/08/2016] [Indexed: 11/17/2022] Open
Abstract
Background Accidental exposure to blood and body fluids is a public health concern, especially among health workers and constitutes a risk of transmission of blood-borne viruses including HIV, hepatitis B virus and hepatitis C virus. The objective of this study was to determine the frequency and the post exposure management of accidental exposures to blood and body fluid among health workers in the Yaoundé University Teaching Hospital. Methods It was a cross-sectional hospital-based study conducted from the 1st to the 30th of September 2013. Self-administered questionnaires to health workers were used to collect data on self-reported accidents, circumstances and post-exposure management. Their knowledge on accidental exposure to blood was also assessed. Data were entered and analyzed using Epi Info software version 3.5.4. Descriptive analysis was performed to measure the importance of AEB and to evaluate the risk of contamination. Results One hundred and fifty health workers were interviewed among which 36.7 % reported having been exposed to blood and body fluid at least once in the preceding 3 months. Splash was the most reported injury (in 60.3 % of cases), followed by needle stick (28.7 %) and cuts (10.9 %). Moreover, 43.6 % of victims were not vaccinated against HBV, 7.3 % were not wearing gloves during the accident and 41 % of splash occurs on injured skin. The majority of victims belong to the surgical Department [20 %, p = 0.2310]. None of these injuries had been reported in the registry of accidental exposure to blood. Conclusions There is a high rate of accidental exposure to blood and body fluid in the daily hospital routine. Preventives measures, including wearing of protective equipment’s during care and vaccination against HBV are not systematically done among health workers. Health institution should develop and provide standard operating procedures targeting surveillance of occupational risks, staff training, and supervision.
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Moorhouse M, Bekker LG, Black V, Conradie F, Harley B, Howell P, Maartens G, Papavarnavas T, Rebe K, Sorour G, Venter F, Wallis CL. Guideline on the management of occupational and non-occupational exposure to the human immunodeficiency virus and recommendations for post-exposure prophylaxis: 2015 Update. South Afr J HIV Med 2015; 16:399. [PMID: 29568597 PMCID: PMC5843151 DOI: 10.4102/sajhivmed.v16i1.399] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This guideline is an update of the post-exposure prophylaxis (PEP) guideline published by the Southern African HIV Clinicians Society in 2008. It updates the recommendations on the use of antiretroviral medications to prevent individuals who have been exposed to a potential HIV source, via either occupational or non-occupational exposure, from becoming infected with HIV. No distinction is made between occupational or non-occupational exposure, and the guideline promotes the provision of PEP with three antiretroviral drugs if the exposure confers a significant transmission risk. The present guideline aligns with the principles of the World Health Organization PEP guidelines (2014), promoting simplification and adherence support to individuals receiving PEP.
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Affiliation(s)
| | - Linda G Bekker
- The Desmond Tutu HIV Centre, University of Cape Town, South Africa
| | - Vivian Black
- Wits Reproductive Health and HIV Institute, Johannesburg, South Africa
| | - Francesca Conradie
- Right to Care and Clinical HIV Research Unit, University of Witwatersrand, South Africa
| | - Beth Harley
- City Health, City of Cape Town, South Africa
| | - Pauline Howell
- Wits Health Consortium, University of Witwatersrand, South Africa
| | - Gary Maartens
- Department of Medicine, University of Cape Town, South Africa
| | | | - Kevin Rebe
- Anova Health Institute, Johannesburg, South Africa
| | - Gillian Sorour
- Gauteng Department of Health, Gauteng, South Africa.,President's Emergency Plan for AIDS Relief, Wits Reproductive Health & HIV Institute, South Africa
| | - Francois Venter
- Wits Reproductive Health and HIV Institute, Johannesburg, South Africa
| | - Carole L Wallis
- BARC, Johannesburg, South Africa.,Lancet Laboratories, Johannesburg, South Africa
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Mbonu NC, Van den Borne B, De Vries NK. A model for understanding the relationship between stigma and healthcare-seeking behaviour among people living with HIV/AIDS in sub-Saharan Africa. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2015; 8:201-12. [PMID: 25875571 DOI: 10.2989/ajar.2009.8.2.8.860] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
People living with HIV or AIDS (PLHIV) in sub-Saharan Africa sometimes have care-seeking behaviours that result in a suboptimal quality of life. This paper seeks to examine the role of stigma in the care-seeking behaviour of PLHIV. We hypothesise that stigma relates to the behaviour of PLHIV themselves and with societal reactions, including those of healthcare professionals. From a literature review, we identified the following as important correlates of care-seeking behavior: beliefs about pathways of HIV infection and people infected with HIV, social reactions, coping strategies, knowledge of HIV and AIDS, and self-efficacy in finding care and treatment in addition to coping with the disease. Poverty, gender, age, religion and policy were found to be moderating variables. The Precede-Proceed model was adapted to build an explanatory model of healthcare-seeking behaviour among PLHIV and particularly to explore the role of stigma in the non-utilisation of healthcare institutions.
