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Yared G, Sokhn ES, Al-Khatib A, Kassis C, Younes R. Knowledge, Attitude, and Practice of Hepatitis B Vaccination among Dentists in Lebanon. J Contemp Dent Pract 2024; 25:134-140. [PMID: 38514410 DOI: 10.5005/jp-journals-10024-3635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
BACKGROUND The hepatitis B virus (HBV) is a serious occupational hazard for healthcare workers, including dentists. The purpose of this study is to assess dentists' knowledge, attitude, and practice (KAP) with respect to hepatitis B vaccination. MATERIALS AND METHODS A cross-sectional survey of a representative sample of dentists (n = 349) from Lebanon was carried out. Participants' knowledge of hepatitis B, attitudes toward vaccination, and immunization habits were assessed using a standardized questionnaire. To examine the data, descriptive statistics were used, and associations between variables were investigated using appropriate statistical tests. RESULTS The study found that most participating dentists are HBV-vaccinated. These dentists boast a basic to a significantly substantial understanding of HBV infection prevention strategies, such as immunization, routine preventive measures, and handling equipment. Notwithstanding the generally positive attitudes towards vaccination, a proportion of dentists lacked some HBV prevention practices, specifically with respect to conducting regular follow-ups of anti-HBs titer levels and getting booster vaccination doses when warranted. CONCLUSION This study sheds light on the KAP of hepatitis B immunization among Lebanese dentists. The findings emphasize the significance of focused educational efforts in view of improving awareness and encouraging a more thorough understanding of the benefits of vaccination. The study provides useful data that can be used to influence public health policies as well as activities aimed at increasing hepatitis B vaccination rates among dental professionals in Lebanon. How to cite this article: Yared G, Sokhn ES, Al-Khatib A, et al. Knowledge, Attitude, and Practice of Hepatitis B Vaccination among Dentists in Lebanon. J Contemp Dent Pract 2024;25(2):134-140.
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Affiliation(s)
- Ghassan Yared
- Department of Oral Medicine and Radiology, Faculty of Dental Medicine, Saint Joseph University, Beirut, Lebanon, Phone: +961 3605340, e-mail:
| | - Elie S Sokhn
- Department of Laboratory Medicine, Lebanese Hospital Geitaoui - University Medical Center (UMC), Achrafieh; Department of Medical Laboratory Technology, Molecular Testing Laboratory, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Aynaa Al-Khatib
- Department of Medical Laboratory Technology, Molecular Testing Laboratory, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Cynthia Kassis
- Department of Esthetic and Restorative Dentistry, Faculty of Dental Medicine, Saint Joseph University, Beirut, Lebanon
| | - Ronald Younes
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University, Beirut, Lebanon
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Panta G, Richardson AK, Shaw IC, Coope PA. Healthcare workers’ knowledge and attitudes towards sterilization and reuse of medical devices in primary and secondary care public hospitals in Nepal: A multi-centre cross-sectional survey. PLoS One 2022; 17:e0272248. [PMID: 35913951 PMCID: PMC9342727 DOI: 10.1371/journal.pone.0272248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 07/15/2022] [Indexed: 11/18/2022] Open
Abstract
Background Healthcare facilities reprocess and sterilize reusable medical devices before each invasive clinical procedure, such as surgery, to prevent person-to-person or environmental transmission of pathogens through medical devices. We conducted a nationwide multi-centre cross-sectional survey in primary and secondary-care public hospitals in Nepal to assess the knowledge and attitudes of healthcare workers towards sterilization and reuse of medical devices. Methods We carried out a multi-centre cross-sectional survey comprising eleven primary-care (two district-level and nine district hospitals) and two secondary-care (zonal hospitals) public hospitals which covered all seven provinces of Nepal. Survey questionnaires were distributed to 234 healthcare workers including doctors, nurses, paramedics, and office assistants (involved in medical device reprocessing); 219 (93.6%) returned the completed questionnaire. Descriptive analyses of demographic information, knowledge and attitude responses of survey participants were performed. Logistic regression and ordinal regression models for complex samples were used to investigate associations between responses and independent variables. Results Except for a few areas, more than 70% of healthcare workers had proper knowledge about different aspects of sterilization and reuse of medical devices. Paramedics and office assistants were less likely to have the correct knowledge in different aspects compared to nurses. Permanent staff were more likely to give correct answers to some knowledge questions compared to temporary staff. Previous infection control training was positively associated with correct responses to some knowledge items. Most of the healthcare workers had positive attitudes towards different aspects of sterilization and reuse of medical devices, and nurses were more likely to have positive attitudes compared with other staff categories. Conclusions Most of the healthcare workers had correct knowledge and positive attitudes towards most areas of sterilization and reuse of medical devices. However, they need proper education and training in some areas such as sterilization procedures, storage of sterilized devices, prion decontamination and standard precautions.
