坦桑尼亚坦比和多多马医院医护人员的 HIV 感染风险估计和职业暴露预防实践研究。
Estimated risk of HIV acquisition and practice for preventing occupational exposure: a study of healthcare workers at Tumbi and Dodoma Hospitals, Tanzania.
机构信息
National Institute for Medical Research, P,O, Box 9653, Dar es Salaam, Tanzania.
出版信息
BMC Health Serv Res. 2013 Sep 30;13:369. doi: 10.1186/1472-6963-13-369.
BACKGROUND
Healthcare workers (HCWs) are at risk of acquiring human immuno-deficiency virus (HIV) and other infections via exposure to infectious patients' blood and body fluids. The main objective of this study was to estimate the risk of HIV transmission and examine the practices for preventing occupational exposures among HCWs at Tumbi and Dodoma Hospitals in Tanzania.
METHODS
This study was carried out in two hospitals, namely, Tumbi in Coast Region and Dodoma in Dodoma Region. In each facility, hospital records of occupational exposure to HIV infection and its management were reviewed. In addition, practices to prevent occupational exposure to HIV infection among HCWs were observed.
RESULTS
The estimated risk of HIV transmission due to needle stick injuries was calculated to be 7 cases per 1,000,000 HCWs-years. Over half of the observed hospital departments did not have guidelines for prevention and management of occupational exposure to HIV infections and lacked well displayed health and safety instructions. Approximately, one-fifth of the hospital departments visited failed to adhere to the instructions pertaining to correlation between waste materials and the corresponding colour coded bag/container/safety box. Seventy four percent of the hospital departments observed did not display instructions for handling infectious materials. Inappropriate use of gloves, lack of health and safety instructions, and lack of use of eye protective glasses were more frequently observed at Dodoma Hospital than at Tumbi Hospital.
CONCLUSIONS
The poor quality of the hospital records at the two hospitals hampered our effort to characterise the risk of HIV infection acquisition by HCWs. Greater data completeness in hospital records is needed to allow the determination of the actual risk of HIV transmission for HCWs. To further reduce the risk of HIV infection due to occupational exposure, hospitals should be equipped with sufficient personal protective equipment (PPE) and HCWs should be reminded of the importance of adhering to universal precautions.
背景
医护人员（HCWs）在接触感染患者的血液和体液时，有感染人类免疫缺陷病毒（HIV）和其他感染的风险。本研究的主要目的是评估 HIV 传播的风险，并检查坦桑尼亚 Tumbo 和多多马医院 HCWs 预防职业暴露的实践。
方法
本研究在两家医院进行，即滨海地区的 Tumbo 和多多马地区的多多马。在每个设施中，审查了医院记录的 HIV 感染职业暴露及其管理。此外，还观察了 HCWs 预防职业暴露于 HIV 感染的实践。
结果
估计因针刺伤导致 HIV 传播的风险为每 100 万 HCWs 年 7 例。观察到的一半以上医院科室没有预防和管理 HIV 感染职业暴露的指南，并且缺乏良好展示的健康和安全说明。大约五分之一的医院科室未能遵守关于废物材料与相应颜色编码的袋子/容器/安全盒之间相关性的说明。所观察到的 74%的医院科室没有展示处理传染性材料的说明。在多多马医院，手套使用不当、缺乏健康和安全说明以及缺乏使用护目镜的情况比 Tumbo 医院更为频繁。
结论
两家医院的医院记录质量较差，阻碍了我们对 HCWs 感染 HIV 风险特征的评估。需要有更完整的医院记录，以确定 HCWs 实际感染 HIV 的风险。为了进一步降低因职业暴露而感染 HIV 的风险，医院应配备足够的个人防护设备（PPE），并提醒 HCWs 遵守普遍预防措施的重要性。
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