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Affiliation(s)
- Ngozi C Mbonu
- a Department of Health Promotion, The School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences , Maastricht University , PO Box 616 , Maastricht , 6200 MD , The Netherlands
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Ogoina D, Pondei K, Adetunji B, Chima G, Isichei C, Gidado S. Prevalence and determinants of occupational exposures to blood and body fluids among health workers in two tertiary hospitals in Nigeria. Afr J Infect Dis 2015; 8:50-4. [PMID: 25729538 DOI: 10.4314/ajid.v8i2.7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Healthcare associated infections among health workers commonly follow occupational exposures to pathogens infecting blood or body fluids of patients. We evaluated the prevalence and determinants of occupational exposures to blood/body fluids among health workers in two tertiary hospitals in Nigeria. METHODS In a cross section study undertaken in two tertiary hospitals in North-central and South-south Nigeria in 2011, a structured self-administered questionnaire was used to obtain demographic data and occupational exposures to blood/body fluids in the previous year from doctors, nurses and laboratory scientists. Independent predictors of occupational exposures were determined in an unconditional logistic regression model. RESULTS Out of 290 health workers studied, 75.8%, 44.7%, 32.9%, 33.9% and 84.4% had skin contact with patient's blood, needle stick injuries, cut by sharps, blood/body fluid splashes to mucous membranes and one or more type of exposures respectively. Ninety one percent, 86%, 71.1%, 87.6%, 81.3%, and 84.4% of house officers, resident doctors, consultant doctors, staff nurses, principal/chief nursing officers and laboratory scientists, respectively had one or more type of exposures in the previous year (P>0.05). Professional group was found to be the only independent predictor of cut by sharps. House officers and nurses had higher and more frequent occupational exposures than other professional groups. CONCLUSION Our results suggest high rates of occupational exposures to blood/body fluid among health workers in Nigeria, especially among newly qualified medical doctors and nurses. Health facilities in Nigeria ought to strengthen infection prevention and control practices while targeting high risk health workers such as house officers and nurses.
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Affiliation(s)
- Dimie Ogoina
- Department of Medicine, Microbiology Niger Delta University, Wilberforce Island, Amassoma, Bayelsa State
| | - Kemebradikumo Pondei
- Microbiology Niger Delta University, Wilberforce Island, Amassoma, Bayelsa State
| | - Babatunde Adetunji
- Department of Medicine, Bingham University Teaching Hospital, Jos Plateau State
| | - George Chima
- Family Medicine, Bingham University Teaching Hospital, Jos Plateau State
| | - Christian Isichei
- Chemical Pathology and Surgery, Bingham University Teaching Hospital, Jos Plateau State
| | - Sanusi Gidado
- Bingham University Teaching Hospital, Jos Plateau State
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Promoting the Safety of Healthcare Workers in Africa: From HIV Pandemic to Ebola Epidemic. Infect Control Hosp Epidemiol 2015; 36:361-2. [DOI: 10.1017/ice.2014.68] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Wu Q, Xue XF, Shah D, Zhao J, Hwang LY, Zhuang G. Knowledge, Attitude, and Practices Regarding Occupational HIV Exposure and Protection among Health Care Workers in China: Census Survey in a Rural Area. J Int Assoc Provid AIDS Care 2014; 15:363-9. [PMID: 25425637 DOI: 10.1177/2325957414558300] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Health care workers (HCWs) seek, treat, and care for patients living with HIV/AIDS on a daily basis and thus face a significant risk to work-related infections. To assess the knowledge, attitude, and practices regarding occupational HIV exposure and protection among HCWs in low HIV prevalence areas of rural China. METHODS A cross-sectional questionnaire survey was carried out among all medical units in Pucheng County, Shaanxi, China. RESULTS Response rate of this study was 94%. The average overall knowledge score of HCWs was 10.9 of 21.0. Deficiencies in general, transmission, exposure, and protection knowledge were identified among HCWs at all levels. A high rate of occupational exposure (85%) and lack of universal precautions practice behavior were recorded. Significant predictors of universal precautions practice behavior were female sex, prior training, and greater knowledge about HIV/AIDS. CONCLUSION Health care workers at various levels have inadequate knowledge on HIV/AIDS and do not practice universal precautions. Nurses and medical technicians at the county level faced more occupation risk than other HCWs. The key of AIDS training for different levels of HCWs should be distinguished.