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Affiliation(s)
- Gopal Panta
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
- * E-mail:
| | - Ann K. Richardson
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
| | - Ian C. Shaw
- School of Physical and Chemical Sciences, University of Canterbury, Christchurch, New Zealand
| | - Patricia A. Coope
- College of Education, Health and Human Development, University of Canterbury, Christchurch, New Zealand
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The impact of COVID-19 on knowledge, attitude, and infection control behaviors among dentists. BMC Oral Health 2021; 21:584. [PMID: 34798843 PMCID: PMC8602991 DOI: 10.1186/s12903-021-01946-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 11/04/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND This study seeks to elucidate the impact of COVID-19 on knowledge, attitude, and infection control behaviors among dentists. METHODS Changes in knowledge, attitude, and infection control behaviors reported in 2020 (COVID-19 period) were compared to the historical control of the non-COVID-19 period in 2018. A proportional random sampling method was used to select the study samples from 400 dental institutions. The response rate was 69% in 2018 and 62.8% in 2020. A total of 276 dentists in 2018 and 251 dentists in 2020 responded to this questionnaire. Multiple logistic regression was used to assess the associations between factors and recommended infection control practices. RESULTS High rates of correct COVID-19 knowledge (94.76%), fears of being infected with the virus (94%) and use of personal protective equipment (mask, glove and protection gown; 95%) were reported. We found that knowledge regarding environmental infection control, HIV transmission, and the window of HIV transmission were significantly higher in the post-COVID-19 period compared with the pre-COVID-19 period. High compliance rates of wearing mask, gloves and protection were reported. The number of dentists wearing a hair cap and a protective eye mask/face shield during the pandemic significantly increased compared with that noted before the COVID-19 pandemic. Factors associated with the use of a hair cap and an eye mask/face shield differed between the pre- and post-COVID-19 periods. The factors associated with compliance regarding environment infection control also differed between the pre- and post-COVID-19 periods. CONCLUSION The significant impact of COVID-19 on the knowledge, attitude, and infection control behaviors among dental care workers was observed in the current study. In particular, the use of hair caps and protective eye mask or face shields as well as environmental disinfection protocols has significantly improved. Trial registration TMU-JIRB: N201804006.
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Rostamzadeh M, Afkhamzadeh A, Afrooz S, Mohamadi K, Rasouli MA. Dentists' knowledge, attitudes and practices regarding Hepatitis B and C and HIV/AIDS in Sanandaj, Iran. BMC Oral Health 2018; 18:220. [PMID: 30563497 PMCID: PMC6299669 DOI: 10.1186/s12903-018-0685-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 12/04/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Healthcare workers including physicians, dentists, nurses and laboratory workers are considered to be among the groups at the risk of blood-borne pathogen transmission. Thus, it is necessary to evaluate the Knowledge, Attitude, and Practices (KAP) of dentists regarding infection control and basic principles. METHODS This cross-sectional study recruited 106 dentists in Sanandaj, Iran. The dentists' KAP regarding hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV/AIDS were evaluated. Chi-square test, student's t-test, and one-way ANOVA were used to assess differences between the groups. Data were analyzed in Stata 12. RESULTS The results showed that the majority of the subjects in the study population (53.8%) were female. The mean ± standard deviation (SD) for age and work experience was 39.6 ± 9.80 and 10.6 ± 8.7 years, respectively. The mean ± SD for knowledge, attitude and practices of participants was 37.3 ± 3.01, 22.9 ± 4.80 and 24.07 ± 5.06, respectively. The results also indicated that dentists' higher level of knowledge about HBV, HCV and HIV/AIDS was significantly influenced by work experience (≥10 years; P < 0.001) and graduation year (after 2006: P < 0.001). Positive attitude towards HBV, HCV and HIV/AIDS was considerably influenced by age group (< 30 years: P = 0.021), work experience (≥10 years: P < 0.001), and workplace (dental office: P = 0.016). CONCLUSIONS The results of this study demonstrated a satisfactory level of knowledge and attitude of dentists about HBV, HCV and HIV/AIDS infections, but some gaps were observed, suggesting that higher knowledge level of dentists plays a very important role in forming the attitudes and practices regarding patients with HBV, HCV and HIV/AIDS.
