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Oche OM, Umar AS, Gana GJ, Okafoagu NC, Oladigbolu RA. Determinants of appropriate knowledge on human immunodeficiency virus postexposure prophylaxis among professional health-care workers in Sokoto, Nigeria. J Family Med Prim Care 2018; 7:340-345. [PMID: 30090775 PMCID: PMC6060946 DOI: 10.4103/jfmpc.jfmpc_32_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introduction: The prevention of human immunodeficiency virus (HIV/AIDS) among health-care workers (HCWs) has remained a major topical issue worldwide. Accidental transmission of HIV infection to HCWs during occupational exposure is a real threat today. The study aimed to assess the knowledge, attitude, and practice of postexposure prophylaxis (PEP) among HCWs in a tertiary health institution in Sokoto, Northwestern Nigeria. Methodology: The study was carried out at Usmanu Danfodiyo University Teaching Hospital, Sokoto, through a cross-sectional descriptive study design; a total of 156 participants were recruited using a stratified sampling technique. Data were collected using a semi-structured, self-administered questionnaire and analyzed using SPSS computer software after obtaining ethical clearance from the Health Ethics and Research Committee of the teaching hospital. Results: A total of 87.2% (136) of the respondents had heard of PEP and 71.8% (112) thought that HIV/AIDs could be prevented through PEP. A total of 71.2% (111) had good knowledge about PEP, whereas 86.8% (118) had a positive attitude toward PEP. Conclusion: Although the study demonstrated high knowledge and positive attitude toward PEP, the observance of safety measures against needlestick injuries that could result in HIV infections was abysmally low. There is the need to create more awareness and strengthen the use of PEP protocol by all cadres of health workers as this will go a long way in minimizing blood-borne infections.
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Affiliation(s)
- Oche Mansur Oche
- Department of Community Health, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria.,Department of Community Health, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Abubakar Sadiq Umar
- Department of Community Health, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Godwin Jiya Gana
- Department of Community Health, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | | | - Remi Abiola Oladigbolu
- Department of Community Health, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
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Wyżgowski P, Rosiek A, Grzela T, Leksowski K. Occupational HIV risk for health care workers: risk factor and the risk of infection in the course of professional activities. Ther Clin Risk Manag 2016; 12:989-94. [PMID: 27366077 PMCID: PMC4913970 DOI: 10.2147/tcrm.s104942] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Virtually created panic among health care workers about pandemic acquired immune deficiency syndrome prompted us to review the scientific literature to investigate the risk of human immunodeficiency virus (HIV) transmission in the daily works of health care workers, especially surgeons and anesthesiologists. In this review, we report worldwide valuations of the number of HIV infections that may occur from unsafe daily work in health care. We also present how to minimize the risk of infection by taking precautions and how to utilize postexposure prophylaxis in accordance with the latest reports of the Centers for Disease Control and Prevention. HIV-infected patients will be aging, and most of them will become the candidates for procedures such as major vascular reconstruction and artery bypass grafting, where the risks of blood contact and staff injury are high. For these reasons, all health care workers need to know how to prevent, and fight following the accidental exposure to HIV.
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Affiliation(s)
- Przemysław Wyżgowski
- Department of General Surgery, Military Hospital, Nicolas Copernicus University in Toruń, Bydgoszcz, Poland
| | - Anna Rosiek
- Public Health Department, Faculty of Health Sciences, Nicolas Copernicus University in Toruń, Bydgoszcz, Poland
| | - Tomasz Grzela
- Department of General Surgery, Military Hospital, Nicolas Copernicus University in Toruń, Bydgoszcz, Poland
| | - Krzysztof Leksowski
- Department of General Surgery, Military Hospital, Nicolas Copernicus University in Toruń, Bydgoszcz, Poland
- Public Health Department, Faculty of Health Sciences, Nicolas Copernicus University in Toruń, Bydgoszcz, Poland
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Ajibola S, Akinbami A, Elikwu C, Odesanya M, Uche E. Knowledge, attitude and practices of HIV post exposure prophylaxis amongst health workers in Lagos University Teaching Hospital. Pan Afr Med J 2014; 19:172. [PMID: 25815093 PMCID: PMC4366120 DOI: 10.11604/pamj.2014.19.172.4718] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 10/13/2014] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Timely PEP after needle stick exposure to high risk body fluids can reduce the rate of occupational transmission significantly. Ignorance of this may increase the risk of seroconversion to HIV for healthcare workers. This study was conducted with the aim of demonstrating the current level of knowledge and practise of healthcare workers as regards PEP. METHODS This was a cross-sectional study, pretested questionnaire were self administered to 372 health workers from various clinical specialties. The responses were collated and analyzed; results were presented in frequency tables. RESULTS This study revealed a high level of awareness among the respondents as 83.3% were aware of PEP. Despite the high level of awareness, respondents still have an inadequate knowledge about PEP, only 32% of the respondents could name at least two of the recommended drugs for PEP, only 54.0% of respondents knew when to commence PEP following occupational exposure to HIV. There was a low level of practice of PEP among the respondents as only 6.3% of respondents had PEP despite occurrence of needle stick injury. CONCLUSION This study revealed a general low level use of PEP despite the average knowledge of PEP and the favourable attitude towards HIV PEP amongst the respondents.
