Lahuerta Maria, Selenic Dejana, Kassa Getachew, Mwakitosha Goodluck, Hokororo Joseph, Ngonyani Henock, Basavaraju Sridhar V, Courtenay-Quirk Cari, Liu Yang, Kazaura Koku, Simbeye Daimon, Bock Naomi
ICAP at Columbia University, Mailman School of Public Health, NY, USA.
Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, USA.
J Infect Prev. 2016 Jul;17(4):153-160. doi: 10.1177/1757177416645343. Epub 2016 May 13.
In sub-Saharan Africa, blood-borne pathogens exposure (BPE) is a serious risk to healthcare workers (HCW).
We conducted a cross-sectional study assessing BPE among HCW at three public hospitals in Tanzania. From August to November 2012, HCW were surveyed using Audio-Computer Assisted Self-Interview. All HCW at risk for BPE were invited to participate. Factors associated with reporting BPE were identified using logistic regression.
Of the 1102 eligible HCW, 973 (88%) completed the survey. Of these, 690 (71%) were women and 499 (52%) were nurses and nurse assistants. Of the 357 HCW who had a BPE (32%) in the previous 6 months, 120 (34%) reported it. Among these 120 reported exposures, 93 (78%) HCWs reported within 2 h of exposure, 98 (82%) received pre- and post-HIV test counselling, and 70 (58%) were offered post-exposure prophylaxis (PEP). Independent factors associated with reporting BPE were being female (adjusted odds ratio [AOR], 2.0; 95% confidence interval [CI], 1.2-3.5), having ever-received BPE training (AOR, 2.0; 95% CI, 1.2-3.5), knowledge that HCW receive PEP at another facility (AOR, 2.6; 95% CI, 1.5-4.4), low/no perceived risk related to BPE (AOR, 4.2; 95% CI, 1.9-9.4) and HIV testing within the past year (AOR, 2.3; 95% CI, 1.2-4.4).
These results highlight the importance of appropriate training on the prevention and reporting of occupational exposure to increase acceptance of HIV testing and improve access to PEP after BPE.
在撒哈拉以南非洲地区，医护人员面临血源性病原体暴露（BPE）的严重风险。
我们开展了一项横断面研究，评估坦桑尼亚三家公立医院医护人员的BPE情况。2012年8月至11月，采用音频计算机辅助自我访谈对医护人员进行调查。所有有BPE风险的医护人员均受邀参与。使用逻辑回归确定与报告BPE相关的因素。
在1102名符合条件的医护人员中，973人（88%）完成了调查。其中，690人（71%）为女性，499人（52%）为护士和护士助理。在过去6个月中有357名医护人员发生BPE（32%），其中120人（34%）报告了此事。在这120例报告的暴露事件中，93名（78%）医护人员在暴露后2小时内报告，98名（82%）接受了HIV检测前后的咨询，70名（58%）接受了暴露后预防（PEP）。与报告BPE相关的独立因素包括女性（调整优势比[AOR]，2.0；95%置信区间[CI]，1.2 - 3.5）、曾接受BPE培训（AOR，2.0；95% CI，1.2 - 3.5）、了解医护人员在另一家机构可接受PEP（AOR，2.6；95% CI，1.5 - 4.4）、对BPE的低/无感知风险（AOR，4.2；95% CI，1.9 - 9.4）以及过去一年内进行过HIV检测（AOR，2.3；95% CI，1.2 - 4.4）。
这些结果凸显了关于职业暴露预防和报告的适当培训的重要性，以提高对HIV检测的接受度并改善BPE后获得PEP的机会。