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Affiliation(s)
- Masomeh Rostamzadeh
- Department of Prosthodontics, Faculty of Dentistry, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Abdorrahim Afkhamzadeh
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Sirus Afrooz
- Dentistry Student, Faculty of Dentistry, Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Kaveh Mohamadi
- DDS & Fellowship Oral Implantology (ICOI Fellowship), Faculty of Dentistry, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohammad Aziz Rasouli
- Vice Chancellor for Educational and Research, Kowsar Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Thivichon-Prince B, Barsotti O, Girard R, Morrier JJ. Hand hygiene practices in a dental teaching center: Measures and improve. Eur J Dent 2014; 8:481-486. [PMID: 25512728 PMCID: PMC4253103 DOI: 10.4103/1305-7456.143629] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To measure the compliance and the quality of HH practices and the knowledge of the healthcare workers' of the university dental care center. MATERIALS AND METHODS All educators and students present were eligible for inclusion in the study. Each healthcare professional was observed in care situation over a period of 30 min. The knowledge, attitudes and opinions were collected through a questionnaire. RESULTS Number of healthcare professionals included was 190 (64.4%). Study group consisted of 151 students (74.4%) and 39 educators (42.4%). Out of a total number of expected disinfection of hands (993), 396 were made (39.9%). Educators had a higher compliance rates than students (63.7-35.8%, P = 10(-9)). Large differences were found between care situations (compliance higher before the first care to a patient and lower during installation of patient in dental X-ray area or at exit of dental X-ray area). Concerning hand rubbing (HR), 36.6% were performed correctly, and the main error was all steps of HR not observed (54.4%), and shorter duration (46.7%). The observance and the quality of HR were associated with better knowledge. CONCLUSION This data suggests areas of improvement: (1) A comprehensive intervention including care organization/clinic ergonomics/planning/anticipation of materials needed for care; (2) the development of HH education program should include the educators, since the behavior of students is strongly influenced and formed by their mentor's attitude and behaviors.
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Affiliation(s)
- Béatrice Thivichon-Prince
- Faculty of Odontology, Services de consultations et de traitements dentaires de Lyon, University Lyon1, Hospices civils de Lyon, Lyon, France
| | - Odile Barsotti
- Faculty of Odontology, Services de consultations et de traitements dentaires de Lyon, University Lyon1, Hospices civils de Lyon, Lyon, France
| | - Raphaele Girard
- Hygiene and Epidemiology Unit, CH Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Jean-Jacques Morrier
- Faculty of Odontology, Services de consultations et de traitements dentaires de Lyon, University Lyon1, Hospices civils de Lyon, Lyon, France
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Kateeb E, Amer R, Bajali M. Factors related to the willingness of Palestinian dentists to treat patients with blood-borne diseases. Int Dent J 2014; 65:103-9. [PMID: 25345747 DOI: 10.1111/idj.12138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
This study aimed to explore, using groups of simulated patients, the willingness of Palestinian dentists to treat patients with blood-borne diseases. Simulated patients conducted a telephone survey of a random sample of dentists registered with the Palestinian Dental Association. A random system was used to assign dentists to one of two groups, in which simulated patients randomly identified themselves with either human immunodeficiency virus (HIV) or hepatitis B virus (HBV) and asked for a dental appointment. Three-hundred and four dentists (76%) responded to our telephone survey. Sixty-six per cent accepted requests for appointments and 34% declined the appointment requests. Sixty-eight per cent of the dentists declined appointment requests from patients with HIV and 32% declined appointments from patients with HBV. Dentist's gender, 'blood-borne disease type', 'place of private practice', 'country of graduation' and 'years since graduation' were all significant predictors in the final logistic model. More than one-third of our respondents declined appointment requests from patients with blood-borne disease, two-thirds of which were for patients who identified themselves as having HIV. Education and training programmes are needed to improve attitudes of dentists - especially female dentists, older dentists and dentists practising in northern governorates - towards patients with blood-borne diseases.