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Affiliation(s)
- Sarah Ajibola
- Department of Haematology Ben Carson School of Medicine, Babcock University Teaching Hospital, Ilisan-Remo, Ogun State, Nigeria
| | - Akinsegun Akinbami
- Department of Haematology, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Charles Elikwu
- Department of Medical Microbiology Ben Carson School of Medicine, Babcock University Teaching Hospital, Ilisan-Remo, Ogun State, Nigerian
| | | | - Ebele Uche
- Department of Haematology, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
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De Villiers HC, Nel M, Prinsloo EAM. Occupational exposure to bloodborne viruses amongst medical practitioners in Bloemfontein, South Africa. S Afr Fam Pract (2004) 2014. [DOI: 10.1080/20786204.2007.10873522] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Kuhar DT, Henderson DK, Struble KA, Heneine W, Thomas V, Cheever LW, Gomaa A, Panlilio AL. Updated US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis. Infect Control Hosp Epidemiol 2014; 34:875-92. [PMID: 23917901 DOI: 10.1086/672271] [Citation(s) in RCA: 197] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
This report updates US Public Health Service recommendations for the management of healthcare personnel (HCP) who experience occupational exposure to blood and/or other body fluids that might contain human immunodeficiency virus (HIV). Although the principles of exposure management remain unchanged, recommended HIV postexposure prophylaxis (PEP) regimens and the duration of HIV follow-up testing for exposed personnel have been updated. This report emphasizes the importance of primary prevention strategies, the prompt reporting and management of occupational exposures, adherence to recommended HIV PEP regimens when indicated for an exposure, expert consultation in management of exposures, follow-up of exposed HCP to improve adherence to PEP, and careful monitoring for adverse events related to treatment, as well as for virologic, immunologic, and serologic signs of infection. To ensure timely postexposure management and administration of HIV PEP, clinicians should consider occupational exposures as urgent medical concerns, and institutions should take steps to ensure that staff are aware of both the importance of and the institutional mechanisms available for reporting and seeking care for such exposures. The following is a summary of recommendations: (1) PEP is recommended when occupational exposures to HIV occur; (2) the HIV status of the exposure source patient should be determined, if possible, to guide need for HIV PEP; (3) PEP medication regimens should be started as soon as possible after occupational exposure to HIV, and they should be continued for a 4-week duration; (4) new recommendation-PEP medication regimens should contain 3 (or more) antiretroviral drugs (listed in Appendix A ) for all occupational exposures to HIV; (5) expert consultation is recommended for any occupational exposures to HIV and at a minimum for situations described in Box 1 ; (6) close follow-up for exposed personnel ( Box 2 ) should be provided that includes counseling, baseline and follow-up HIV testing, and monitoring for drug toxicity; follow-up appointments should begin within 72 hours of an HIV exposure; and (7) new recommendation-if a newer fourth-generation combination HIV p24 antigen-HIV antibody test is utilized for follow-up HIV testing of exposed HCP, HIV testing may be concluded 4 months after exposure ( Box 2 ); if a newer testing platform is not available, follow-up HIV testing is typically concluded 6 months after an HIV exposure.
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Affiliation(s)
- David T Kuhar
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Mbaisi EM, Ng'ang'a Z, Wanzala P, Omolo J. Prevalence and factors associated with percutaneous injuries and splash exposures among health-care workers in a provincial hospital, Kenya, 2010. Pan Afr Med J 2013; 14:10. [PMID: 23504245 PMCID: PMC3597860 DOI: 10.11604/pamj.2013.14.10.1373] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 11/19/2012] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Accidental occupational exposure of healthcare workers to blood and body fluids after skin injury or mucous membrane contact constitutes a risk for transmission of blood-borne pathogens. Such pathogens include Human Immunodeficiency Virus (HIV), Hepatitis B virus (HBV) and Hepatitis C virus (HCV). We conducted a study to determine the prevalence and associated factors for percutaneous injuries and splash exposures among health-care workers in Rift Valley provincial hospital. METHODS A cross-sectional study was carried out from October to November 2010. Self reported incidents, circumstances surrounding occupational exposure and post-exposure management were sought by use of interviewer administered questionnaire. Descriptive, bivariate and multiple logistic regression (forward stepwise procedure) analyses were performed. The level of significance was set at 0.05. RESULTS Twenty five percent of health-care workers interviewed (N=305) reported having been exposed to blood and body fluids in the preceding 12 months. Percutaneous injuries were reported by 19% (n=305) and splash to mucous membrane by 7.2%. Higher rates of percutaneous injuries were observed among nurses (50%), during stitching (30%), and in obstetric and gynecologic department (22%). Health workers aged below 40 years were more likely to experience percutaneous injuries (OR=3.7; 95% CI=1.08-9.13) while previous training in infection prevention was protective (OR=0.52; 95% CI=0.03-0.90). Forty eight percent (n=83) reported the incidents with 20% (n=83) taking PEP against HIV. CONCLUSION Percutaneous injuries and splashes are common in Rift Valley Provincial hospital. Preventive measures remain inadequate. Health institutions should have policies, institute surveillance for occupational risks and enhance training of health care workers.
