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Kaweti G, Feleke T. Prevalence and associated factors of needlestick and sharp object injuries among healthcare workers in Ethiopia: a systematic review and meta-analysis. FRONTIERS IN EPIDEMIOLOGY 2024; 4:1385417. [PMID: 38983789 PMCID: PMC11232479 DOI: 10.3389/fepid.2024.1385417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/28/2024] [Indexed: 07/11/2024]
Abstract
Background Needlestick and sharp object injuries affect healthcare workers. However, there are limitations in the evidence available for informed decision-making by stakeholders, as individual research shows inconsistent results. Therefore, this study aims to assess the pooled prevalence of needlestick and sharp object injuries and their associated factors. Methods MEDLINE/PubMed, EMBASE, Web of Science, Google Scholar, and other databases were searched from 5 September 2023 to 10 October 2023 using the following search terms: "Prevalence" OR "Burden" OR "Magnitude" AND "Associated factors" OR "related factors" OR "Risk factors" OR "determinants" OR "Predictors" AND "Needle stick Injury" OR "Sharp Injury" OR "Health care Workers" OR " Health Care Personnel" OR "Nurses" OR "Professional" AND "Ethiopia". Results The pooled prevalence of needle sticks and sharp objects injury was 40.5 (95% CI: 35.0, 45.9). Needle-stick (AOR, 2.3; 95% CI: 1.6, 3.3, P < 0.001], absence of routine precaution [AOR, 2.3; 95% CI: 1.1, 4.5, P < 0.01] and lack of training (AOR = 2.4; 95% CI: 1.4, 4.1, p < 0.001) had increased odds of needle-sticks and sharp objects injury. Conclusion Forty percent of healthcare workers in Ethiopia have experienced needlestick and sharp object injuries. The identified factors included recapping, absence of routine precautions, and lack of training. Systematic Review Registration PROSPERO, identifier (CRD42023462311).
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Affiliation(s)
- Gudeta Kaweti
- Department of Social and Population Health, Yirgalem Hospital Medical College, Yirgalem, Ethiopia
| | - Tihun Feleke
- Hawassa College of Health Science, Research and Community Service Directorate, Hawassa, Ethiopia
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Bamashmous S, Almalki F, Alrefaei W, Alsamadani E, Fattouh M, Kenawi LM, Elfirt E. Evaluation of Knowledge and Attitude of Dental Hygienists and Dental Assistants Regarding People Living with HIV/AIDS and HIV-Associated Oral and Periodontal Lesions in Jeddah, Saudi Arabia. Cureus 2024; 16:e53719. [PMID: 38455831 PMCID: PMC10919378 DOI: 10.7759/cureus.53719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Oral manifestations serve as important indicators of human immunodeficiency virus (HIV) infection, and dental healthcare practitioners play a pivotal role in preventing and managing HIV. This study aims to assess and compare the knowledge and attitude of dental assistants and dental hygienists concerning people with HIV/acquired Immunodeficiency syndrome (AIDS) patients in Jeddah province of Saudi Arabia. MATERIALS AND METHODS This cross-sectional survey enrolled 160 dental hygienists and assistants practicing in Jeddah. Data was collected using a pretested, self-administered questionnaire comprising 50 questions that investigated knowledge about HIV/AIDS, awareness of HIV-associated oral and periodontal lesions, understanding of HIV transmission routes, and attitudes toward people with AIDS. RESULTS In the study, 120 (75.0%) participants correctly recognized that individuals with HIV may appear healthy, while 123 (76.9%) participants admitted that HIV carriers have lower resistance to other diseases. Additionally, 126 (78.8%) participants confirmed an association between the virus and oral lesions, and 137 (85.6%) participants were aware of HIV transmission through blood. Moreover, 150 (93.7%) participants expressed their willingness to support, treat, and assist patients with AIDS, while only 10 (6.3%) participants expressed unwillingness. Notably, no statistically significant differences were found between dental assistants and hygienists in their knowledge and attitudes toward HIV/AIDS and people with AIDS. CONCLUSION This study demonstrated that dental hygienists and assistants possess good general knowledge regarding HIV/AIDS and are well-informed about the disease's transmission routes. Moreover, a significant majority endorses the importance of treating and supporting AIDS patients.
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Affiliation(s)
- Shatha Bamashmous
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Fatimah Almalki
- Department of Dental Hygiene and Nursing, King Abdulaziz University Dental Hospital, Jeddah, SAU
| | - Wehad Alrefaei
- Department of Dental Hygiene and Nursing, King Abdulaziz University Dental Hospital, Jeddah, SAU
| | - Eatizaz Alsamadani
- Department of Dental Hygiene and Nursing, King Abdulaziz University Dental Hospital, Jeddah, SAU
| | - Mohamed Fattouh
- Department of Fixed Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, EGY
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, SAU
| | - Laila M Kenawi
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, EGY
- Department of Restorative Dentistry, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, SAU
| | - Eman Elfirt
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, EGY
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Perumal K, Shanmugam P. Needle Stick Injury: A Decade Retrospection Among Health Care Workers in a Tertiary Care Center. Asia Pac J Public Health 2024; 36:115-118. [PMID: 38095620 DOI: 10.1177/10105395231212311] [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: 12/21/2023]
Abstract
Needle stick injury (NSI) is a common incidence in a health care facility which can have a great impact on the psychological status of a health care worker (HCW). In the present study, over a decade, 76 incidents of NSI were reported. Nurses (47.3%) were at high risk followed by doctors (28.94%). Recapping (30.2%) was the major activity associated with NSI. Percutaneous injury (97.3%) with a hollow bore needle to the fingers was the most common type of injury. Three (3.9%) of the sources were positive for Hepatitis B virus (HBV), and one (1.3%) for human immunodeficiency virus (HIV). Postexposure prophylaxis was administered to eight (10.5%) HCWs with high-risk exposure. The incidence of NSI is low, as there exists an underreporting which cannot be denied. Following stringent universal precautions and adoption of safety-guided devices can reduce the rate of injury to a great extent. Regular training, monitoring, auditing, and adequate control modalities are the core strategies to reduce the incidence of NSI.
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Affiliation(s)
- Kruthika Perumal
- Department of Microbiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chengalpattu, India
| | - Priyadarshini Shanmugam
- Department of Microbiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chengalpattu, India
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Abdalkareem Jasim S, Thaeer Hammid A, Turgunpulatovich Daminov B, Kadhem Abid M, Lateef Al-Awsi GR, Afra A, Ekrami HA, Ameer Muhammed FA, Mohammadi MJ. Investigation ways of causes needle sticks injuries, risk factors affecting on health and ways to preventive. REVIEWS ON ENVIRONMENTAL HEALTH 2023; 38:629-636. [PMID: 35962992 DOI: 10.1515/reveh-2022-0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/05/2022] [Indexed: 06/15/2023]
Abstract
Needle sticks injuries (NSIs) has caused many health concerns, including the widespread infection disease. Needle sticks injuries can have high threaten health human especially, all those who are in contact with health and medical centers. The purpose of this review study was the determination the effects of needle sticks injuries (NSIs) on health care worker and patents. In this a review study of literature studied conducted on international databases included Google Scholar, ISI/WOS (Web of Science), Springer, Scopus, Medline/PubMed. The literature signs a notable undesirable affect from potential needle sticks injuries related to ways to preventive and risks factors among patents and health care worker. The literature was shown needle stick injuries can cause with a variety of ways including needle recapping, non-standard safety boxes, thin gloves, and inadequate personal protective equipment. According to the result this study, needle stick injuries can transfer infectious disease (Human Immunodeficiency viruses [HIV], Hepatitis C virus [HCV]) and increase risk health on health care worker and patients. According to research related to the subject, the ways to prevent reduce needle sticks include personal protective equipment, holding retraining courses for medical staff in the direction to raise awareness can significantly reduce cases of needle sticks injuries. Further research using more sophisticated methodology is warranted.
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Affiliation(s)
- Saade Abdalkareem Jasim
- Medical Laboratory Techniques Department, Al-maarif University College, Al-anbar-Ramadi, Iraq
| | - Ali Thaeer Hammid
- Computer Engineering Techniques Department, Faculty of Information Technology, Imam Ja'afar Al-Sadiq University, Baghdad, Iraq
| | | | - Mohammed Kadhem Abid
- Department of Anesthesia, College of Health & medical Technology, Al-Ayen University, Thi-Qar, Iraq
| | | | - Arghavan Afra
- Department of Nursing, School of Nursing, Abadan University of Medical Sciences, Abadan, Iran
| | - Hafez Ajam Ekrami
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Mohammad Javad Mohammadi
- Department of Environmental Health Engineering, School of Public Health and Environmental Technology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Global Occupational Exposure to Blood and Body Fluids among Healthcare Workers: Systematic Review and Meta-Analysis. CANADIAN JOURNAL OF INFECTIOUS DISEASES AND MEDICAL MICROBIOLOGY 2022; 2022:5732046. [PMID: 35692264 PMCID: PMC9187485 DOI: 10.1155/2022/5732046] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/19/2022] [Indexed: 11/23/2022]
Abstract
Background Occupational exposure to blood and body fluids has become a serious public health problem for healthcare workers and is a major risk for the transmission of various infections such as human immune-deficiency virus, hepatitis B virus, and hepatitis C virus. This systematic review and meta-analysis aims to determine the career time and previous one-year global pooled prevalence of occupational exposure to blood and body fluids among healthcare workers. Methods For the review, the articles published in English were searched using the electronic databases (SCOPUS/Science Direct, PubMed, Web of Science, Google Scholar, CINAHL, MEDLINE, Cochrane Library, DOAJ, and MedNar) with a combination of Boolean logic operators (AND, OR, and NOT), Medical Subject Headings (MeSH), and keywords. A quality assessment was conducted to determine the relevance of the articles using JBI critical appraisal tools. Furthermore, several steps of assessment and evaluation were taken to select and analyze the relevant articles. Results Of the 3912 articles identified through the electronic database search, 33 that met the inclusion criteria were included in the final analysis. The current study found that the global pooled prevalence of blood and body fluids among healthcare workers during career time and in the previous one year accounted for 56.6% (95% CI: 47.3, 65.4) and 39.0% (95% CI: 32.7, 45.7), respectively. Based on subgroup analysis by publication year, survey year, and World Health Organization regions, the highest prevalence of blood and body fluid exposure in the last 12 months was observed among articles published between 2004 and 2008 (66.3%), conducted between 2003 and 2008 (66.6%), and conducted in the Southeast Asia Region (46.9%). The highest career time prevalence was 60.6%, 71.0%, and 68.4% for articles published between 2015 and 2020, conducted between 2015 and 2019, and reported in the African region, respectively. Conclusion The current study revealed a high prevalence of occupational exposure to blood and body fluids among healthcare workers and suggests the need to improve occupational health and safety services in healthcare systems globally.
