Post exposure prophylaxis following occupational exposure to HIV: a survey of health care workers in Mbeya, Tanzania, 2009-2010

Abstract

IntroductionApproximately, 1,000 HIV infections are transmitted annually to health care workers (HCWs) worldwide from occupational exposures. Tanzania HCWs experience one to nine needle stick injuries (NSIs) per year, yet the use of post-exposure prophylaxis (PEP) is largely undocumented. We assessed factors influencing use of PEP among HCWs following occupational exposure to HIV.MethodsA cross-sectional study was conducted in Mbeya Referral Hospital, Mbozi and Mbarali District Hospitals from December 2009 to January 2010 with a sample size of 360 HCWs. Participants were randomly selected from a list of eligible HCWs in Mbeya hospital and all eligible HCWs were enrolled in the two District Hospitals. Information regarding risk of exposure to body fluids and NSIs were collected using a questionnaire. Logistic regression was done to identify predictors for PEP use using Epi Info 3.5.1 at 95% confidence interval.ResultsOf 291 HCWs who participated in the study, 35.1% (102/291) were exposed to NSIs and body fluids, with NSIs accounting for 62.9% (64/102). Exposure was highest among medical attendants 38.8% (33/85). Out of exposed HCWs, (22.5% (23/102) used HIV PEP with females more likely to use PEP than males. Reporting of exposures (OR=21.1, CI: 3.85-115.62) and having PEP knowledge (OR =6.5, CI: 1.78-23.99) were significantly associated with using PEP.ConclusionDespite the observed rate of occupational exposure to HCWs in Tanzania, use of PEP is still low. Effective prevention from HIV infection at work places is required through proper training of HCWs on PEP with emphasis on timely reporting of exposures.

Magnitude of splash exposure and associated factors among health care workers in Hawassa referral and Adare District hospitals, January 2014

“…About 18% of exposed HCWs started Post exposure prophylaxis (PEP). This result was almost similar to study conducted in Iran [35] and Tanzania [9], but about four times less than study conducted in Gondar, north west of Ethiopia [24].…”

“…HCWs are at increased risk of this exposure and acquiring infections including hepatitis virus and HIV because of direct chance of exposure they have to patients blood and other body fluids [5][6][7][8][9][10]. Blood borne pathogens can be transmitted through contact with eyes, nose and mouth or through broken skin [1,3].…”

“…Other studies have also shown that occupational exposure to blood through mouth, nose or eyes is a serious health issue among HCWs in developing countries [9,19]. This exposure is obviously more dangerous in those developing countries because, work related blood borne pathogens are more prevalent in low income countries of the world, specifically endemic in sub Saharan African countries [20].…”

Healthcare professionals' level of medication knowledge in Africa: a systematic review

“…Forty‐seven questions in nine papers were on antiretroviral medications for HIV/AIDS . In these papers, it is reported that HCPs lacked knowledge on use of microbicides to prevent HIV and other sexually transmitted diseases, that they were unable to identify medications used for post‐exposure prophylaxis (PEP), and did not know the time point to initiate PEP, duration of treatment and effectiveness of PEP.…”

“…Forty-seven questions in nine papers were on antiretroviral medications for HIV/AIDS [30][31][32][33][34][35][36][37][38]. In these papers, it is reported that HCPs lacked knowledge on use of microbicides Tool (questionnaires) validation: a Self-made with expanded/formal validation process, b Self-made with pretest only, c Cited previous developed tool and used as such, or d Cited previously developed tool with modification, and e Self-made without clear explanation for validation…”