Self-reported incidence of accidental exposures to patients' blood and body fluids by resident doctors in Nigeria

Abstract

An anonymous survey of 149 resident doctors was conducted to estimate the extent of accidental exposures to blood and body fluids of patients over a one-year period. There was a total of 1142 exposures. Ninety-three percent of respondents reported one or more exposure incident(s). Analysis of events and procedures leading to accidental exposures revealed that recapping needles was involved in 17%, suturing accounted for 14%, setting up intravenous lines 11%, cuts with scalpel 9% and phlebotomy 9%. Surgical residents had a threefold greater risk of exposure compared with medicine residents. No trend was found for accidental exposures by level of residency training. Seventy-four percent of the residents used universal precautions 50% or less of the time. Only half of the doctors could recall formal instruction on correct course of action after exposure and 5% of them had as undergraduates hepatitis B vaccine prior to the commencement of venepuncture duties. All but one of the residents' exposures were not reported to the Staff Medical Services Department. The doctor who reported was neither tested for hepatitis B virus or human immunodeficiency virus nor was he properly treated. Only 5 (4.6%) of the contaminating patients were evaluated serologically for their status of these viruses. These data emphasize the need for increased efforts toward improved early and continuing education, prevention and correct management of accidental exposures to blood or body fluids of patients by resident doctors in Nigeria. No recent study exists that exclusively addresses this problem in doctors in tropical Africa.

Survey of the knowledge, attitude and practice of Nigerian surgery trainees to HIV-infected persons and AIDS patients

“…The incidence of percutaneous exposure to patients' body fluids was similar to that reported from one of the training centers encompassed by this study two years earlier by Olubuyide and Olawuyi [12]. Non-availability of relevant devices remains the most important factor militating against the use of universal precautions.…”

“…Non-availability of relevant devices remains the most important factor militating against the use of universal precautions. The percentage of our respondents reporting this was higher than that reported by others [12] probably because of the increased requirements of surgical compared to ward practice. Years of neglect and lack of new investment in the health sector coupled with poor policies have resulted in poorly staffed medical centers with inadequate, old and poorly functioning medical equipment [13].…”

“…Since we do not have any information about non-responders, the direction and influence of this bias cannot be predicted; this represents a limitation of the study. Since previous studies of the KAP to HIV in our environment have been limited to a one institution or a few urban centers, we are unable to compare those response rates to our study[6-8,11,12,15,18]. Given the methodology, the study is also liable to recall bias, information bias, and reverse causation.…”

Prevalence of Hepatitis B and C Virus in Health Care Personnel in Ibn Sina Hospital, Rabat, Morocco

“…The epidemiological profile of BEA reported in our study is similar to that already described in other studies where needlestick injuries accounted for the majority of BEA: 75% by GERES [29], 88% for the committee against the nosocomial infections of Hôpital Ibn-Roshd of Casablanca [13], 80% in Paris-Nord [30], 73% in Ivory Coast [31], 86.2% in Japan [32] and 60% in France [29]. The rate (94.12%) suffered high BEA personnel infected in our series has corroborated the data from the literature: 93% in Nigeria [28], 82% in the (Nord-Pasde-Calais) France [25] and 78% in Chile [33].…”

“…Nurses were the most affected by those viral infections, especially by HCV with a seroprevalence of HCV-Ab of 4.44%. The significant prevalence of nursing staff found in our study corroborates the majority of the literature [8] [28]. The population concerned is the one with an important volume of work and high risk care actions: phlebotomy, arterial, muscle and intravenous injections, sutures, wound dressings and especially recapping needles which is the action during which occurs the majority of BEA.…”