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Affiliation(s)
- Qian Wu
- Department of Epidemiology, Xi'an Jiaotong University School of Public Health, Shaanxi, People's Republic of China
| | - Xiao Fei Xue
- Pucheng County Hospital, Weinan, Shaanxi, People's Republic of China
| | - Dimpy Shah
- Division of Epidemiology, Center for Infectious Diseases, School of Public Health, University of Texas Health Science Center, Houston, TX, USA
| | - Jian Zhao
- Pucheng County Hospital, Weinan, Shaanxi, People's Republic of China
| | - Lu-Yu Hwang
- Division of Epidemiology, Center for Infectious Diseases, School of Public Health, University of Texas Health Science Center, Houston, TX, USA
| | - GuiHua Zhuang
- Department of Epidemiology, Xi'an Jiaotong University School of Public Health, Shaanxi, People's Republic of China
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Godfrey C, Schouten JT. Infection control best practices in clinical research in resource-limited settings. J Acquir Immune Defic Syndr 2014; 65 Suppl 1:S15-8. [PMID: 24321978 PMCID: PMC3930462 DOI: 10.1097/qai.0000000000000034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Infection control activities in the international research setting include the development of meaningful and effective policies on specific topics such as hand and respiratory hygiene. Prevention of infection in health care workers and management of occupational exposure to transmissible agents are important aspects of the role of an infection control practitioner. Hand hygiene reduces health care associated infections and practices may be implemented in the research setting.
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Affiliation(s)
- Catherine Godfrey
- National Institutes of Health, National Institute of Allergy and Infectious Diseases (NIAID)
| | - Jeffrey T. Schouten
- Office of HIV/AIDS Network Coordination, Fred Hutchinson Cancer Research Center
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Are healthcare workers at higher risk of HIV infection than the general population in Burkina Faso? Epidemiol Infect 2013; 142:662-70. [PMID: 23759388 DOI: 10.1017/s0950268813001404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
In order to assess the HIV prevalence in healthcare workers (HCWs) in Burkina Faso, we conducted a national survey in 97 health facilities from urban and rural areas. Of 1570 HCWs who agreed to participate, 1013 (64·5%) provided a urine sample for HIV testing. The crude prevalence of HIV in HCWs was 3·5% (95% CI 2·3-4·6). HIV prevalence was 0·7% in students and trainees, 3·8% in nurses and midwives, 4·5% in administrative workers, and 4·6% in laboratory workers. After age and area standardization, men from the Demographic Health Survey (DHS) had a similar HIV prevalence (2·3%, 95% CI 1·4-2·9) as male HCWs (2·5%, 95% CI 1·1-4·0), while female HCWs were more infected (4·5%, 95% CI 2·5-6·0) than women from the DHS (2·1%, 95% CI 1·3-2·4). A voluntary counselling and testing (VCT) programme should be specifically implemented and adapted for female HCWs.
