International Healthcare Worker Safety Center, University of Virginia Health System, P.O. Box 800764, Department of Medicine, Division of Infectious Diseases, Charlottesville, VA 22901, USA.
J Infect Public Health. 2012 Jun;5(3):244-9. doi: 10.1016/j.jiph.2012.02.005. Epub 2012 Apr 12.
Understanding the risks of bloodborne pathogen transmission is fundamental to prioritizing interventions when resources are limited. This study investigated the risks to healthcare workers in Zambia.
A survey was completed anonymously by a convenience sample of workers in three hospitals and two clinics in Zambia. Respondents provided information regarding job category, injuries with contaminated sharps, hepatitis B vaccination status and the availability of HIV post-exposure prophylaxis (PEP).
Nurses reported the largest number of injuries. The average annual sharps injury rate was 1.3 injuries per worker, and service workers (housekeepers, laundry, ward assistants) had the highest rate of these injuries, 1.9 per year. Injuries were often related to inadequate disposal methods. Syringe needles accounted for the largest proportion of injuries (60%), and 15% of these injuries were related to procedures with a higher-than-average risk for infection. Most workers (88%) reported the availability of PEP, and only 8% were fully vaccinated against hepatitis B.
The injury risks identified among Zambian workers are serious and are exacerbated by the high prevalence of bloodborne pathogens in the population. This suggests that there is a high risk of occupationally acquired bloodborne pathogen infection. The findings also highlight the need for a hepatitis B vaccination program focused on healthcare workers. The risks associated with bloodborne pathogens threaten to further diminish an already scarce resource in Zambia - trained healthcare workers. To decrease these risks, we suggest the use of low-cost disposal alternatives, the implementation of cost-sensitive protective strategies and the re-allocation of some treatment resources to primary prevention.
在资源有限的情况下，了解血源性病原体传播的风险对于确定干预措施的优先级至关重要。本研究旨在调查赞比亚医护人员所面临的风险。
本研究采用便利抽样法，对赞比亚的三家医院和两家诊所的工作人员进行了匿名调查。受访者提供了有关职业类别、被污染锐器刺伤的情况、乙型肝炎疫苗接种状况以及是否可获得艾滋病毒暴露后预防（PEP）的信息。
护士报告的受伤人数最多。医护人员每年锐器伤的平均发生率为 1.3 例/人，服务人员（清洁工、洗衣工、病房助理）的锐器伤发生率最高，为 1.9 例/年。受伤通常与不当的处理方法有关。注射器针头造成的伤害比例最大（60%），其中 15%的伤害与感染风险较高的操作有关。大多数工作人员（88%）报告说可以获得 PEP，只有 8%的人完全接种了乙型肝炎疫苗。
在赞比亚工人中发现的受伤风险是严重的，并且由于该人群中血源性病原体的高流行率而进一步加剧。这表明存在职业性血源性病原体感染的高风险。这些发现还强调了需要针对医护人员开展乙型肝炎疫苗接种计划。血源性病原体相关风险有可能进一步削弱赞比亚本已稀缺的资源——经过培训的医护人员。为了降低这些风险，我们建议使用低成本的处理替代方法，实施具有成本效益的保护策略，并将部分治疗资源重新分配到初级预防上。
