Access to occupational postexposure prophylaxis for primary health care workers in rural Africa: a cross-sectional study

Understanding the magnitude of occupational exposure to human immunodeficiency virus (HIV) and uptake of HIV post-exposure prophylaxis among healthcare workers in a rural district in Tanzania

BACKGROUND

Occupational exposure to blood or other body fluids in healthcare settings puts healthcare workers (HCWs) at risk of acquiring human immunodeficiency virus (HIV) infection. It is estimated that between 200 and 5000 HIV infections are transmitted annually to HCWs worldwide. Use of post-exposure prophylaxis (PEP) has been documented to reduce the rate of HIV infection from workplace exposures by 81%.

AIM

To investigate the extent of occupational exposure to HIV infection during the period of 12 months before the survey and to identify factors associated with uptake of PEP services among HCWs.

METHODS

We interviewed 221 HCWs from selected healthcare facilities in Kongwa, Tanzania. Data included occupational exposures to body fluids, knowledge and use of PEP.

FINDINGS

Sixty (27.1%) of the HCWs had experienced exposures to blood and body fluids, of whom 71.7% (43/60) had needlestick injuries. Medical attendants were more frequently exposed, followed by nurses (31.7% and 28.6% respectively). Of the exposed HCWs, seven (11.7%) reported use of HIV PEP. Reporting of exposure [odds ratio (OR): 8.44; P = 0.016], knowledge of the HIV status of the source patient (OR: 42.19; P = 0.007) and awareness of PEP (OR: 12.72; P = 0.010) were significant predictors of PEP use.

CONCLUSION

Uptake of PEP services among HCWs remains low despite high rate of occupational exposures. Wider dissemination of HIV PEP guidelines and training of HCWs is required in Tanzania to ensure that HCWs have knowledge of, and prompt access to, PEP services.

Fatores determinantes e condutas pós-acidente com material biológico entre profisisonais do atentimento pré-hospitalar

Estudo transversal realizado com a equipe multiprofissional do Atendimento Pré-hospitalar de Minas Gerais, Brasil. Objetivou-se estimar a incidência dos acidentes ocupacionais por exposição a material biológico e condutas pós-acidente. Utilizou-se análise descritiva e regressão logística. A incidência de acidentes foi de 19,8%: 39,1% por perfurocortantes e 56,5% por fluidos corporais,l 33,3% ocorreu entre médicos, 24,0% entre condutores, 69,6% sem avaliação médica, 91,3% subnotificação, 52,2% nenhuma conduta pós-acidente, e, 52,2% sem acompanhamento sorológico. Estiveram associadas ao acidente: idade acima de 31 anos, p= 0,014 (OR= 3,02; IC95%: 1,25 - 7,33); e lotação na Unidade de Suporte Básico, p=0,010 (OR=5,36; IC95%: 1,5119,08). Discute-se a necessidade da implantação de protocolos pós-acidentes visando à redução da subnotificação e o aumento do acompanhamento pós-acidente.