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Occupational exposure to sharp injuries among medical and dental house officers in Nigeria. Int J Occup Med Environ Health 2013; 26:283-90. [DOI: 10.2478/s13382-013-0098-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Accepted: 11/08/2012] [Indexed: 11/20/2022] Open
Abstract
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The level of knowledge of, attitude toward and emphasis given to HBV and HCV infections among healthcare professionals: Data from a tertiary hospital in Turkey. Int J Occup Med Environ Health 2013; 26:122-31. [DOI: 10.2478/s13382-013-0077-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 07/25/2012] [Indexed: 11/20/2022] Open
Abstract
Abstract
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Is universal HBV vaccination of healthcare workers a relevant strategy in developing endemic countries? The case of a university hospital in Niger. PLoS One 2012; 7:e44442. [PMID: 22970218 PMCID: PMC3436880 DOI: 10.1371/journal.pone.0044442] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 08/03/2012] [Indexed: 11/19/2022] Open
Abstract
Background Exposure to hepatitis B virus (HBV) remains a serious risk to healthcare workers (HCWs) in endemic developing countries owing to the strong prevalence of HBV in the general and hospital populations, and to the high rate of occupational blood exposure. Routine HBV vaccination programs targeted to high-risk groups and especially to HCWs are generally considered as a key element of prevention strategies. However, the high rate of natural immunization among adults in such countries where most infections occur perinatally or during early childhood must be taken into account. Methodology/Principal Findings We conducted a cross sectional study in 207 personnel of 4 occupational groups (medical, paramedical, cleaning staff, and administrative) in Niamey’s National Hospital, Niger, in order to assess the prevalence of HBV markers, to evaluate susceptibility to HBV infection, and to identify personnel who might benefit from vaccination. The proportion of those who declared a history of occupational blood exposure ranged from 18.9% in the administrative staff to 46.9% in paramedical staff. Only 7.2% had a history of vaccination against HBV with at least 3 injections. Ninety two percent were anti-HBc positive. When we focused on170 HCWs, only 12 (7.1%) showed no biological HBV contact. Twenty six were HBsAg positive (15,3%; 95% confidence interval: 9.9%–20.7%) of whom 8 (32%) had a viral load >2000 IU/ml. Conclusions/Significance The very small proportion of HCWs susceptible to HBV infection in our study and other studies suggests that in a global approach to prevent occupational infection by bloodborne pathogens, a universal hepatitis B vaccination of HCWs is not priority in these settings. The greatest impact on the risk will most likely be achieved by focusing efforts on primary prevention strategies to reduce occupational blood exposure. HBV screening in HCWs and treatment of those with chronic HBV infection should be however considered.
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Needlestick Injuries, Short Peripheral Catheters, and Health Care Worker Risks. JOURNAL OF INFUSION NURSING 2012; 35:164-78. [DOI: 10.1097/nan.0b013e31824d276d] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Leow JJ, Groen RS, Bae JY, Adisa CA, Kingham TP, Kushner AL. Scarcity of healthcare worker protection in eight low- and middle-income countries: surgery and the risk of HIV and other bloodborne pathogens. Trop Med Int Health 2011; 17:397-401. [PMID: 22035344 DOI: 10.1111/j.1365-3156.2011.02909.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE In view of the substantial incidence of bloodborne diseases and risk to surgical healthcare workers in low- and middle-income countries (LMICs), we evaluated the availability of eye protection, aprons, sterile gloves, sterilizers and suction pumps. METHODS Review of studies using the WHO Tool for the Situational Analysis of Access to Emergency and Essential Surgical Care. RESULTS Eight papers documented data from 164 hospitals: Afghanistan (17), Gambia (18), Ghana (17), Liberia (16), Mongolia (44), Sierra Leone (12), Solomon Islands (9) and Sri Lanka (31). No country had a 100% supply of any item. Eye protection was available in only one hospital in Sri Lanka (4%) and most abundant in Liberia (56%). The availability of sterile gloves ranged from 24% in Afghanistan to 94% in Ghana. CONCLUSION Substantial deficiencies of basic protective supplies exist in low- and middle-income countries.
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Hosoglu S, Akalin S, Sunbul M, Otkun M, Ozturk R. Healthcare workers' compliance with universal precautions in Turkey. Med Hypotheses 2011; 77:1079-82. [PMID: 21963357 DOI: 10.1016/j.mehy.2011.09.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 08/23/2011] [Accepted: 09/05/2011] [Indexed: 11/18/2022]
Abstract
Blood-borne pathogens (BBP) represent remarkable occupational risks for healthcare workers (HCWs). Avoiding occupational blood exposure is a basis of prevention of the blood-borne pathogens (BBP). The effectiveness of the prevention strategies depends on the compliance and adherence to the program by healthcare-facility personnel. The aim of this study was to evaluate Turkish HCWs' compliance with Universal Precautions (UP). An analytic, cross-sectional, countrywide survey study was performed in hospital settings, (n = 5145) in 30 hospitals in 19 cities. In total, 1726 of the 5143 (33.6%) participants' behaviors were accepted as satisfactory for compliance with UP. The hepatitis knowledge levels of 2,650 (51.5%) participants were found to be satisfactory. In the multivariate analysis, working at a surgical site (P = 0.004), living in a rich region (P = .007) and the existence of a health office for HCWs (p = .000) were found to be contributor factors for HCWs' compliance with UP. Conversely, being a nurse (P = .000) and HBV/HCV carrier status (P = .039) were significant preventing predictors for HCWs' compliance with UP. Along with the other well-known predictive factors, regional economic status and a health office for HCWs are contributors for compliance with UP.