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Simmons J, Elliott L, Bennett AS, Beletsky L, Rajan S, Anders B, Dastparvardeh N. Evaluation of an Experimental Web-based Educational Module on Opioid-related Occupational Safety Among Police Officers: Protocol for a Randomized Pragmatic Trial to Minimize Barriers to Overdose Response. JMIR Res Protoc 2022; 11:e33451. [PMID: 35212639 PMCID: PMC8917434 DOI: 10.2196/33451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/15/2021] [Accepted: 01/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND As drug-related morbidity and mortality continue to surge, police officers are on the front lines of the North American overdose (OD) crisis. Drug law enforcement shapes health risks among people who use drugs (PWUD), while also impacting the occupational health and wellness of officers. Effective interventions to align law enforcement practices with public health and occupational safety goals remain underresearched. OBJECTIVE The Opioids and Police Safety Study (OPS) aims to shift police practices relating to PWUD. It adapts and evaluates the relative effectiveness of a curriculum that bundles content on public health promotion with occupational risk reduction (ORR) to supplement a web-based OD response and naloxone training platform (GetNaloxoneNow.org, or GNN). This novel approach has the potential to improve public health and occupational safety practices, including using naloxone to reverse ODs, referring PWUD to treatment and other supportive services, and avoiding syringe confiscation. METHODS This longitudinal study uses a randomized pragmatic trial design. A sample of 300 active-duty police officers from select counties in Pennsylvania, Vermont, and New Hampshire with high OD fatality rates will be randomized (n=150 each) to either the experimental arm (GNN + OPS) or the control arm (GNN + COVID-19 ORR). A pre- and posttraining survey will be administered to all 300 officers, after which they will be administered quarterly surveys for 12 months. A subsample of police officers will also be qualitatively followed in a simultaneous embedded mixed-methods approach. Research ethics approval was obtained from the New York University Institutional Review Board. RESULTS Results will provide an understanding of the experiences, knowledge, and perceptions of this sample of law enforcement personnel. Generalized linear models will be used to analyze differences in key behavioral outcomes between the participants in each of the 2 study arms and across multiple time points (anticipated minimum effect size to be detected, d=0.50). Findings will be disseminated widely, and the training products will be available nationally once the study is completed. CONCLUSIONS The OPS is the first study to longitudinally assess the impact of a web-based opioid-related ORR intervention for law enforcement in the U.S. Our randomized pragmatic clinical trial aims to remove barriers to life-saving police engagement with PWUD/people who inject drugs by focusing both on the safety of law enforcement and evidence-based and best practices for working with persons at risk of an opioid OD. Our simultaneous embedded mixed-methods approach will provide empirical evaluation of the diffusion of the naloxone-based response among law enforcement. TRIAL REGISTRATION ClinicalTrail.gov NCT05008523; https://clinicaltrials.gov/show/NCT05008523. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/33451.
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Affiliation(s)
- Janie Simmons
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
| | - Luther Elliott
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
| | - Alex S Bennett
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
| | - Leo Beletsky
- School of Law and Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States
| | - Sonali Rajan
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, United States
| | | | - Nicole Dastparvardeh
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
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Ayoğlu H, Ayoğlu FN. Occupational Risks for Anaesthesiologists and Precautions. Turk J Anaesthesiol Reanim 2021; 49:93-99. [PMID: 33997836 PMCID: PMC8098723 DOI: 10.5152/tjar.2020.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 04/12/2020] [Indexed: 11/29/2022] Open
Abstract
Anaesthesiology is an extremely stressful and risky branch of medicine. New techniques, new procedures, and innovations in anaesthesia increase the responsibilities and obligations of anaesthesiologists day by day. Operating rooms and intensive care units, which are the working environment of anaesthesiologists, are considered to be an unhealthy workplace. Anaesthesiologists are exposed to various potential physical, chemical, biological, ergonomic, and psychosocial risk factors and hazards in their work environments. The occupational risks anaesthesiologists are exposed to threaten their health and may cause their professional performance to decline. This article aimed to raise awareness about the occupational risks, hazards, and precautions in anaesthesiology practice.
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Affiliation(s)
- Hilal Ayoğlu
- Department of Anaesthesiology and Reanimation, Zonguldak Bülent Ecevit University School of Medicine, Zonguldak, Turkey
| | - Ferruh Niyazi Ayoğlu
- Department of Public Health, Zonguldak Bülent Ecevit University School of Medicine, Zonguldak, Turkey
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Nagao Y, Kimura T, Nagao H. Analysis of hepatitis B and C virus infections amongst members of the Dental National Health Insurance Society in the Oita Prefecture. Biomed Rep 2021; 14:23. [PMID: 33335729 PMCID: PMC7739858 DOI: 10.3892/br.2020.1399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022] Open
Abstract
In Japan, ~3 million individuals are estimated to be infected with hepatitis B virus (HBV) or hepatitis C virus (HCV). The rates of hepatitis virus infection amongst dentists is higher than that amongst other healthcare workers due to increased exposure to both saliva and blood. However, an efficient method for the testing of hepatitis virus infections amongst dentists remains to be established. The aim of the present study was to examine the rate of hepatitis virus infection amongst dental healthcare workers (DHWs) by introducing a health checkup that included screening for HBV and HCV infections. A total of 1,834 members of the Dental National Health Insurance Society in the Oita Prefecture, consisting of dentists and other employees, were tested for hepatitis B surface antigen (HBsAg), antibodies to HBsAg (anti-HBs) and antibodies to HCV (anti-HCV) during routine medical checkups. Anonymized data, including the age, sex, occupation (dentist or employee), and presence of a hepatitis virus marker, was collected and analyzed. The positive rates of HBsAg, anti-HBs and anti-HCV in the study sample were 0.6, 44.1 and 0.5%, respectively; the positive rates were higher amongst dentists than the employees. Furthermore, the positive rates of HBsAg and anti-HCV increased with age and were higher in subjects aged 50-79 (1.7-2.2%). The positive rate of presence of anti-HBs was significantly higher in the dentists compared with employees (56.4 vs. 39.6%; respectively; P<0.0001). The three factors associated with anti-HB positivity were HBsAg negativity, occupation (dentist) and age (20-29 years) with adjusted odds ratios of 8.29, 2.27 and 1.59, respectively (P<0.05). These results suggest that introducing a hepatitis virus examination during routine health checkups of DHWs may prove useful in identifying infected individuals.
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Affiliation(s)
- Yumiko Nagao
- Department of Public Health, Graduate School of Medicine, Juntendo University, Bunkyo-ku, Tokyo 113-8421, Japan
- Department of Pathology and Microbiology, Faculty of Medicine, Saga University, Nabeshima, Saga 849-8501, Japan
| | - Tetsuya Kimura
- Oita Dental Association, Oujishinmachi, Oita 870-0819, Japan
| | - Hiromichi Nagao
- Oita Dental Association, Oujishinmachi, Oita 870-0819, Japan
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Lin SY, Ju SW, Lin CL, Lin CC, Hsu WH, Chou CH, Chi CY, Hsu CY, Kao CH. Risk of Viral Infection in Patients Using Either Angiotensin-converting Enzyme Inhibitors or Angiotensin Receptor Blockers: A Nationwide Population-based Propensity Score Matching Study. Clin Infect Dis 2020; 71:2695-2701. [PMID: 32504531 DOI: 10.1093/cid/ciaa734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/04/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND We hypothesized that renin-angiotensin system (RAS) blockers have systemic protective effects beyond the respiratory tract and could reduce the risk of viral infections. METHODS We used the National Health Insurance Research Database and identified 2 study cohorts: the angiotensin receptor blocker (ARB) cohort and angiotensin-converting enzyme inhibitor (ACEI) cohort. Propensity score matching was applied at a 1:1 ratio by all associated variables to select 2 independent control cohorts for the ARB and ACEI cohorts. A Cox proportional hazards model was applied to assess the end outcome of viral infection. RESULTS The number of ARB and ACEI users was 20 207 and 18 029, respectively. The median age of ARB users and nonusers was 53.7 and 53.8 years, respectively. The median follow-up duration of ARB users and nonusers was 7.96 and 7.08 years; the median follow-up duration of ACEI users and nonusers was 8.70 and 8.98 years, respectively. The incidence rates of viral infections in ARB users and nonusers were 4.95 and 8.59 per 1000 person-years, respectively, and ARB users had a lower risk of viral infection than nonusers (adjusted hazard ratio [aHR], 0.53 [95% confidence interval {CI}, .48-.58]). The incidence rates of viral infections in ACEI users and nonusers were 6.10 per 1000 person-years and 7.72 per 1000 person-years, respectively, and ACEI users had a lower risk of viral infection than nonusers (aHR, 0.81 [95% CI, .74-.88]). CONCLUSIONS Hypertensive patients using either ARBs or ACEIs exhibit a lower risk of viral infection than nonusers.
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Affiliation(s)
- Shih-Yi Lin
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan.,Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan
| | - Shu-Woei Ju
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan.,Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Cheng-Chieh Lin
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Wu-Huei Hsu
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Chest Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Hui Chou
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Infection, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Yu Chi
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Infection, China Medical University Hospital, Taichung, Taiwan
| | - Chung-Y Hsu
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Nuclear Medicine and Positron Emission Tomography Center, China Medical University Hospital, Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.,Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung, Taiwan
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Awoke N, Mulgeta H, Lolaso T, Tekalign T, Samuel S, Obsa MS, Olana R. Full-dose hepatitis B virus vaccination coverage and associated factors among health care workers in Ethiopia: A systematic review and meta-analysis. PLoS One 2020; 15:e0241226. [PMID: 33108365 PMCID: PMC7591041 DOI: 10.1371/journal.pone.0241226] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 10/09/2020] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION The hepatitis B vaccine is the backbone of hepatitis B prevention. All health care workers must receive a full-dose (3-dose vaccine series) to achieve >90% protection against hepatitis B virus. There is limited evidence available on vaccination coverage of HBV among health care workers in Ethiopia. Therefore, the objective of this study was to estimate the national full-dose hepatitis B vaccination coverage and the associated factors among health care workers in Ethiopia. METHODS Studies were retrieved from PubMed, EMBASE, Web of Science, SCOPUS, CINAHL, and Google Scholar by using a combination of search terms with Boolean operators. The quality of each study was evaluated independently by three authors using the modified Newcastle-Ottawa Scale (NOS) for cross-sectional studies. Statistical analyses were performed using STATA™ Version 14 software. Meta-analysis was carried out using a random-effects (DerSimonian and Laird) method. The heterogeneity test was conducted by using I-squared (I2) statistics. Leave-one-out sensitivity analysis was performed. RESULTS A total of 15 articles with 5734 participants were included in this systematic review and meta-analysis. The pooled prevalence of full-dose hepatitis B virus vaccination coverage among health care workers in Ethiopia was 20.04% (95% CI: 13.83, 26.26); I2 = 98.9%). Being male sex (p = 0.002), having work experience of less than 5 years (p < 0.001), educational level of diploma and below (p = 0.003), health care providers who received training on infection prevention (p < 0.001), and those who had a history of exposure to blood and body fluids (p = 0.001), were factors significantly associated with full-dose hepatitis B virus vaccination. CONCLUSION The national full-dose hepatitis B vaccination coverage among health care workers was low. Training of health care workers in infection prevention, particularly in hepatitis B and testing and providing hepatitis B vaccination for newly recruited staff and every 5 years for those long-term workers were recommended to increase the uptake of the vaccine.
