Talaat Maha, Kandeel Amr, El-Shoubary Walid, Bodenschatz Caroline, Khairy Iman, Oun Said, Mahoney Frank J
US Naval Medical Research Unit, No. 3, Cairo, Egypt.
Am J Infect Control. 2003 Dec;31(8):469-74. doi: 10.1016/j.ajic.2003.03.003.
The health care worker (HCW) is at substantial risk of acquiring bloodborne pathogen infections through exposure to blood or infectious body fluids. Hepatitis B vaccination of HCWs and optimal HCW practices regarding management of sharps can minimize these risks. This study explores the frequency of exposure to needlestick injuries and the hepatitis B vaccination coverage among HCWs in Egypt.
All HCWs available in a 25% random sample of different types of health care facilities from 2 governorates in Egypt (Nile Delta and Upper Egypt) were included in the study. A total of 1485 HCWs were interviewed. History of exposure to needlestick injuries, vaccination status, and socioeconomic data were collected.
Of the 1485 HCWs interviewed, 529 (35.6%) were exposed to at least 1 needlestick injury during the past 3 months with an estimated annual number of 4.9 needlesticks per worker. The most common behavior associated with needlestick injuries was 2-handed recapping. Overall, 64% of HCWs disposed of needles unsafely in nonpuncture-proof containers. Overall 15.8% of HCWs reported receiving 3 doses of hepatitis B vaccine. Vaccination coverage was highest among professional staff (38%) and lowest among housekeeping staff (3.5%). Using Kane's model to predict infections after needlestick exposures, we estimate 24,004 hepatitis C virus and 8617 hepatitis B virus infections occur each year in Egypt as a result of occupational exposure in the health care environment.
High rates of needlestick injuries and low vaccination coverage contribute highly to the rates of viral hepatitis infections among HCWs. Prevention of occupational infection with bloodborne pathogens should be a priority to the national program for promotion of infection control. Training of HCWs on safe handling and collection of needles and sharps, and hepatitis B vaccination of all HCWs is required to reduce transmission.
医护人员面临通过接触血液或感染性体液而感染血源性病原体的重大风险。医护人员接种乙肝疫苗以及对锐器管理采取最佳做法可将这些风险降至最低。本研究探讨了埃及医护人员针刺伤暴露频率及乙肝疫苗接种覆盖率。
本研究纳入了埃及两个省（尼罗河三角洲和上埃及）不同类型医疗保健机构25%随机样本中的所有医护人员。共对1485名医护人员进行了访谈。收集了针刺伤暴露史、疫苗接种状况和社会经济数据。
在接受访谈的1485名医护人员中，529人（35.6%）在过去3个月中至少遭受过1次针刺伤，估计每名医护人员每年针刺伤次数为4.9次。与针刺伤相关的最常见行为是双手重新盖帽。总体而言，64%的医护人员将针头不安全地丢弃在无防刺容器中。总体而言，15.8%的医护人员报告接种了3剂乙肝疫苗。专业人员的疫苗接种覆盖率最高（38%），家政人员最低（3.5%）。使用凯恩模型预测针刺伤暴露后的感染情况，我们估计埃及每年因医疗保健环境中的职业暴露分别发生24004例丙型肝炎病毒感染和8617例乙型肝炎病毒感染。
针刺伤发生率高和疫苗接种覆盖率低是医护人员病毒性肝炎感染率高的重要原因。预防血源性病原体职业感染应成为国家感染控制促进计划的优先事项。需要对医护人员进行安全处理和收集针头及锐器的培训，并为所有医护人员接种乙肝疫苗以减少传播。