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Affiliation(s)
- Salih Hosoglu
- Department of Infectious Diseases, Dicle University Hospital, Diyarbakir, Turkey.
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Prévalence des accidents professionnels d’exposition au sang chez le personnel soignant au Togo (Afrique). ARCH MAL PROF ENVIRO 2011. [DOI: 10.1016/j.admp.2011.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Onia R, Eshun-Wilson I, Arce C, Ellis C, Parvu V, Hassman D, Kassler-Taub K. Evaluation of a new safety peripheral IV catheter designed to reduce mucocutaneous blood exposure. Curr Med Res Opin 2011; 27:1339-46. [PMID: 21627396 DOI: 10.1185/03007995.2011.581275] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES We evaluated performance and clinical acceptability of a new peripheral intravenous catheter (PIVC) designed to reduce blood exposure. METHODS A two phased, unblinded, randomized controlled trial was conducted at a clinical research center in New Jersey, USA. In Phase 1, clinicians were asked to evaluate two devices: a PIVC with blood control (BD Insyte Autoguard * BC [Blood Control] Shielded IV Catheter), and a reference conventional PIVC (BD Insyte Autoguard Shielded IV Catheter). In Phase 2, clinicians compared two insertions of the investigational PIVC with blood control (PIVC-BC); one with venous compression and one without. The PIVC-BC was evaluated for superiority to the conventional PIVC with regard to blood exposure and for equivalence in general performance characteristics. RESULTS Seventy-eight clinicians (mean age: 41.4 years; 89.7% female) and 234 healthy volunteers (mean age: 40.2 years; 61.5% female) were enrolled. Blood leakage occurred significantly more in the conventional PIVC group (39.1%) as compared to the PIVC-BC group (2.0%) (difference: 37.1% [95% CI: 28.8%; 45.15%]). Blood leakage rates for the PIVC-BC with or without use of venous compression were similar, 2.6% and 1.3% respectively (difference: 1.3% [95% CI: -7.8%; 4.7%]). A total of 98.7% of clinicians rated the PIVC-BC as clinically acceptable compared to 89.6% with the reference PIVC (difference: -9.1; 95% CI: -18; -1.5%) and 98.7% agreed it replaced the need for venous compression during catheter insertion (95% CI: 92.8%; 100%). Although the inability to blind clinicians to the investigational product was a potential source of bias, this was unlikely to affect assessments of observed blood leakage. CONCLUSIONS The PIVC with blood control demonstrated reduced blood leakage during insertion and was rated no different for clinical acceptability and insertion performance compared to the conventional PIVC. Clinicians agreed that the new design replaced the need for venous compression to control blood flow during IV catheter insertion.
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Affiliation(s)
- Rudy Onia
- Becton, Dickinson and Company, Sandy, UT, USA.
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Deuffic-Burban S, Delarocque-Astagneau E, Abiteboul D, Bouvet E, Yazdanpanah Y. Blood-borne viruses in health care workers: prevention and management. J Clin Virol 2011; 52:4-10. [PMID: 21680238 DOI: 10.1016/j.jcv.2011.05.016] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Revised: 05/15/2011] [Accepted: 05/18/2011] [Indexed: 02/07/2023]
Abstract
Three pathogens account for most cases of occupationally acquired blood-borne infection: hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). The highest proportion of occupational transmission is due to percutaneous injury (PI) via hollow-bore needles with vascular access. We briefly review prevention and management of blood-borne pathogens in health care workers (HCWs) in developed countries. HCW compliance with standard precautions is necessary for prevention of PI. Safety-engineered devices are now being increasingly promoted as an approach to decreasing the rate of PI. Prevention of HBV transmission requires HCW immunization through vaccination against HBV. In non-vaccinated HCWs (or HCWs with an unknown antibody response to vaccination) exposed to an HbsAg-positive or an untested source patient, post-exposure prophylaxis with HBV vaccine, hepatitis B immunoglobulin or both must be started as soon as possible. Although no available prophylaxis exists for HCV, it is crucial to identify HCV exposure and infection in health care settings and to consequently propose early treatment when transmission occurs. Following occupational exposure with potential for HIV transmission, use of antiretroviral post-exposure prophylaxis must be evaluated. Patients need to be protected from blood-borne pathogen-infected HCWs, and especially surgeons performing exposure-prone procedures (EPPs) with risk of transmission to the patient. However, HCWs not performing EPPs should be protected from arbitrary administrative decisions that would restrict their practice rights. Finally, it must be emphasized that occupational blood exposure is of great concern in developing countries, with higher risk of exposure to blood-borne viruses because of a higher prevalence of the latter than in developed countries, re-use of needles and syringes and greater risk of sustaining PI, since injection routes are more frequently used for drug administration than in developed countries.