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Affiliation(s)
- Nefsu Awoke
- Department of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Henok Mulgeta
- Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Tsegaye Lolaso
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Tiwabwork Tekalign
- Department of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Serawit Samuel
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Mohammed Suleiman Obsa
- Department of Anesthesia, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Robera Olana
- Department of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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11
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Yoo WS, Min J, Chung PS, Woo SH. Biochemical and Pain Comparisons Between the Laser Lancing Device and Needle Lancets for Capillary Blood Sampling: A Randomized Control Trial. Lasers Surg Med 2020; 53:316-323. [PMID: 32638427 DOI: 10.1002/lsm.23298] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/22/2020] [Accepted: 06/26/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Patients around the world use a lancing device to perform self-monitoring of blood sugar (SMBG). However, there are always fears of needles and pain. Therefore, less painful devices are being developed. The purpose of this study was to compare the usefulness and safety of a laser lancing device (without a needle) to a conventional needle lancet (with a needle) for capillary blood sampling. STUDY DESIGN/MATERIALS AND METHODS A total of 40 healthy subjects were enrolled in the study. Capillary blood was collected from a laser lancing device (without a needle) and a conventional needle lancet (with a needle) on opposite fingers, the choice of which was randomly selected. The laser lancing device (LMT-3000) uses a 2940 nm mono-pulse laser, a radiation field of 350 μm, laser energy of 210 mJ, and a 3.7 V battery. One week later, capillary blood was obtained by switching the devices and fingers. The biochemical measurements and pain were compared between the two groups. Puncture pain was measured on a pain scale from 0 to 10. RESULT All patients were tested with both a laser lancing device and a conventional needle lancet. In the biochemical analysis, the blood glucose level was 103.21 ± 17.20 mg/dl in laser lancing device group and 102.25 ± 22.44 mg/dl in the conventional needle lancet group, and there were no significant differences between the two groups (P = 0.940). The pH, CO2 , O2 , lactate and hematocrit levels of the blood were no significant differences between the two groups. In the first trial, the median pain score (interquartile range) of patients using laser lancing device was 2.0 (1.0-3.0), whereas it was 2.5 (2.0-4.0) in patients using a conventional needle lancet (P = 0.029). In the second trial, one week later, the median pain score in the laser lancing device group was 2.5 (1.0-4.0), whereas it was 3.5 (2.25-5.0) in the conventional needle lancet group (P = 0.001). The difference in pain scores between the first and second trials was significant in the conventional needle lancet group (P = 0.007), but not in the laser lancing device group (P = 0.150). CONCLUSION There was no difference in biochemical results between the laser lancing device group and the conventional needle lancet group. The laser lancing device demonstrated comparatively lower pain than the conventional needle lancet. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
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Affiliation(s)
- Won Sang Yoo
- Department of Internal Medicine, Dankook University College of Medicine, 201 Manghyang-ro, Dongnam-gu, Cheonan, 31116, Korea
| | - Junwon Min
- Department of Surgery, Dankook University College of Medicine, 201 Manghyang-ro, Dongnam-gu, Cheonan, 31116, Korea
| | - Phil-Sang Chung
- Department of Otolaryngology-Head and Neck surgery, Dankook University College of Medicine, 201 Manghyang-ro, Dongnam-gu, Cheonan, 31116, Korea
| | - Seung Hoon Woo
- Department of Otolaryngology-Head and Neck surgery, Dankook University College of Medicine, 201 Manghyang-ro, Dongnam-gu, Cheonan, 31116, Korea
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Beletsky L, Abramovitz D, Arredondo J, Baker P, Artamonova I, Marotta P, Mittal ML, Rocha-Jimenez T, Cepeda JA, Morales M, Clairgue E, Patterson TA, Strathdee SA. Addressing Police Occupational Safety During an Opioid Crisis: The Syringe Threat and Injury Correlates (STIC) Score. J Occup Environ Med 2020; 62:46-51. [PMID: 31658223 PMCID: PMC6933083 DOI: 10.1097/jom.0000000000001754] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To develop and validate syringe threat and injury correlates (STIC) score to measure police vulnerability to needlestick injury (NSI). METHODS Tijuana police officers (N = 1788) received NSI training (2015 to 2016). STIC score incorporates five self-reported behaviors: syringe confiscation, transportation, breaking, discarding, and arrest for syringe possession. Multivariable logistic regression was used to evaluate the association between STIC score and recent NSI. RESULTS Twenty-three (1.5%) officers reported NSI; higher among women than men (3.8% vs 1.2%; P = 0.007). STIC variables had high internal consistency, a distribution of 4.0, a mode of 1.0, a mean (sd) of 2.0 (0.8), and a median (interquartile range [IQR]) of 2.0 (1.2 to 2.6). STIC was associated with recent NSI; odds of NSI being 2.4 times higher for each point increase (P-value <0.0001). CONCLUSIONS STIC score is a novel tool for assessing NSI risk and prevention program success among police.
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Affiliation(s)
- Leo Beletsky
- Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, 9500 Gilman Dr., La Jolla, California. 92093, United States
- School of Law & Bouvé College of Health Sciences, Northeastern University, 360 Huntington Ave., Massachusetts 02115, United States
| | - Daniela Abramovitz
- Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, 9500 Gilman Dr., La Jolla, California. 92093, United States
| | - Jaime Arredondo
- Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, 9500 Gilman Dr., La Jolla, California. 92093, United States
| | - Pieter Baker
- Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, 9500 Gilman Dr., La Jolla, California. 92093, United States
- School of Public Health, San Diego State University, 5500 Campanile Dr., San Diego, California. 92182, United States
| | - Irina Artamonova
- Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, 9500 Gilman Dr., La Jolla, California. 92093, United States
| | - Phil Marotta
- School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY, 10027, United States
| | - Maria Luisa Mittal
- Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, 9500 Gilman Dr., La Jolla, California. 92093, United States
- School of Medicine, Universidad Xochicalco, 4850 Calle Rampa Yumalinda, Chapultepec Alamar, Tijuana, Baja California, 22110, Mexico
| | - Teresita Rocha-Jimenez
- Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, 9500 Gilman Dr., La Jolla, California. 92093, United States
- School of Public Health, San Diego State University, 5500 Campanile Dr., San Diego, California. 92182, United States
| | - Javier A. Cepeda
- Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, 9500 Gilman Dr., La Jolla, California. 92093, United States
| | - Mario Morales
- Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, 9500 Gilman Dr., La Jolla, California. 92093, United States
| | - Erika Clairgue
- Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, 9500 Gilman Dr., La Jolla, California. 92093, United States
| | - Thomas A. Patterson
- Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, 9500 Gilman Dr., La Jolla, California. 92093, United States
| | - Steffanie A. Strathdee
- Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, 9500 Gilman Dr., La Jolla, California. 92093, United States
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Yazie TD, Chufa KA, Tebeje MG. Prevalence of needlestick injury among healthcare workers in Ethiopia: a systematic review and meta-analysis. Environ Health Prev Med 2019; 24:52. [PMID: 31409284 PMCID: PMC6693183 DOI: 10.1186/s12199-019-0807-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 07/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health facilities can provide diagnostic, curative, and prognostic services for the community. While providing services, healthcare workers can be exposed to needlestick injuries that can transmit pathogenic organisms through body fluids. OBJECTIVE The aim was to establish the pooled prevalence of needlestick injuries among healthcare workers in Ethiopia. METHODS This systematic review and meta-analysis was conducted according to PRISMA guidelines. Articles were searched from Google Scholar, PubMed, Science Direct, and Scopus databases using a combination of keywords and Boolean functions. All the searched articles were imported into the EndNote X9 software, and then, duplicate data files were removed. Article screening and data extraction were done independently by two authors. Data manipulation and analyses were done using STATA version 15.1 software. RESULTS The analysis of 23 full-text articles showed that the prevalence of the 12-month and lifetime needlestick injuries among the primary studies ranged from 13.2 to 55.1% and 18.6 to 63.6%, respectively. The pooled prevalence of needlestick injuries among the Ethiopian healthcare workers was 28.8% (95% CI 23.0-34.5) and 43.6% (95% CI 35.3-52.0) for the 12 months and lifetime, respectively. CONCLUSIONS The pooled prevalence of needlestick injuries among Ethiopian healthcare workers was high. Therefore, efforts should be implemented to reduce the occurrence of injuries. Adequate protective equipment and safety-engineered devices should be supplied for the healthcare workers. It could be more effective to reduce the factors contributing to increased exposures through the allocation of adequate numbers of the healthcare workforce and implementing in-service training.
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Affiliation(s)
- Teshiwal Deress Yazie
- Unit of Quality Assurance and Laboratory Management, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
| | - Kasaw Adane Chufa
- Unit of Quality Assurance and Laboratory Management, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Mekonnen Girma Tebeje
- Unit of Quality Assurance and Laboratory Management, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
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Dasgupta S, Tie Y, Lemons A, Wu K, Burnett J, Shouse RL. Injection Practices and Sexual Behaviors Among Persons with Diagnosed HIV Infection Who Inject Drugs - United States, 2015-2017. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2019; 68:653-657. [PMID: 31369525 PMCID: PMC6677170 DOI: 10.15585/mmwr.mm6830a1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
During 2016, 6% of persons in the United States who received a diagnosis of human immunodeficiency virus (HIV) infection had their HIV infection attributed to injection drug use (1). Injection practices and sexual behaviors among HIV-positive persons who inject drugs, such as injection equipment sharing and condomless sex, can increase HIV transmission risk; nationally representative estimates of the prevalences of these behaviors are lacking. The Medical Monitoring Project (MMP) is an annual, cross-sectional survey that reports nationally representative estimates of clinical and behavioral characteristics among U.S. adults with diagnosed HIV (2). CDC used MMP data to assess high-risk injection practices and sexual behaviors among HIV-positive persons who injected drugs during the preceding 12 months and compared their HIV transmission risk behaviors with those of HIV-positive persons who did not inject drugs. During 2015-2017, approximately 10% (weighted percentage estimate) of HIV-positive persons who injected drugs engaged in distributive injection equipment sharing (giving used equipment to another person for use); nonsterile syringe acquisition and unsafe disposal methods were common. Overall, among HIV-positive persons who injected drugs, 80% received no treatment, and 57% self-reported needing drug or alcohol treatment. Compared with HIV-positive persons who did not inject drugs, those who injected drugs were more likely to have a detectable viral load (48% versus 35%; p = 0.008) and engage in high-risk sexual behaviors (p<0.001). Focusing on interventions that reduce high-risk injection practices and sexual behaviors and increase rates of viral suppression might decrease HIV transmission risk among HIV-positive persons who inject drugs. Successful substance use treatment could also lower risk for transmission and overdose through reduced injection.