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Affiliation(s)
- Elham Kateeb
- School of Dental Medicine, Al Quds University, University Main Street, East Jerusalem, Palestine; College of Dentistry, University of Iowa, 801 Newton Rd #451, Iowa City, IA, 52242, USA
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Mohamoud YA, Miller FD, Abu-Raddad LJ. Potential for human immunodeficiency virus parenteral transmission in the Middle East and North Africa: An analysis using hepatitis C virus as a proxy biomarker. World J Gastroenterol 2014; 20:12734-12752. [PMID: 25278675 PMCID: PMC4177460 DOI: 10.3748/wjg.v20.i36.12734] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 02/20/2014] [Accepted: 05/29/2014] [Indexed: 02/06/2023] Open
Abstract
The Middle East and North Africa (MENA) region has endured several major events of infection parenteral transmission. Recent work has established the utility of using hepatitis C virus (HCV) as a proxy biomarker for assessing the epidemic potential for human immunodeficiency virus (HIV) parenteral transmission. In this review, we use data on the prevalence of HCV infection antibody (seroprevalence) among general population and high risk population groups to assess the potential for HIV parenteral transmission in MENA. Relatively low prevalence of HCV infection in the general population groups was reported in most MENA countries indicating that parenteral HIV transmission at endemic levels does not appear to be a cause for concern. Nonetheless, there could be opportunities for localized HIV outbreaks and transmission of other blood-borne infections in some settings such as healthcare facilities. Though there have been steady improvements in safety measures related to parenteral modes of transmission in the region, these improvements have not been uniform across all countries. More precautions, including infection control training programs, surveillance systems for nosocomial infections and wider coverage and evaluation of hepatitis B virus immunization programs need to be implemented to avoid the unnecessary spread of HIV, HCV, and other blood-borne pathogens along the parenteral modes of transmission.
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Hedayati H, Marjadi B, Askarian M. Barriers to standard precautions adherence in a dental school in Iran: a qualitative study. Am J Infect Control 2014; 42:750-4. [PMID: 24969126 DOI: 10.1016/j.ajic.2014.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 04/04/2014] [Accepted: 04/04/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Setting up good infection control practices in educational institutions is crucial in shaping future health professionals. The implementation of standard precautions (SPs) in Iranian dental schools has not been explored qualitatively to identify barriers to good practice. METHODS Twelve focus group discussions and 8 semistructured interviews were conducted with students, residents, and staff members (n = 83) of the Shiraz University of Medical Sciences Dental School. The interview guide addressed performance, subjective norms, and behavioral control domains of SP-related behaviors. Thematic analysis was performed manually to identify barriers to SP practices. RESULTS Proximal factors of poor SP adherence were a lack of knowledge and technical difficulties. These factors were compounded by intermediate factors in the work environment: lack of facilities, heavy workload, patient expectations, interprofessional conflicts, and lack of good role models. Two underlying distal factors were financial issues and unsupportive organizational culture. The social constructionism theory was useful in analyzing the situation and suggesting an educational approach as part of the solution. CONCLUSION Complex and intertwined barriers of SP adherence were found in this dental school. A social construction approach may assist in addressing these problems by shifting the culture through education to construct a contextual new knowledge. Further research in medical sociology of SP practices would be useful.
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Affiliation(s)
- Hamidreza Hedayati
- Student Research Committee, Department of Community Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mehrdad Askarian
- Department of Community Medicine, Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Hedayati-Moghaddam MR, Marjaneh MM, Mashhadi IE. Knowledge and attitudes of physicians in private practice towards HIV/AIDS in Mashhad, Iran. Int J STD AIDS 2012; 23:e11-6. [DOI: 10.1258/ijsa.2009.009447] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Being responsible for providing care for HIV/AIDS in a society, physicians should be knowledgeable and have favourable attitudes. We designed a cross-sectional study to assess knowledge and attitudes towards HIV/AIDS of private practicing physicians in Mashhad, Iran. A total of 346 general practitioners and specialists completed anonymous self-administered questionnaires with response rate of 91.1%. For knowledge questions, the mean proportion of correct responses was 53.5% (±13.2). Misconceptions about HIV transmission were the main areas of insufficient knowledge. Surprisingly only 20% knew how to manage a patient who had experienced sexual contact with an HIV-positive partner. While 84% disagreed that ‘HIV-infected individuals deserved to catch infection’ owing to high-risk behaviours, 38% sympathized less with people who were infected via extramarital sex. It seems that knowledge and attitudes towards HIV/AIDS among the studied physicians is not favourable and is an area that requires attention to enable effective management of the disease in Iran.