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Affiliation(s)
- S Deuffic-Burban
- ATIP-AVENIR, Inserm U995, Université Lille Nord de France, 152 rue du Docteur Yersin, 59120 Loos, France.
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Kumakech E, Achora S, Berggren V, Bajunirwe F. Occupational exposure to HIV: a conflict situation for health workers. Int Nurs Rev 2011; 58:454-62. [DOI: 10.1111/j.1466-7657.2011.00887.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Risk factors for transmission of HIV in a hospital environment of Yaoundé, Cameroon. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2010; 7:2085-100. [PMID: 20623013 PMCID: PMC2898038 DOI: 10.3390/ijerph7052085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Revised: 03/10/2010] [Accepted: 04/04/2010] [Indexed: 11/24/2022]
Abstract
Risk factors for HIV transmission within a hospital setting were assessed using pre-structured questionnaires and observations. Of 409 respondents, 66.3% corresponded to the nursing staff, 14.4% doctors and 8.3% laboratory staff. The irregular use of gloves and other protective clothing for risky tasks, and recapping of needles after use were some of the risk factors identified, especially amongst nurses. Preventive measures were not always implemented by health personnel. More emphasis should be placed not only on diffusing universal precautions and recommendations for hospital staff safety, but accompanying measures for monitoring and evaluation of implementation of these standards are also indispensable.
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Lee R. Occupational transmission of bloodborne diseases to healthcare workers in developing countries: meeting the challenges. J Hosp Infect 2009; 72:285-91. [DOI: 10.1016/j.jhin.2009.03.016] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2008] [Accepted: 03/23/2009] [Indexed: 12/31/2022]
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The structure and outcomes of a HIV postexposure prophylaxis program in a high HIV prevalence setup in western Kenya. J Acquir Immune Defic Syndr 2009; 51:47-53. [PMID: 19339898 DOI: 10.1097/qai.0b013e318198a96a] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In 2001, HIV postexposure prophylaxis (PEP) was initiated in western Kenya. METHODS Design, implementation, and evolution of the PEP program are described. Patient data were analyzed for reasons, time to initiation, and PEP outcome. RESULTS Occupational PEP was initiated first followed by nonoccupational PEP (nPEP). Antiretroviral regimens were based upon national PEP guidelines, affordability and availability, and prevailing HIV prevalence. Emerging side effects data and cost improvements influenced regimen changes. Between November 2001 and December 2006, 446 patients sought PEP. Occupational exposure: 91 patients: 51 males; 72 accepted HIV testing; 48 of 52 source patients were HIV infected; median exposure-PEP time 3 hours (range: 0.3-96 hours). Of 72 HIV-negative patients receiving PEP, 3 discontinued, 69 completed, and 23 performed post-PEP HIV RNA polymerase chain reaction (all negative). Eleven follow-up HIV enzyme-linked immunosorbent assay tests have all turned negative. Nonoccupational exposure: 355 patients; 285 females; 90 children; 300 accepted HIV testing; median exposure-nPEP time 19 hours (range: 1-672 hours). Of 296 HIV-negative patients on nPEP, 1 died, 15 discontinued, 104 are on record having completed PEP, and 129 returned for 6-week HIV RNA polymerase chain reaction (1 patient tested positive). Eighty-seven follow-up HIV enzyme-linked immunosorbent assay tests have all turned negative. CONCLUSIONS It is feasible to provide PEP and nPEP in resource-constrained settings.