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16
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Abstract
When children sustain injuries from needles discarded in public places, concerns arise about possible exposure to blood-borne viruses. The risk of infection is low, but assessment, counselling, and follow-up of the injured child are needed. This statement reviews the literature concerning blood-borne viral infections after injuries from needles discarded in the community, and provides recommendations for the prevention and management of such incidents.
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Affiliation(s)
- Dorothy L Moore
- Canadian Paediatric Society, Infectious Diseases and Immunization Committee, Ottawa, Ontario
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17
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Moore DL. Les blessures par piqûre d’aiguille dans un lieu public. Paediatr Child Health 2018. [DOI: 10.1093/pch/pxy130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Dorothy L Moore
- Société canadienne de pédiatrie, comité des maladies infectieuses et d’immunisation, Ottawa (Ontario)
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18
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Abstract
CONTEXT: Infections are common in contact sports. This review aims to describe the epidemiology, presenting signs and symptoms, treatment guidelines, and regulations for several common infections seen in contact sport athletes. The conditions discussed include bacterial skin infections, herpes simplex virus, molluscum contagiosum, common warts, tinea, scabies, head lice, conjunctivitis, human immunodeficiency virus, hepatitis C virus, and vaccine-preventable illnesses. EVIDENCE ACQUISITION: Searches were performed across PubMed and MEDLINE research databases. In addition, general internet search engine results and reviews of reference lists of relevant papers were used to identify additional sources of evidence. STUDY DESIGN: Clinical review. LEVEL OF EVIDENCE: Level 4. RESULTS: The most common infections seen in contact sport athletes include bacterial skin infections, herpes simplex virus, molluscum contagiosum, common warts, tinea, scabies, head lice, conjunctivitis, and vaccine-preventable illnesses. Other infections, including human immunodeficiency virus and hepatitis C, are uncommon but potentially life threatening. CONCLUSION: Infections are common in contact sport athletes. The provider who cares for these athletes should be aware of the most common infections and their appropriate management. Early diagnosis and appropriate clinical management are important for treating the infected athlete, minimizing risk of transmission, minimizing time lost from competition, and preventing large outbreaks.
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Affiliation(s)
- Andrew R. Peterson
- Carver College of Medicine, University of Iowa, Iowa City, Iowa
- Stead Family Department of Pediatrics, University of Iowa, Iowa City, Iowa
- Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, Iowa
- University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Emma Nash
- Carver College of Medicine, University of Iowa, Iowa City, Iowa
- University of Iowa Hospitals and Clinics, Iowa City, Iowa
- Department of Emergency Medicine, University of Iowa, Iowa City, Iowa
| | - B.J. Anderson
- University of Minnesota, Minneapolis, Minnesota
- Boynton Health Service, Minneapolis, Minnesota
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Toro-Tobón D, Berbesi-Fernandez D, Mateu-Gelabert P, Segura-Cardona ÁM, Montoya-Vélez LP. Prevalence of hepatitis C virus in young people who inject drugs in four Colombian cities: A cross-sectional study using Respondent Driven Sampling. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 60:56-64. [PMID: 30107313 DOI: 10.1016/j.drugpo.2018.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 06/16/2018] [Accepted: 07/15/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Colombia has a growing population of young people who inject drugs (PWID). Despite the previously reported association of injection drug use with hepatitis c virus (HCV) in other countries, studies on HCV prevalence in PWID in Colombia are lacking. The objective of this study is to determine the prevalence, demographics, and correlations of risky injection behaviours in HCV seropositive PWID in four Colombian cities (Armenia, Bogotá, Cúcuta and Pereira). METHODS This was a cross-sectional study carried out between January and June of 2014 that included 918 PWID from four Colombian cities, recruited by Respondent Driven Sampling. A survey was administered to each participant, and blood samples were collected. Binary logistic regression and multivariate analyses for each city were conducted. RESULTS Average participant age was 26 years (SD 6.5). Of all participants, 27.3% of PWID were HCV seropositive, of which 52% were 25 years old or younger. In Pereira, increased risk of HCV infection was found for PWID that: had a history of injection drug use of 5 years or more (AOR: 3.0, CI: 1.7-7.8); were between 25 and 28 years of age (AOR: 5.2, CI: 1.0-26.3); had higher injection frequency (AOR: 2.5, CI: 1.4-4.2), and daily use of gifted, sold, or rented needles or syringes (AOR: 4.5, CI: 1.0-7.1). Additionally, in Cucuta, being HIV seropositive appeared to be greatly associated with risk of HCV seropositivity (AOR: 16.9, CI: 3.5-81.5). CONCLUSION Although prevalence of HCV in PWID in Colombia is lower than that reported for other countries, the described demographic characteristics and diverse risky injection behaviors on each city, in the context of a young PWID population with a short injection drug use history, should be taken into account in order to guide efforts towards preventing and reducing risk of HCV infection in PWID in Colombia.
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Affiliation(s)
- David Toro-Tobón
- School of Medicine, CES University, Medellin, Colombia; Epidemiology and Bioestatistics Research Group, CES University, Medellin, Colombia.
| | - Dedsy Berbesi-Fernandez
- Epidemiology and Bioestatistics Research Group, CES University, Medellin, Colombia; School of Nursing, CES University, Medellin, Colombia.
| | | | - Ángela M Segura-Cardona
- School of Medicine, CES University, Medellin, Colombia; Epidemiology and Bioestatistics Research Group, CES University, Medellin, Colombia.
| | - Liliana P Montoya-Vélez
- School of Medicine, CES University, Medellin, Colombia; Division of Public Health, CES University, Medellin, Colombia.
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Fabrizi F, Lunghi G, Ponticelli C. Epidemiology of Human Immunodeficiency Virus (HIV) Infection in Dialysis: Recent Insights. Int J Artif Organs 2018. [DOI: 10.1177/039139880102400704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- F. Fabrizi
- Division of Nephrology and Dialysis, Ospedale Maggiore Policlinico, IRCCS, Milano - Italy
| | - G. Lunghi
- Institute of Hygiene and Preventive Medicine, Ospedale Maggiore Policlinico, IRCCS, Milano - Italy
| | - C. Ponticelli
- Division of Nephrology and Dialysis, Ospedale Maggiore Policlinico, IRCCS, Milano - Italy
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Gulin M, Puretic Z, Begovac J, Civljak R, Jankovic N, Basic-Jukic N, Racki S. Croatian Recommendations for Dialysis of HIV-Positive Patients. BANTAO JOURNAL 2017. [DOI: 10.1515/bj-2016-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Human immunodeficiency virus (HIV) infection may be associated with renal impairment since about 0.4% of all HIV-positive patients develop end-stage renal disease. The share of patients with HIV infection in hemodialysis centers throughout the world ranges from 0.3% to as high as 38%. In Croatia, renal replacement therapy was needed by 1% of all the HIV-positive patients from 1985 until the end of 2014. Healthcare professionals (HP) should be aware of the risks of occupational exposure to blood-borne infections in their daily work. Performing dialysis in HIV-positive patients increases the risk of exposure to HIV during the extracorporeal circulation of the infected blood. However, post-exposure prophylaxis (PEP) with effective antiretroviral drugs significantly reduces the risk of infection after occupational exposure. On behalf of the Croatian Society of Nephrology, Dialysis and Transplantation, the authors of this paper have proposed recommendations for the management of HIVpositive patients on dialysis, which aim to prevent the transmission of HIV among patients and HPs. The important recommendations include the following: 1. when the need arises, it is necessary to provide HIV-positive patients with dialysis in the vicinity of their place of residence. 2. HIV-positive patients should be dialyzed with a separate hemodialysis machine in an isolated area. Alternatively, they can be dialyzed in an area for the hemodialysis of HCV-positive and/or HBVpositive patients. 3. Specialized and trained personnel should be provided during the hemodialysis procedure, together with strict compliance with the standard precautions for the prevention of blood-borne infections. 4. There should be a good and prompt cooperation with the National Referral Center for HIV infection.
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Affiliation(s)
- Marijana Gulin
- Department of Nephrology and Dialysis, Sibenik General Hospital, Stjepana Radica 83 a, 22 000 Sibenik , Croatia
| | - Zvonimir Puretic
- B. Braun Avitum Polyclinic for Medicine and Dialysis, Zagreb , Croatia
| | - Josip Begovac
- Dr. Fran Mihaljevic University Hospital for Infectious Diseases, University of Zagreb School of Medicine, Zagreb , Croatia
| | - Rok Civljak
- Dr. Fran Mihaljevic University Hospital for Infectious Diseases, University of Zagreb School of Medicine, Zagreb , Croatia
| | - Nikola Jankovic
- Department of Nephrology and Dialysis, Sveti Duh General Hospital, Zagreb , Croatia
| | - Nikolina Basic-Jukic
- Department of Nephrology and Dialysis, University Hospital Center, University of Zagreb School of Medicine, Zagreb , Croatia
| | - Sanjin Racki
- Department of Nephrology and Dialysis, University Hospital Center, University of Rijeka School of Medicine, Rijeka , Croatia
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22
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Compliance with occupational exposure risk management procedures in a dental school setting. Br Dent J 2017; 222:859-863. [DOI: 10.1038/sj.bdj.2017.498] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2017] [Indexed: 11/08/2022]
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Midgard H, Weir A, Palmateer N, Lo Re V, Pineda JA, Macías J, Dalgard O. HCV epidemiology in high-risk groups and the risk of reinfection. J Hepatol 2016; 65:S33-S45. [PMID: 27641987 DOI: 10.1016/j.jhep.2016.07.012] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 07/08/2016] [Accepted: 07/12/2016] [Indexed: 12/18/2022]
Abstract
Injecting risk behaviours among people who inject drugs (PWID) and high-risk sexual practices among men who have sex with men (MSM) are important routes of hepatitis C virus (HCV) transmission. Current direct-acting antiviral treatment offers unique opportunities for reductions in HCV-related liver disease burden and epidemic control in high-risk groups, but these prospects could be counteracted by HCV reinfection due to on-going risk behaviours after successful treatment. Based on existing data from small and heterogeneous studies of interferon-based treatment, the incidence of reinfection after sustained virological response range from 2-6/100 person years among PWID to 10-15/100 person years among human immunodeficiency virus-infected MSM. These differences mainly reflect heterogeneity in study populations with regards to risk behaviours, but also reflect variations in study designs and applied virological methods. Increasing levels of reinfection are to be expected as we enter the interferon-free treatment era. Individual- and population-level efforts to address and prevent reinfection should therefore be undertaken when providing HCV care for people with on-going risk behaviour. Constructive strategies include acknowledgement, education and counselling, harm reduction optimization, scaled-up treatment including treatment of injecting networks, post-treatment screening, and rapid retreatment of reinfections.