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Affiliation(s)
- M R Hedayati-Moghaddam
- Research Center for HIV/AIDS, HTLV and Viral Hepatitis, Iranian Academic Center for Education, Culture and Research (ACECR), Mashhad Branch, Mashhad, Iran
| | - M Moradi Marjaneh
- Research Center for HIV/AIDS, HTLV and Viral Hepatitis, Iranian Academic Center for Education, Culture and Research (ACECR), Mashhad Branch, Mashhad, Iran
- Victor Chang Cardiac Research Institute, Darlinghurst, Australia
| | - I Eftekharzadeh Mashhadi
- Research Center for HIV/AIDS, HTLV and Viral Hepatitis, Iranian Academic Center for Education, Culture and Research (ACECR), Mashhad Branch, Mashhad, Iran
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Longer years of practice and higher education levels promote infection control in Iranian dental practitioners. IRANIAN RED CRESCENT MEDICAL JOURNAL 2012; 14:422-9. [PMID: 22997558 PMCID: PMC3438435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2011] [Accepted: 02/20/2012] [Indexed: 10/31/2022]
Abstract
BACKGROUNDS Infection control is one of the primary responsibilities of dental health care personnel. The purpose of this study was to evaluate whether the infection control practices of Iranian dentists and dental nurses working in governmental dental health care centers were influenced by their educational level and years of practice. METHODS This cross-sectional analytical study was completed in 2009, and it included 63 Iranian dental practitioners. Infection control knowledge was evaluated with a self-administered questionnaire, and infection control practices were evaluated with a checklist of questions by observation with one researcher. RESULTS The dental practitioners in Mashad had a low level of infection control knowledge. Dental personnel with a higher educational level had significantly greater knowledge than those with less education. Additionally, dental personnel who had more years of practice had a greater knowledge of infection control. CONCLUSION Since dental practitioners working in Mashad governmental dental health care centers with fewer years of practice and less educational level had a low level of infection control knowledge, we recommend a continuing educational program for this group and dental nurses.
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Knowledge, attitudes and behaviour of students from a medicine faculty, dentistry faculty, and medical technology Vocational Training School toward HIV/AIDS. Int J Occup Med Environ Health 2010; 23:153-60. [PMID: 20630832 DOI: 10.2478/v10001-010-0008-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES With increasing numbers of HIV/AIDS patients, physicians, dentists, and nurses taking care of these patients should have sufficient knowledge of the disease, and their attitude and behaviour should be proper. In our study, we aimed to examine the level of knowledge about HIV/AIDS among students from a medicine faculty, dentistry faculty, and medical technology vocational training school, to investigate attitudes and behaviour, and differences between first- and last-year students (if any) and to determine students' perception of the importance of this disease for our country and our world. MATERIAL AND METHODS This descriptive study comprised first-year and last-year students of Akdeniz University Faculty of Medicine, Akdeniz University Medical Technology Vocational Training School (MTVTS), and Süleyman Demirel University Faculty of Dentistry. A questionnaire was administered to a total of 357 students. RESULTS Lack of the relevant education is obvious among all three occupational groups in our study. CONCLUSIONS The importance of HIV/AIDS as a public health problem all over the world should be emphasized more, and awareness of all humanity should be augmented.