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Hosoglu S, Akalin S, Sunbul M, Otkun M, Ozturk R. Predictive factors for occupational bloodborne exposure in Turkish hospitals. Am J Infect Control 2009; 37:65-9. [PMID: 18834743 DOI: 10.1016/j.ajic.2008.02.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2007] [Revised: 02/25/2008] [Accepted: 02/25/2008] [Indexed: 11/19/2022]
Abstract
BACKGROUND This study was conducted to evaluate the epidemiology of percutaneous injury and/or mucosa exposure (PME) with blood or other body fluids that poses serious risks for health care workers (HCWs). METHODS An analytic, cross-sectional, countrywide survey study was conducted to describe the extent of and predictive factors for PME among HCWs in hospital settings in Turkey, with total of 5258 HCW participants from 30 hospitals in 19 cities throughout the country. RESULTS The respondent group included 41.3% nurses, 29.0% doctors, 9.3% laboratory workers, and 20.3% paramedics. The survey found that 50.1% of the participants reported at least 1 occupational PME in the previous year. Doctors (2.57/person/year) and nurses (2.56/person/year) had the highest PME incidents. In the multivariate analysis, working at a surgical site (P = .000), being a doctor (P = .000), being a nurse (P=.000), young age (P = .025), and living in a poor region (P = .005) were significant factors for high occupational exposure. The presence of a health office for HCWs at the hospital (P = .000) and working at a university hospital (P = .003) were significant predictors of less occupational exposure. Overall, the mean number of PME incidents was 2.16/person/year. CONCLUSION Along with the other well-known predictive factors, regional economic status and a health office for HCWs are preventive factors for PME exposure of HCWs.
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Affiliation(s)
- Salih Hosoglu
- Department of Infectious Diseases, Dicle University Hospital, Diyarbakir, Turkey.
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Ehui E, Kra O, Ouattara I, Eholié S, Kakou A, Bissagnéné E, Kadio A. Prise en charge des accidents d'exposition au sang au CHU de Treichville, Abidjan (Côte-d'Ivoire). Med Mal Infect 2007; 37 Suppl 3:S251-6. [PMID: 17512149 DOI: 10.1016/j.medmal.2007.03.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2006] [Accepted: 03/07/2007] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study was to assess care and preventive measures for accidental exposure to blood (AEB) in Abidjan. METHODS A retrospective study of all AEB reported in the Infectious and Tropical Diseases Center of the Treichville University Hospital was made between January 2000 and December 2005. Epidemiology, management, clinical and biological post-exposure follow-up were analyzed. RESULTS One hundred eighty-two AEB were managed over 6 years (151 needlesticks, 14 ocular projections of blood, 12 cuts, and 5 mucocutaneous exposure to blood). 94 men (51.6%) and 68 women (48.4%) were included [sex ratio 1.4] mean age 33.8 years+/-7.4 years. Physicians (29.1%), nurses (19.8%), assistant nurse (12.1%), and medical students (11.4%) were the professional categories which declared most accidents. Among them, only 51.1% was correctly vaccinated against hepatitis B. The average delay of consultation was 26.5 hours (1-240 hours), and 82.9% of victims consulted before the 48th hour. Antiretroviral prophylaxis was prescribed to 151 patients among whom 45% with bitherapy (Zidovudine and Lamivudine), and 55% with HAART including an antiprotease. Only 60 patients had one actual month of treatment. Despite the weak follow-up, no case of HIV seroconversion was reported 6 month after exposure. CONCLUSION This work underlines once again the high frequency of AEB in Abidjan despite a under reporting, and calls for the implementation of a policy to train health care workers on AEB preventive measures.
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Affiliation(s)
- E Ehui
- Service des maladies infectieuses et tropicales, CHU de Treichville, 01 BP V 3 Abidjan 01, Côte-d'Ivoire.
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M'ikanatha NM, Imunya SG, Fisman DN, Julian KG. Sharp-device injuries and perceived risk of infection with bloodborne pathogens among healthcare workers in rural Kenya. Infect Control Hosp Epidemiol 2007; 28:761-3. [PMID: 17520560 DOI: 10.1086/517955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Tarantola A. Of viruses, gloves, and crêpes. Am J Infect Control 2007; 35:284. [PMID: 17483001 DOI: 10.1016/j.ajic.2006.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2006] [Accepted: 08/04/2006] [Indexed: 11/24/2022]
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