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Affiliation(s)
- Håvard Midgard
- Department of Infectious Diseases, Akershus University Hospital, Lørenskog, Norway; Institute for Clinical Medicine, University of Oslo, Norway; Department of Gastroenterology, Oslo University Hospital, Norway.
| | - Amanda Weir
- School of Health and Life Sciences, Glasgow Caledonian University, United Kingdom; NHS National Services Scotland, Health Protection Scotland, Glasgow, United Kingdom
| | - Norah Palmateer
- School of Health and Life Sciences, Glasgow Caledonian University, United Kingdom; NHS National Services Scotland, Health Protection Scotland, Glasgow, United Kingdom
| | - Vincent Lo Re
- Division of Infectious Diseases, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, United States
| | - Juan A Pineda
- Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Sevilla, Spain
| | - Juan Macías
- Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Sevilla, Spain
| | - Olav Dalgard
- Department of Infectious Diseases, Akershus University Hospital, Lørenskog, Norway; Institute for Clinical Medicine, University of Oslo, Norway
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Audet CM, Salato J, Blevins M, Silva W, González-Calvo L, Vermund SH, Gaspar F. Occupational hazards of traditional healers: repeated unprotected blood exposures risk infectious disease transmission. Trop Med Int Health 2016; 21:1476-1480. [PMID: 27580349 DOI: 10.1111/tmi.12775] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Healers provide support for acute and chronic illnesses in rural Mozambique, such as socially acceptable traditional 'vaccinations' (subcutaneous cuts in the skin to rub herbs directly into the bloody lesion). We aimed to document the frequency of blood exposure by traditional practitioners in Mozambique. METHODS We conducted surveys with a simple random sample of 236 traditional healers in Zambézia province. Chi-square and Wilcoxon rank-sum tests were used to compare 'injection' behaviours across districts. RESULTS Healers treated a median of eight patients in the past month (IQR: 4-15). About 75% conducted 'injections'. These healers 'injected' a median of four patients (IQR: 1-8), used a new razor a median of three times (IQR: 1-8), and almost never used gloves. Lifetime blood exposures among those who provided 'injections' during treatments were estimated to be 1758 over a healer's career. CONCLUSION The majority of healers are exposed repeatedly to patient blood. Given the high prevalence of HIV, hepatitis B and C virus, and other blood-borne agents, specific healer practices are an occupational hazard and reuse of razors is risky for their clients.
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Affiliation(s)
- Carolyn M Audet
- Vanderbilt Institute for Global Health, Nashville, TN, USA. .,Department of Health Policy, Vanderbilt University School of Medicine, Nashville, TN, USA.
| | - José Salato
- Friends in Global Health, Quelimane and Maputo, Mozambique
| | - Meridith Blevins
- Vanderbilt Institute for Global Health, Nashville, TN, USA.,Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Wilson Silva
- Vanderbilt Institute for Global Health, Nashville, TN, USA.,Friends in Global Health, Quelimane and Maputo, Mozambique
| | - Lázaro González-Calvo
- Vanderbilt Institute for Global Health, Nashville, TN, USA.,Friends in Global Health, Quelimane and Maputo, Mozambique
| | - Sten H Vermund
- Vanderbilt Institute for Global Health, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA
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Pfaender S, von Hahn T, Steinmann J, Ciesek S, Steinmann E. Prevention strategies for blood-borne viruses-in the Era of vaccines, direct acting antivirals and antiretroviral therapy. Rev Med Virol 2016; 26:330-9. [PMID: 27185010 PMCID: PMC5084801 DOI: 10.1002/rmv.1890] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 04/27/2016] [Accepted: 04/28/2016] [Indexed: 12/21/2022]
Abstract
Blood-borne viruses, such as hepatitis B virus, hepatitis C virus, human immunodeficiency virus, and the facultative blood-borne hepatitis E virus, are considered a major public health problem given that they are accountable for millions of deaths each year. Treatment options, including effective vaccine design, development of antiviral strategies and the implementation of antiretroviral therapy have improved substantially over the last couple of years and contribute to successful treatment and prevention of these infectious diseases. In this review, we summarise the current knowledge and concepts in prevention of transmission of these blood-borne viruses.
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Affiliation(s)
- Stephanie Pfaender
- Institute for Experimental Virology, Twincore, and Hannover Medical School Hannover, Germany, and Helmholtz Centre for Infection Research, Braunschweig, Germany
- Department of Infectious Diseases and Pathobiology, University of Bern, 3012 Bern, Switzerland, Federal Department of Home Affairs, Institute of Virology and Immunology, 3012 Bern and 3147, Mittelhäusern, Switzerland
| | - Thomas von Hahn
- Department of Gastroenterology, Hepatology and Endocrinology, Medizinische Hochschule Hannover, Hannover, Germany
- German Center for Infection Research (DZIF) - Hannover-Braunschweig Site
- Institute for Molecular Biology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Hospital Essen, Essen, Germany
| | - Sandra Ciesek
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Eike Steinmann
- Institute for Experimental Virology, Twincore, and Hannover Medical School Hannover, Germany, and Helmholtz Centre for Infection Research, Braunschweig, Germany.
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Prevalence and correlates of needle-stick injuries among active duty police officers in Tijuana, Mexico. J Int AIDS Soc 2016; 19:20874. [PMID: 27435711 PMCID: PMC4951532 DOI: 10.7448/ias.19.4.20874] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Revised: 04/25/2016] [Accepted: 05/02/2016] [Indexed: 01/23/2023] Open
Abstract
Introduction Police officers are at an elevated risk for needle-stick injuries (NSI), which pose a serious and costly occupational health risk for HIV and viral hepatitis. However, research on NSIs among police officers is limited, especially in low- and middle-income countries. Despite the legality of syringe possession in Mexico, half of people who inject drugs (PWID) in Tijuana report extrajudicial syringe-related arrests and confiscation by police, which has been associated with needle-sharing and HIV infection. We assessed the prevalence and correlates of NSIs among Tijuana police officers to inform efforts to improve occupational safety and simultaneously reduce HIV risks among police and PWID. Methods Tijuana's Department of Municipal Public Safety (SSPM) is among Mexico's largest. Our binational, multi-sectoral team analyzed de-identified data from SSPM's 2014 anonymous self-administered occupational health survey. The prevalence of NSI and syringe disposal practices was determined. Logistic regression with robust variance estimation via generalized estimating equations identified factors associated with ever having an occupational NSI. Results Approximately one-quarter of the Tijuana police force was given the occupational health survey (N=503). Respondents were predominantly male (86.5%) and ≤35 years old (42.6%). Nearly one in six officers reported ever having a NSI while working at SSPM (15.3%), of whom 14.3% reported a NSI within the past year. Most participants reported encountering needles/syringes while on duty (n=473, 94%); factors independently associated with elevated odds of NSIs included frequently finding syringes that contain drugs (adjusted odds ratio (AOR): 2.98; 95% confidence interval (CI): 1.56–5.67) and breaking used needles (AOR: 2.25; 95% CI: 1.29–3.91), while protective factors included being willing to contact emergency services in case of NSIs (AOR: 0.39; 95% CI: 0.22–0.69), and wearing needle-stick resistant gloves (AOR: 0.43; 95% CI: 0.19–0.91). Conclusions Tijuana police face an elevated and unaddressed occupational NSI burden associated with unsafe syringe-handling practices, exposing them to substantial risk of HIV and other blood-borne infections. These findings spurred the development and tailoring of training to reduce NSI by modifying officer knowledge, attitudes and enforcement practices (e.g. syringe confiscation) – factors that also impact HIV transmission among PWID and other members of the community.
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Police, Law Enforcement and HIV. J Int AIDS Soc 2016. [DOI: 10.7448/ias.19.4.21260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Gholami Parizad E, Gholami Parizad E, Khosravi A, Amraei M, Valizadeh A, Davoudian A. Comparing HBV Viral Load in Serum, Cerumen, and Saliva and Correlation With HBeAg Serum Status in Patients With Chronic Hepatitis B Infection. HEPATITIS MONTHLY 2016; 16:e30385. [PMID: 27313632 PMCID: PMC4908613 DOI: 10.5812/hepatmon.30385] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 02/17/2016] [Accepted: 04/06/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Hepatitis B is a disease that is prevalent worldwide and is responsible for 10% of the deaths that occur every year. The virus persists in 5% of infected adults and 90% of infected children and can cause chronic hepatitis. In addition to blood, the virus may also be present in other secretions. Transmission through saliva, sexual fluids, and urine has also been confirmed. OBJECTIVES The main aim of this study was to compare viral DNA copies in the serum, cerumen, and saliva of patients with HBeAg levels in their sera. PATIENTS AND METHODS This was a cross-sectional study and subjects were selected by non-randomized methods. Serum, cerumen, and saliva samples were collected from 50 patients who were diagnosed with chronic hepatitis B about a year prior to the study. Enzyme-linked immunosorbent assay (ELISA) was performed to determine the presence of HBsAg and HBeAg in the gathered specimens. Viral DNA was extracted from specimens by using a Qiagen kit. The number of viral DNA copies was determined using a real-time polymerase chain reaction (PCR) assay. The study was performed in Ilam province in western Iran. RESULTS Twenty-eight percent of the patients were HBeAg positive. The average number of viral copies in serum, cerumen, and saliva was higher in women than in men, and a significant correlation was observed between the gender and average viral copies. However, no significant correlation was observed between viral copies present in the serum and cerumen with the age and gender of patients. In addition, no correlation was observed between serum HBeAg and viral copies present in serum, cerumen, and saliva. The correlation analysis confirmed a direct and definite correlation between viral DNA loads in the patients' serum and cerumen. CONCLUSIONS A significant direct correlation was observed between the viral DNA copies present in patients' cerumen and serum. However, the correlation between saliva viral load with serum and cerumen viral load was very low and inverse. These findings suggest that the presence of the hepatitis B virus (HBV) in non-invasive specimens (such as cerumen and saliva) should also be evaluated when monitoring patients to determine the course of infection and disease.