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Evidence of intense ongoing endemic transmission of hepatitis C virus in Egypt. Proc Natl Acad Sci U S A 2010; 107:14757-62. [PMID: 20696911 DOI: 10.1073/pnas.1008877107] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Egypt has the highest prevalence of antibodies to hepatitis C virus (HCV) in the world, estimated nationally at 14.7%. An estimated 9.8% are chronically infected. Numerous HCV prevalence studies in Egypt have published various estimates from different Egyptian communities, suggesting that Egypt, relative to the other nations of the world, might be experiencing intense ongoing HCV transmission. More importantly, a new national study provided an opportunity to apply established epidemiologic models to estimate incidence. Validated mathematical models for estimating incidence from age-specific prevalence were used. All previous prevalence studies of HCV in Egypt were reviewed and used to estimate incidence provided that there was sufficient age-specific data required by the models. All reports of anti-HCV antibody prevalence were much higher than any single other national estimate. Age was the strongest and most consistently associated factor to HCV prevalence and HCV RNA positivity. It was not possible to establish a prior reference point for HCV prevalence or incidence to compare with the 2009 incidence estimates. The modeled incidence from the national study and collectively from the modeled incidence from the previous community studies was 6.9/1,000 [95% confidence interval (CI), 5.5-7.4] per person per year and 6.6/1,000 (95% CI, 5.1-7.0) per person per year, respectively. Projected to the age structure of the Egyptian population, more than 500,000 new HCV infections per year were estimated. Iatrogenic transmission is the most likely, underlining exposure to the ongoing transmission. The study demonstrates the urgency to reduce HCV transmission in Egypt.
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Rahmati-Najarkolaei F, Niknami S, Aminshokravi F, Bazargan M, Ahmadi F, Hadjizadeh E, Tavafian SS. Experiences of stigma in healthcare settings among adults living with HIV in the Islamic Republic of Iran. J Int AIDS Soc 2010; 13:27. [PMID: 20649967 PMCID: PMC2919446 DOI: 10.1186/1758-2652-13-27] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2009] [Accepted: 07/22/2010] [Indexed: 11/10/2022] Open
Abstract
Background People living with HIV (PLHIV) sometimes experience discrimination. There is little understanding of the causes, forms and consequences of this stigma in Islamic countries. This qualitative study explored perceptions and experiences of PLHIV regarding both the quality of healthcare and the attitudes and behaviours of their healthcare providers in the Islamic Republic of Iran. Methods In-depth, semi-structured interviews were held with a purposively selected group of 69 PLHIV recruited from two HIV care clinics in Tehran. Data were analyzed using the content analysis approach. Results and discussion Nearly all participants reported experiencing stigma and discrimination by their healthcare providers in a variety of contexts. Participants perceived that their healthcare providers' fear of being infected with HIV, coupled with religious and negative value-based assumptions about PLHIV, led to high levels of stigma. Participants mentioned at least four major forms of stigma: (1) refusal of care; (2) sub-optimal care; (3) excessive precautions and physical distancing; and (4) humiliation and blaming. The participants' healthcare-seeking behavioural reactions to perceived stigma and discrimination included avoiding or delaying seeking care, not disclosing HIV status when seeking healthcare, and using spiritual healing. In addition, emotional responses to perceived acts of stigma included feeling undeserving of care, diminished motivation to stay healthy, feeling angry and vengeful, and experiencing emotional stress. Conclusions While previous studies demonstrate that most Iranian healthcare providers report fairly positive attitudes towards PLHIV, our participants' experiences tell a different story. Therefore, it is imperative to engage both healthcare providers and PLHIV in designing interventions targeting stigma in healthcare settings. Additionally, specialized training programmes in universal precautions for health providers will lead to stigma reduction. National policies to strengthen medical training and to provide funding for stigma-reduction programming are strongly recommended. Investigating Islamic literature and instruction, as well as requesting official public statements from religious leaders regarding stigma and discrimination in healthcare settings, should be used in educational intervention programmes targeting healthcare providers. Finally, further studies are needed to investigate the role of the physician and religion in the local context.
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Affiliation(s)
| | - Shamsaddin Niknami
- Department of Family Medicine, Charles Drew University of Medicine and Science, Los Angeles, California, USA
| | | | - Mohsen Bazargan
- Health Education Department, Tarbiat Modares University, Tehran, Iran
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Acosta-Gío AE, Borges-Yáñez SA, Flores M, Herrera A, Jerónimo J, Martínez M, Meneses P, Peralta H, Pérez L, Portocarrero R, Rodríguez L, Castillo L, Molina M, Larrondo M, Maupomé G, Soriano I. Infection control attitudes and perceptions among dental students in Latin America: implications for dental education. Int Dent J 2008; 58:187-93. [DOI: 10.1111/j.1875-595x.2008.tb00347.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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