Occupational exposure to blood and body fluids among primary healthcare workers in Johannesburg health district: High rate of underreporting

Abstract

Background: Healthcare workers (HCWs) are at risk of bloodborne infections from sharp instrument injuries and skin and mucous membrane exposures to contaminated blood and body fluids (BBF). While these have clinical and occupational health implications, little is known about BBF exposure and its reporting pattern in South African primary healthcare (PHC). The aim of this study was to determine the rate of BBF exposure, the extent of reporting and the reasons for not reporting among HCWs in PHC facilities in Johannesburg, South Africa.Methods: In a cross-sectional study involving 444 participants, an 18-item, self-administered questionnaire was used to collect information on socio-demographic characteristics, HCWs’ exposures to BBF in the last year, whether the exposure was reported and the reasons for not reporting. Analysis included descriptive statistics and chi-square test.Results: Most participants were nurses (87.4%) and female (88.1%). About a quarter of participants (112) reported having at least one BBF exposure in the last year. Overall, there were 355 exposures, resulting in 0.8 BBF exposure per HCW per year. Of these exposures, 291 (82.0%) were not reported. Common reasons for not reporting include lack of time (42.72%), perception that the source patient was at low risk for human immunodeficiency virus (24.7%) and concerns about confidentiality (22.5%). Blood and body fluids exposures involving nurses (p 0.001), sharp instrument (p 0.001) and HCWs aged 50 years (p = 0.02) were significantly more likely to be reported.Conclusion: This study found a high rate of underreporting of BBF exposures among HCWs in PHC facilities in Johannesburg, suggesting an urgent need for interventions to improve reporting.

The Prevalence, Predictors, and Knowledge, Attitudes, and Practices Concerning Percutaneous Exposure Incidents among Healthcare Workers and Students in Africa: A Narrative Review.

“…few that employed an analytical [43] and quasi-experimental study design [24]. The study regions included Botswana [24], Cameroon [25][26], Egypt [27], Ethiopia [10,[28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45], Ghana [46], Kenya [47], Morocco [48], Nigeria [49][50][51][52][53][54][55][56][57][58][59], South Africa [1,[60][61][62][63][64][65][66][67][68], Sudan [69], Tanzania…”

“…South Africa reported a prevalence ranging from 13.0% to 82.0% [62][63][64][65][66][67][68], Sudan at 67.3%, and Tanzania between 27.1% and 59.2% [70][71][72][73][74]. Uganda [75][76] experienced rates fluctuating from 28.0% to 48.0% [Figure 1].…”

Global Occupational Exposure to Blood and Body Fluids among Healthcare Workers: Systematic Review and Meta-Analysis

“…e highest prevalence of exposure to BBFs in the last year and career time was reported in China and Ethiopia, respectively. Among the included studies, 4 articles were conducted in Ethiopia [2,[17][18][19], 3 were conducted in South Africa [20][21][22], 3 were conducted in Serbia [23][24][25], 3 were conducted in Iran [26][27][28], 3 were conducted in China [29][30][31], 2 were conducted in Tanzania [32,33], 2 were conducted in India [34,35], 2 were conducted in United Arab Emirate [36,37], 2 were conducted in Nigeria [38,39],and 1 was conducted in each of ailand [40], Kenya [41], Turkey [42], Lebanon [43], Bosnia and Herzegovina [44], Togo [45], Georgia [46], Croatia [47], and USA [48]. About three-quarters were conducted in hospitals (Table 1).…”

Microbiological Assessment of Health-Care Providers in Africa: Systematic Review and Meta-Analysis

“…The included articles in this meta-analysis and the assessment of their quality are illustrated in S1 Publication bias assessment indicated no major asymmetry. (29) and Tanzania (30)(31) (32), two in each of Kenya (33) (34), Sierra Leone (35) (36) and Ghana (37) (38); one in each of Egypt (39), Nigeria (40), Mozambique (41), Sudan (42) and Madagascar (43). The conduction of the studies ranged from 2009 to 2018.…”

“…Seven studies have assessed the occupational exposure to needle stick injuries, while four have studied the exposure to sharp injuries in general. These studies were conducted in Ethiopia (18)(20)(21) (19) (22), Sierra Leone (36), Tanzania (32) (31), Egypt (39) and South Africa (29). History of exposure to needle stick injuries was investigated for 1,830 participants; 26.81% [95% Cl; 14.58, 39.05] were identified exposed, while the history of exposure to sharp injuries was assessed for 1,307 participants; 27.83% [14.29, 41.37] were found exposed.…”