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Affiliation(s)
- Elaheh Gholami Parizad
- Clinical Microbiology Research Centre, Ilam University of Medical Sciences, Ilam, IR Iran
| | - Eskandar Gholami Parizad
- Public Health Department, Psychosocial Injuries Prevention Research Centre, Ilam University of Medical Sciences, Ilam, IR Iran
- Corresponding Author: Eskandar Gholami Parizad, Public Health Department, Psychosocial Injuries Prevention Research Centre, Ilam University of Medical Sciences, Ilam, IR Iran. Tel: +98-8432240404, Fax: +98-8432240404, E-mail:
| | - Afra Khosravi
- Clinical Microbiology Research Centre, Ilam University of Medical Sciences, Ilam, IR Iran
| | - Mansour Amraei
- Department of Clinical Physiology, Research Centre, Ilam University of Medical Sciences, Ilam, IR Iran
| | - Azar Valizadeh
- Clinical Microbiology Research Centre, Ilam University of Medical Sciences, Ilam, IR Iran
| | - Abdoullah Davoudian
- Department of Clinical Immunology, Ilam University of Medical Sciences, Ilam, IR Iran
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Basazn Mekuria A, Melaku Gebresillassie B, Asfaw Erku D, Taye Haile K, Melese Birru E. Knowledge and Self-Reported Practice of Insulin Injection Device Disposal among Diabetes Patients in Gondar Town, Ethiopia: A Cross-Sectional Study. J Diabetes Res 2016; 2016:1897517. [PMID: 27738637 PMCID: PMC5055957 DOI: 10.1155/2016/1897517] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 08/28/2016] [Indexed: 12/13/2022] Open
Abstract
Background. Incorrect sharp disposal practices may expose the public to needle-stick injuries. The present study aimed at assessing the knowledge and practice of diabetic patients towards insulin injection device disposal in Gondar town, Ethiopia. Methods. A cross-sectional study was employed on insulin requiring diabetes patients who visited the diabetes clinic at Gondar University Referral Hospital (GURH) from February 1 to March 28, 2016. Frequencies, percentages, and ANOVA (analysis of variance) and Student's t-test were used to analyze variables. Results. About half of the participants (49.5%) had poor knowledge towards safe insulin injection waste disposal. More than two-thirds (80.7%) of respondents had poor practice and 64.3% of respondents did not put insulin needle and lancets into the household garbage. 31% of respondents threw sharps on street when they travel outside. Respondents living in urban areas had a higher mean of knowledge and practice score than those who live in rural area. Conclusions. This study revealed that knowledge and practice of diabetic patients were low towards safe insulin injection waste disposal in study area. Healthcare providers should also be aware of safe disposing system and counsel patients on appropriate disposal of used syringes.
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Affiliation(s)
- Abebe Basazn Mekuria
- Department of Pharmacology, College of Medicine and Health Sciences, University of Gondar, Chechela Street, Lideta Subcity Kebele 16, Gondar, Ethiopia
- *Abebe Basazn Mekuria:
| | - Begashaw Melaku Gebresillassie
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar, Chechela Street, Lideta Subcity Kebele 16, Gondar, Ethiopia
| | - Daniel Asfaw Erku
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar, Chechela Street, Lideta Subcity Kebele 16, Gondar, Ethiopia
| | - Kaleab Taye Haile
- Department of Pharmaceutics, School of Pharmacy, University of Gondar, Chechela Street, Lideta Subcity Kebele 16, Gondar, Ethiopia
| | - Eshetie Melese Birru
- Department of Pharmacology, College of Medicine and Health Sciences, University of Gondar, Chechela Street, Lideta Subcity Kebele 16, Gondar, Ethiopia
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Bajwa SJS, Kaur J. Risk and safety concerns in anesthesiology practice: The present perspective. Anesth Essays Res 2015; 6:14-20. [PMID: 25885495 PMCID: PMC4173431 DOI: 10.4103/0259-1162.103365] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Newer developments and advancements in anesthesiology, surgical, and medical fields have widened the functional scope of anesthesiologist thus increasing his professional responsibilities and obligations. While at workplace, anesthesiologist is exposed to a wide array of potential hazards that can be detrimental to his overall health. Numerous risks and safety concerns have been mentioned in the literature, but the magnitude of challenges in anesthesiology practice are far greater than those cited and anticipated. Many times these challenging situations are unavoidable and the attending anesthesiologist has to deal with them on an individual basis. These hazards not only affect the general health but can be extremely threatening in various other ways that can increase the potential risks of morbidity and mortality. This article is an attempt to bring a general awareness among anesthesia fraternity about the various health hazards associated with anesthesia practice. Also, a genuine attempt has been made to enumerate the various preventive methods and precautions that should be adopted to make practice of anesthesiology safe and smooth.
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Affiliation(s)
- Sukhminder Jit Singh Bajwa
- Department of Anaesthesiology and Intensive Care, Gian Sagar Medical College and Hospital, Ram Nagar, Banur, Punjab, India
| | - Jasbir Kaur
- Department of Anaesthesiology and Intensive Care, Gian Sagar Medical College and Hospital, Ram Nagar, Banur, Punjab, India
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Le Pont F, Hatungimana V, Guiguet M, Ndayiragije A, Ndoricimpa J, Niyongabo T, Larouzé B. Assessment of Occupational Exposure to Human Immunodeficiency Virus and Hepatitis C Virus in a Referral Hospital in Burundi, Central Africa. Infect Control Hosp Epidemiol 2015; 24:717-8. [PMID: 14587928 DOI: 10.1086/502908] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
A 30-year-old homosexual Japanese man had fourteen days of fever, malaise, appetite loss, sore throat, and four days of diarrhea and slightly congested eyes before he developed a skin eruption. He presented with measles-like exanthems on his face, trunk, and extremities. Deep red enanthems were seen on his left buccal mucosa opposite the premolar teeth, and whitish enanthems were seen on the buccal and gingival mucosa. HIV RNA was detected at the high concentration of 5.8 x 10(6) copies /ml in his serum. Cerebrospinal fluid examination revealed aseptic meningitis with 5,488 copies /ml of HIV RNA. Anti-HIV 1 antibodies against Gp160 and p24 tested by Western blot assay showed seroconversion on day 5 of his admission, seven days after he developed the skin eruptions. The fever lasted for three weeks from the initial onset, and the skin eruptions lasted for twelve days. Histopathologically, a mononuclear cell infiltration was seen mainly in the upper dermis surrounding small vessels and sweat ducts, with CD8+ cytotoxic T lymphocytes predominant. Additionally, CD1a+ putative interdigitating dendritic cells had also infiltrated perivascularly, and were surrounded by CD8+ and CD4+ T cells. In situ hybridization study failed to detect HIV products in skin biopsy specimens. Our findings suggested that CD8+ T cells and their interaction with CD1a+ dendritic cells in the skin may be important in inducing skin manifestations in acute HIV infections.
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Affiliation(s)
- Satomi Kobayashi
- Department of Dermatology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan
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Pépin J, Abou Chakra CN, Pépin E, Nault V, Valiquette L. Evolution of the global burden of viral infections from unsafe medical injections, 2000-2010. PLoS One 2014; 9:e99677. [PMID: 24911341 PMCID: PMC4049770 DOI: 10.1371/journal.pone.0099677] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 05/15/2014] [Indexed: 12/12/2022] Open
Abstract
Background In 2000, the World Health Organization estimated that, in developing and transitional countries, unsafe injections accounted for respectively 5%, 32% and 40% of new infections with HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV). Safe injection campaigns were organized worldwide. The present study sought to measure the progress in reducing the transmission of these viruses through unsafe injections over the subsequent decade. Methods A mass action model was updated, to recalculate the number of injection-related HIV, HCV and HBV infections acquired in 2000 and provide estimates for 2010. Data about the annual number of unsafe injections were updated. HIV prevalence in various regions in 2000 and 2010 were calculated from UNAIDS data. The ratio of HIV prevalence in healthcare settings compared to the general population was estimated from a literature review. Improved regional estimates of the prevalence of HCV seropositivity, HBsAg and HBeAg antigenemia were used for 2000 and 2010. For HIV and HCV, revised estimates of the probability of transmission per episode of unsafe injection were used, with low and high values allowing sensitivity analyses. Results Despite a 13% population growth, there was a reduction of respectively 87% and 83% in the absolute numbers of HIV and HCV infections transmitted through injections. For HBV, the reduction was more marked (91%) due to the additional impact of vaccination. While injections-related cases had accounted for 4.6%–9.1% of newly acquired HIV infections in 2000, this proportion decreased to 0.7%–1.3% in 2010, when unsafe injections caused between 16,939 and 33,877 HIV infections, between 157,592 and 315,120 HCV infections, and 1,679,745 HBV infections. Conclusion From 2000 to 2010, substantial progress was made in reducing the burden of HIV, HCV and HBV infections transmitted through injections. In some regions, their elimination might become a reasonable public health goal.
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Affiliation(s)
- Jacques Pépin
- Department of Microbiology and Infectious Diseases, Université de Sherbrooke, Sherbrooke, Québec, Canada
- * E-mail:
| | - Claire Nour Abou Chakra
- Department of Microbiology and Infectious Diseases, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Eric Pépin
- Department of Microbiology and Infectious Diseases, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Vincent Nault
- Department of Microbiology and Infectious Diseases, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Louis Valiquette
- Department of Microbiology and Infectious Diseases, Université de Sherbrooke, Sherbrooke, Québec, Canada
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Anti-HBs response to hepatitis B immunoglobulin prophylaxis in liver transplant recipients. Indian J Gastroenterol 2014; 33:226-30. [PMID: 24760685 DOI: 10.1007/s12664-014-0457-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Accepted: 10/13/2013] [Indexed: 02/04/2023]
Abstract
BACKGROUND Hepatitis B virus (HBV) recurrence after a liver transplant (LT) is a global issue. Several strategies have been adopted to prevent this recurrence. Most strategies recommend a combination of hepatitis B immunoglobulin (HBIG) and or nucleos(t)ide analogue. AIM OF THE STUDY The aim of the study is to determine the anti-HBs response to HBIG among Indian patients who had undetectable pre-transplant HBV DNA. METHODS Seven adult HBV-related LT recipients of Indian origin with low pre-transplant HBV titres who had a liver transplant between August 2009 and June 2012 were included in the study. The protocol followed for post-liver transplant HBIG dose was titrated to achieve an anti-HBs titre of at least 100 IU/L. All recipients were on entecavir. Anti-HBs titre, and HBsAg status was checked at regular intervals. A retrospective analysis of the anti-HBs response to a loading and maintenance dose of HBIG was done. RESULTS Seven adult HBV-related LT recipients on post-transplant prophylaxis with HBIG and nucleoside analogue (entecavir) fulfilled the criteria for the study. The median anti-HBs response to the anhepatic and loading dose of HBIG was high at 555 IU/L. In two, the response was less than 100 IU/L. The median dose of HBIG reduced at end of 1 month to 800 IU, and the median titre was 223 IU/L. For the next 11 months, the median requirement of HBIG was 3,000 and 4,000 IU, and the titre was low at 53.8 and 60.9 IU/L at end of 6 and 12 months, respectively. CONCLUSIONS The anti-HBs response to HBIG was variable, and titres even below 100 IU/L did not result in HBV recurrence when HBIG was given in combination with entecavir.