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Affiliation(s)
- Everline Muhonja Mbaisi
- Jomo Kenyatta University of Agriculture and Technology, Field Epidemiology and Laboratory Training Programme and Ministry of Public Health and Sanitation, Nairobi, KNH grounds, Kenya
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Incidence of visits for health care worker blood or body fluid exposures and HIV postexposure prophylaxis provision at Rhode Island emergency departments. J Acquir Immune Defic Syndr 2008; 47:358-68. [PMID: 18176321 DOI: 10.1097/qai.0b013e318160d599] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare the incidence and types of emergency department (ED) visits for blood or body fluid exposures sustained by health care workers (HCWs) in Rhode Island and to identify factors predictive of HIV postexposure prophylaxis (PEP) utilization for these exposures. METHODS A retrospective study of ED visits for blood or body fluid exposures to all Rhode Island EDs from January 1995 to June 2001 was conducted. Average incidence rates (IRs) of visits by HCW occupation and type of exposure were estimated and compared. Logistic regression models were created to determine which HCWs were more likely to be offered and to accept HIV PEP. RESULTS Of 1551 HCW ED visits for occupational exposures, 72.5% sustained a percutaneous injury and only 2.5% were exposed to a source known to be HIV-infected. Hospital custodians had the highest IR of ED visits for percutaneous injuries (81 ED visits per year per 10,000 workers). Visits for all exposures increased over the study years and were most common during March, on weekends, and at 5:00 PM. Of all HCWs, 91.2% presented within 24 hours of their exposure and 98.2% presented within 72 hours. HIV PEP was offered to 469 HCWs and accepted 229 times. HCWs more likely to be offered HIV PEP were exposed to a known HIV-infected source (odds ratio [OR] = 6.38), sustained a significant exposure (OR = 4.98), presented to an academic hospital ED (OR = 2.60), were a member of the medical staff (OR = 2.02), and were exposed during the latter years of the study (OR = 1.23). HCWs were more likely to accept HIV PEP when it was offered if they were male (OR = 1.64) and presented to an academic hospital ED (OR = 2.72). CONCLUSIONS The IRs of ED visits for exposures varied by occupation, and there were clear temporal trends for these visits. Despite the existence of federal guidelines for HIV PEP for occupational blood or body fluid exposures, factors other than characteristics of the exposure, such as type of hospital, occupation, and gender, may be influencing HIV PEP utilization.
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Abstract
Since the onset of the HIV epidemic, AIDS and HIV infection have presented tremendous challenges to infected individuals seeking to remain productive in the workplace, to employers coping with the special needs of such individuals, and to physicians who treat and counsel exposed or infected personnel. OEM physicians should strive to ensure that employers are familiar with legislation and guidelines protecting the rights of infected employees, and they should support rational workplace policies applying to employees with HIV infection or AIDS. When the potential for occupational HIV exposure exists, OEM physicians should ensure that adequate training around exposure prevention, triage, and treatment is provided. OEM physicians who treat individuals with occupational HIV exposures should involve themselves in institutional efforts to prevent exposures through the use of safer devices and procedures, and they should ensure that immediate and adequate clinical evaluation of exposures is available at all times.
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Abstract
A 12-month experience with human immunodeficiency virus (HIV) postexposure prophylaxis (PEP) in a tertiary care center was evaluated for timeliness of treatment and adherence to treatment recommendations. Forty-six health care workers were started on HIV PEP. Risk status of the source patient, rather than type of exposure, was a significant determinant for both initiating and completing treatment. Of those exposed to HIV-positive sources, 79% completed the full 28 days of therapy. Only 22% of all health care workers who started PEP discontinued treatment because of adverse effects. Excluding three cases with significant delays in reporting and one in which treatment was controversial, the mean time from exposure to first dose of PEP was 1 hour and 46 minutes. The use of a defined treatment protocol, with supporting educational material and PEP medication immediately available, is an effective way of managing HIV exposures.
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Affiliation(s)
- James Robert Garb
- Occupational Health & Safety Department, Baystate Health System, P5901, 759 Chestnut Street, Springfield, MA 01199, USA
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