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Serdar T, Derek L, Unić A, Marijancević D, Marković D, Primorac A, Petrovecki M. Occupational exposures in healthcare workers in University Hospital Dubrava--10 year follow-up study. Cent Eur J Public Health 2014; 21:150-4. [PMID: 24344541 DOI: 10.21101/cejph.a3803] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Occupational hazardous exposure in healthcare workers is any contact with a material that carries the risk of acquiring an infection during their working activities. Among the most frequent viral occupational infections are those transmitted by blood such as hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Therefore, they represent a significant public health problem related to the majority of documented cases of professionally acquired infections. Reporting of occupational exposures in University Hospital Dubrava has been implemented in connection with the activity of the Committee for Hospital Infections since January 2002. During the period of occupational exposures' monitoring (from January 2002 to December 2011) 451 cases were reported. The majority of occupational exposures were reported by nurses and medical technicians (55.4%). The most common type of exposure was the needlestick injury (77.6%). 27.9% of the accidents occurred during the blood sampling and 23.5% during the surgical procedure. In 59.4% of the exposed workers aHBs-titer status was assessed as satisfactory. Positive serology with respect to HBV was confirmed in 1.6% of patients, HCV in 2.2% of patients and none for HIV. Cases of professionally acquired infections were not recorded in the registry. Consequences of the occupational exposure could include the development of professional infection, ban or inability to work further in health care services and last but not least a threat to healthcare workers life. It is therefore deemed necessary to prevent occupational exposure to blood-borne infections. The most important preventive action in respect to HBV, HCV and HIV infections is nonspecific pre-exposure prophylaxis.
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Affiliation(s)
- Tihana Serdar
- Clinical Department for Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia.
| | - Lovorka Derek
- Clinical Department for Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
| | - Adriana Unić
- Clinical Department for Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
| | - Domagoj Marijancević
- Clinical Department for Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
| | - Durda Marković
- Department for Clinical Microbiology and Hospital Infections, University Hospital Dubrava, Zagreb, Croatia
| | - Ana Primorac
- Hospital Management, University Hospital Dubrava, Zagreb, Croatia
| | - Mladen Petrovecki
- Department of Medical Informatics, Rijeka University School of Medicine, Croatia
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Palmateer N, Hutchinson S, McAllister G, Munro A, Cameron S, Goldberg D, Taylor A. Risk of transmission associated with sharing drug injecting paraphernalia: analysis of recent hepatitis C virus (HCV) infection using cross-sectional survey data. J Viral Hepat 2014; 21:25-32. [PMID: 24329854 DOI: 10.1111/jvh.12117] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 03/27/2013] [Indexed: 12/23/2022]
Abstract
Sharing injecting paraphernalia (containers, filters and water) poses a risk of transmitting the hepatitis C virus (HCV). The prevalence of, and risk of HCV from, such behaviour has not been extensively reported in Europe. People who inject drugs (PWID) were recruited in cross-sectional surveys from services providing sterile injecting equipment across Scotland between 2008 and 2010. Participants completed a questionnaire and provided a blood spot for anonymous testing. Logistic regression was used to examine the association between recent HCV infection (anti-HCV negative and HCV-RNA positive) and self-reported measures of injecting equipment sharing in the 6 months preceding interview. Twelve per cent of the sample reported sharing needles/syringes, and 40% reported sharing paraphernalia in the previous 6 months. The adjusted odds ratios (AOR) for sharing needles/syringes (+/- paraphernalia), and sharing only paraphernalia in the last 6 months were 6.7 (95% CI 2.6-17.1) and 3.0 (95% CI 1.2-7.5), respectively. Among those who reported not sharing needles/syringes, sharing containers and filters were both significantly associated with recent HCV infection (AOR 3.1, 95% CI 1.3-7.8 and 3.1, 95% CI 1.3-7.5, respectively); sharing water was not. We present the first study to apply a cross-sectional approach to the analysis of the association between sharing paraphernalia and incident HCV infection and demonstrate consistent results with previous longitudinal studies. The prevalence of paraphernalia sharing in our study population is high, representing significant potential for HCV transmission.
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Affiliation(s)
- N Palmateer
- Blood-borne Viruses and Sexually Transmitted Infections Section, Health Protection Scotland, Glasgow, UK
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Soman SO, Vijayaraghavan G, Padmaja NP, Warrier AR, Unni M. Aspergilloma of the heart. Indian Heart J 2014; 66:238-40. [PMID: 24814126 DOI: 10.1016/j.ihj.2013.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 07/07/2013] [Accepted: 12/04/2013] [Indexed: 11/26/2022] Open
Affiliation(s)
- Suman Omana Soman
- Department of Cardiology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India.
| | - G Vijayaraghavan
- Department of Cardiology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
| | - N P Padmaja
- Department of Cardiology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
| | - Anoop R Warrier
- Department of Infectious Disease, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
| | - Madhavan Unni
- Department of Radio Diagnosis, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
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Pierce AB, Armishaw J, Aitchison S. Developing an evidence-based guideline for the management of exposure to hepatitis B at a Victorian tertiary hospital. Aust N Z J Public Health 2013; 37:411-5. [DOI: 10.1111/1753-6405.12107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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MacArthur GJ, van Velzen E, Palmateer N, Kimber J, Pharris A, Hope V, Taylor A, Roy K, Aspinall E, Goldberg D, Rhodes T, Hedrich D, Salminen M, Hickman M, Hutchinson SJ. Interventions to prevent HIV and Hepatitis C in people who inject drugs: a review of reviews to assess evidence of effectiveness. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2013; 25:34-52. [PMID: 23973009 DOI: 10.1016/j.drugpo.2013.07.001] [Citation(s) in RCA: 212] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 06/25/2013] [Accepted: 07/03/2013] [Indexed: 01/23/2023]
Abstract
BACKGROUND Injecting drug use is a major risk factor for the acquisition and transmission of HIV and Hepatitis C virus (HCV). Prevention of these infections among people who inject drugs (PWID) is critical to reduce ongoing transmission, morbidity and mortality. METHODS A review of reviews was undertaken involving systematic literature searches of Medline, Embase, CINAHL, PsychINFO, IBSS and the Cochrane Library (2000-2011) to identify English language reviews regarding the effectiveness of harm reduction interventions in relation to HIV transmission, HCV transmission and injecting risk behaviour (IRB). Interventions included needle and syringe programmes (NSP); the provision of injection paraphernalia; opiate substitution treatment (OST); information, education and counselling (IEC); and supervised injecting facilities (SIFs). Reviews were classified into 'core' or 'supplementary' using critical appraisal criteria, and the strength of review-level evidence was assessed. RESULTS Twelve core and thirteen supplementary reviews were included. From these reviews we identified: (i) for NSP: tentative review-level evidence to support effectiveness in reducing HIV transmission, insufficient review-level evidence relating to HCV transmission, but sufficient review-level evidence in relation to IRB; (ii) for OST: sufficient review-level evidence of effectiveness in relation to HIV transmission and IRB, but tentative review-level evidence in relation to HCV transmission; (iii) for IEC, the provision of injection paraphernalia and SIFs: tentative review-level evidence of effectiveness in reducing IRB; and either insufficient or no review-level evidence for these interventions in relation to HIV or HCV transmission. CONCLUSION Review-level evidence indicates that harm reduction interventions can reduce IRB, with evidence strongest for OST and NSP. However, there is comparatively little review-level evidence regarding the effectiveness of these interventions in preventing HCV transmission among PWID. Further studies are needed to assess the effectiveness and impact of scaling up comprehensive packages of harm reduction interventions to minimise HIV and HCV transmission among PWID.
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Affiliation(s)
- Georgina J MacArthur
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK.
| | - Eva van Velzen
- NHS Sutton and Merton/London KSS Specialty School of Public Health, UK
| | | | - Jo Kimber
- University of New South Wales, Sydney, Australia
| | | | - Vivian Hope
- Centre for Research on Drugs and Health Behaviour, London School of Hygiene and Tropical Medicine, London, UK; Health Protection Services, Health Protection Agency, London, UK
| | - Avril Taylor
- University of the West of Scotland, Paisley, Scotland, UK
| | | | - Esther Aspinall
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | | | - Tim Rhodes
- Centre for Research on Drugs and Health Behaviour, London School of Hygiene and Tropical Medicine, London, UK
| | - Dagmar Hedrich
- European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
| | - Mika Salminen
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Matthew Hickman
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Sharon J Hutchinson
- Health Protection Scotland, Glasgow, UK; University of the West of Scotland, Paisley, Scotland, UK
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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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Zarra T, Lambrianidis T. Occupational ocular accidents amongst Greek endodontists: a national questionnaire survey. Int Endod J 2013; 46:710-9. [DOI: 10.1111/iej.12048] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Accepted: 12/10/2012] [Indexed: 11/26/2022]
Affiliation(s)
- T. Zarra
- Department of Endodontology; Dental School; Aristotle University of Thessaloniki; Thessaloniki; Greece
| | - T. Lambrianidis
- Department of Endodontology; Dental School; Aristotle University of Thessaloniki; Thessaloniki; Greece
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Shiferaw Y, Abebe T, Mihret A. Sharps injuries and exposure to blood and bloodstained body fluids involving medical waste handlers. WASTE MANAGEMENT & RESEARCH : THE JOURNAL OF THE INTERNATIONAL SOLID WASTES AND PUBLIC CLEANSING ASSOCIATION, ISWA 2012; 30:1299-1305. [PMID: 22964471 DOI: 10.1177/0734242x12459550] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Exposure to healthcare waste can result in disease or injury. Though much attention is paid to the safety of healthcare professionals and their protection from sharps injury and exposure to blood and bloodstained body fluids (BBFs), the welfare and safety of non-healthcare professionals who are collecting, transporting and disposing waste has received very little attention. The objective of this study was to understand the incidence of sharps injury and occupational BBF exposure of mucous membranes involving medical waste handlers (MWHs). A cross-sectional study was carried out using a self-administered questionnaire, observation and interview. Data analysis was performed using SPSS version 16. The χ(2) value was calculated and P <0.05 was considered statistically significant. One or more incidents of sharps injuries and BBF exposures to mucous membranes occurred among 42.1% and 67.5% of MWHs respectively. None of the respondents was immunized with hepatitis B vaccine owing to the high cost of immunization and absence of free universal availability of the vaccine for the adult population. Less than 50% of MWHs wore either gloves or boots while performing their activities. Even though all knew about HIV, most of the respondents demonstrated a lack of knowledge regarding viral hepatitis. The risk of sharps injury and BBF exposure appeared high in MWHs. The establishment of safe waste-management techniques and the appropriate use of personnel protective equipment among MWHs in Addis Ababa is urgently required.
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Affiliation(s)
- Yitayal Shiferaw
- Department of Medical Laboratory Science, University of Gondar, College of Medicine and Health Science, Gondar, Ethiopia.
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Rossin IR, Machado AA, Junqueira ÉM, Martinez R. Quantification of HIV-1 viral RNA in the blood in needles used for venous puncture in HIV-infected individuals. Rev Soc Bras Med Trop 2012; 44:661-4. [PMID: 22231239 DOI: 10.1590/s0037-86822011000600002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Accepted: 08/08/2011] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Occupational HIV infection among healthcare workers is an important issue in exposures involving blood and body fluids. There are few data in the literature regarding the potential and the duration of infectivity of HIV type 1 (HIV-1) in contaminated material under adverse conditions. METHODS We quantified HIV-1 viral RNA in 25×8mm calibre hollow-bore needles, after punctures, in 25 HIV-1-infected patients selected during the sample collection. All of the patients selected were between the ages of 18 and 55. Five samples were collected from 16 patients: one sample for the immediate quantification of HIV-1 RNA in the plasma and blood samples from the interior of 4 needles to be analyzed at 0 h, 6 h, 24 h, and 72 h after collection. In nine patients, another test was carried out in the blood from one additional needle, in which HIV-1 RNA was assessed 168 h after blood collection. The method used to assess HIV-1 RNA was nucleic acid sequence-based amplification. RESULTS Up to 7 days after collection, HIV-1 RNA was detected in all of the needles. The viral RNA remained stable up to 168 h, and there were no statistically significant differences among the needle samples. CONCLUSIONS Although the infectivity of the viral material in the needles is unknown, the data indicate the need to re-evaluate the practices in cases of occupational accidents in which the source is not identified.
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Affiliation(s)
- Iris Ricardo Rossin
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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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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Sharps injuries among medical students in the Faculty of Medicine, Colombo, Sri Lanka. Int J Occup Med Environ Health 2012; 25:275-80. [PMID: 22729497 DOI: 10.2478/s13382-012-0036-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2011] [Accepted: 04/03/2012] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Medical students undertake clinical procedures which carry a risk of sharps injuries exposing them to bloodborne infections. OBJECTIVES To study the prevalence and correlates of sharps injuries among 4th-year medical students in the Faculty of Medicine, University of Colombo, Sri Lanka. MATERIALS AND METHODS The survey was conducted among 4th-year medical students to find out the incidence of injuries during high-risk procedures, associated factors and practice and perceptions regarding standard precautions. A self-administered questionnaire was administered to a batch of 197 4th-year medical students. RESULTS A total of 168 medical students responded. One or more injury was experienced by 95% (N = 159) of the students. The majority (89%) occurred during suturing; 23% during venipuncture and 14% while assisting in deliveries. Most of the incidents (49%) occurred during Obstetrics and Gynecology attachments. Recapping needles led to 8.6% of the injuries. Thirty-five percent of students believed they were inadequately protected. In this group, adequate protection was not available in 21% of the incidences and 24% thought protection was not needed. Following the injury, 47% completely ignored the event and only 5.7% followed the accepted post-exposure management. Only 34% of the students knew about post-exposure management at the time of the incident. Only 15% stated that their knowledge regarding prevention and management was adequate. The majority (97%) believed that curriculum should put more emphasis on improving the knowledge and practice regarding sharps injuries. CONCLUSIONS The incidence of sharps injuries was high in this setting. Safer methods of suturing should be taught and practiced. The practice of standard precautions and post-injury management should be taught.
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Hepatitis C prevalence in injecting drug users in Europe, 1990-2007: impact of study recruitment setting. Epidemiol Infect 2012; 141:563-72. [PMID: 22595549 DOI: 10.1017/s0950268812000921] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Monitoring injecting drug users' (IDUs) health is challenging because IDUs form a difficult to reach population. We examined the impact of recruitment setting on hepatitis C prevalence. Individual datasets from 12 studies were merged. Predictors of HCV positivity were sought through a multilevel analysis using a mixed-effects logistic model, with study identifier as random intercept. HCV prevalence ranged from 21% to 86% across the studies. Overall, HCV prevalence was higher in IDUs recruited in drug treatment centres compared to those recruited in low-threshold settings (74% and 42%, respectively, P < 0·001). Recruitment setting remained significantly associated with HCV prevalence after adjustment for duration of injecting and recent injection (adjusted odds ratio 0·7, 95% confidence interval 0·6-0·8, P = 0·05). Recruitment setting may have an impact on HCV prevalence estimates of IDUs in Europe. Assessing the impact of mixed recruitment strategies, including respondent-driven sampling, on HCV prevalence estimates, would be valuable.
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Doerrbecker J, Friesland M, Ciesek S, Erichsen TJ, Mateu-Gelabert P, Steinmann J, Steinmann J, Pietschmann T, Steinmann E. Inactivation and survival of hepatitis C virus on inanimate surfaces. J Infect Dis 2011; 204:1830-8. [PMID: 22013220 DOI: 10.1093/infdis/jir535] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) cross-contamination from inanimate surfaces or objects has been implicated in transmission of HCV in health-care settings and among injection drug users. We established HCV-based carrier and drug transmission assays that simulate practical conditions to study inactivation and survival of HCV on inanimate surfaces. METHODS Studies were performed with authentic cell culture derived viruses. HCV was dried on steel discs and biocides were tested for their virucidal efficacy against HCV. Infectivity was determined by a limiting dilution assay. HCV stability was analyzed in a carrier assay for several days or in a drug transmission assay using a spoon as cooker. RESULTS HCV can be dried and recovered efficiently in the carrier assay. The most effective alcohol to inactivate the virus was 1-propanol, and commercially available disinfectants reduced infectivity of HCV to undetectable levels. Viral infectivity on inanimate surfaces was detectable in the presence of serum for up to 5 days, and temperatures of about 65-70°C were required to eliminate infectivity in the drug transmission assay. CONCLUSIONS These findings are important for assessment of HCV transmission risks and should facilitate the definition of stringent public health interventions to prevent HCV infections.
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Affiliation(s)
- Juliane Doerrbecker
- Division of Experimental Virology, Twincore, Centre for Experimental and Clinical, Infection Research, a joint venture between the Medical School Hannover (MHH) and the Helmholtz Centre for Infection Research (HZI), Germany
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Removille N, Origer A, Couffignal S, Vaillant M, Schmit JC, Lair ML. A hepatitis A, B, C and HIV prevalence and risk factor study in ever injecting and non-injecting drug users in Luxembourg associated with HAV and HBV immunisations. BMC Public Health 2011; 11:351. [PMID: 21595969 PMCID: PMC3123592 DOI: 10.1186/1471-2458-11-351] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2010] [Accepted: 05/19/2011] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND In Luxembourg, viral hepatitis and HIV infection data in problem drug users (PDUs) are primarily based on self-reporting. Our study aimed to determine the prevalence of HAV, HBV, HCV and HIV infections in ever injecting (IDUs) and non-injecting drug users (nIDUs) including inherent risk factors analysis for IDUs. Secondary objectives were immunisation against HAV and HBV, referral to care and treatment facilities as well as reduction in risk behaviour. METHODS A nationwide, cross-sectional multi-site survey, involving 5 in-, 8 out-treatment and 2 prison centres, included both an assisted questionnaire (n = 368) and serological detection of HIV and Hepatitis A, B, C (n = 334). A response rate of 31% resulted in the participation of 310 IDUs and 58 nIDUs. Risk factors such as drug use, sexual behaviour, imprisonment, protection and health knowledge (HAV, HBV status and immunisations, HCV, HIV), piercing/tattoo and use of social and medical services were studied by means of chi2 and logistic models. RESULTS Seroprevalence results for IDUs were 81.3% (218/268, 95%CI=[76.6; 86.0]) for HCV, 29.1% (74/254, 95%CI=[25.5;34.7 ]) for HBV (acute/chronic infection or past cured infection), 2.5% (5/202, 95%CI=[0.3; 4.6]) for HIV-1 and 57.1% (108/189, 95%CI=[50.0; 64.1]) for HAV (cured infections or past vaccinations). Seroprevalence results for nIDUs were 19.1% (9/47, 95%CI=[7.9;30.3]) for HCV, 8.9% (4/45, 95%CI=[0.6;17.2]) for HBV (acute/chronic infection or past cured infection), 4.8% (2/42, 95%CI=[-1.7;11.3]) for HIV-1 and 65.9% (27/41, 95%CI=[51.4;80.4]) for HAV. Prisoners showed the highest rates for all infections. Age, imprisonment and setting of recruitment were statistically associated with HCV seropositivity. Age, speedball career and nationality were significantly associated with HBV seropositivity. Only 56% of the participants in outpatient centres collected their serology results and 43 doses of vaccine against HAV and/or HBV were administered. CONCLUSIONS Despite the existing national risk-reduction strategies implemented since 1993, high prevalence of HCV and HBV infections in injecting drug users is observed. Our study showed that implementing risk-prevention strategies, including immunisation remains difficult with PDUs. Improvement should be looked for by the provision of field healthcare structures providing tests with immediate results, advice, immunisation or treatment if appropriate.
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Affiliation(s)
- Nathalie Removille
- Centre d'Etudes en Santé (CES), Centre de Recherche Public de la Santé, Luxembourg
| | - Alain Origer
- European Monitoring Centre for Drugs and Drug Addictions (EMCDDA) Focal Point Luxembourg, Centre de Recherche Public de la Santé, Luxembourg
| | - Sophie Couffignal
- Centre d'Etudes en Santé (CES), Centre de Recherche Public de la Santé, Luxembourg
| | - Michel Vaillant
- Centre d'Etudes en Santé (CES), Centre de Recherche Public de la Santé, Luxembourg
| | - Jean-Claude Schmit
- Service National des Maladies Infectieuses, Centre Hospitalier de Luxembourg, Luxembourg
| | - Marie-Lise Lair
- Centre d'Etudes en Santé (CES), Centre de Recherche Public de la Santé, Luxembourg
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Grimberg BT. Methodology and application of flow cytometry for investigation of human malaria parasites. J Immunol Methods 2011; 367:1-16. [PMID: 21296083 DOI: 10.1016/j.jim.2011.01.015] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2010] [Revised: 12/29/2010] [Accepted: 01/27/2011] [Indexed: 02/03/2023]
Abstract
Historically, examinations of the inhibition of malaria parasite growth/invasion, whether using drugs or antibodies, have relied on the use of microscopy or radioactive hypoxanthine uptake. These are considered gold standards for measuring the effectiveness of antimalarial treatments, however, these methods have well known shortcomings. With the advent of flow cytometry coupled with the use of fluorescent DNA stains allowed for increased speed, reproducibility, and qualitative estimates of the effectiveness of antibodies and drugs to limit malaria parasite growth which addresses the challenges of traditional techniques. Because materials and machines available to research facilities are so varied, different methods have been developed to investigate malaria parasites by flow cytometry. This review is intended to serve as a reference guide for advanced users and importantly, as a primer for new users, to support expanded use and improvements to malaria flow cytometry, particularly in endemic countries.
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Affiliation(s)
- Brian T Grimberg
- Center for Global Health and Diseases, Case Western Reserve, University, Wolstein Research Building, 4-134 Cleveland, OH 44106-7286, United States.
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