School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Fylde Road, Preston, PR1 2HE, England.
Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
Bull World Health Organ. 2017 Dec 1;95(12):831-841F. doi: 10.2471/BLT.17.195735. Epub 2017 Oct 13.
To estimate the lifetime and 12-month prevalence of occupational exposure to body fluids among health-care workers in Africa.
Embase®, PubMed® and CINAHL databases were systematically searched for studies published between January 2000 and August 2017 that reported the prevalence of occupational exposure to blood or other body fluids among health-care workers in Africa. The continent-wide prevalence of exposure was estimated using random-effects meta-analysis.
Of the 904 articles identified, 65 studies from 21 African countries were included. The estimated pooled lifetime and 12-month prevalence of occupational exposure to body fluids were 65.7% (95% confidence interval, CI: 59.7-71.6) and 48.0% (95% CI: 40.7-55.3), respectively. Exposure was largely due to percutaneous injury, which had an estimated 12-month prevalence of 36.0% (95% CI: 31.2-40.8). The pooled 12-month prevalence of occupational exposure among medical doctors (excluding surgeons), nurses (including midwives and nursing assistants) and laboratory staff (including laboratory technicians) was 46.6% (95% CI: 33.5-59.7), 44.6% (95% CI: 34.1-55.0) and 34.3% (95% CI: 21.8-46.7), respectively. The risk of exposure was higher among health-care workers with no training on infection prevention and those who worked more than 40 hours per week.
The evidence available suggests that almost one half of health-care workers in Africa were occupationally exposed to body fluids annually. However, a lack of data from some countries was a major limitation. National governments and health-care institutions across Africa should prioritize efforts to minimize occupational exposure among health-care workers.
估计非洲医护人员职业性接触体液的终生患病率和 12 个月患病率。
系统检索了 2000 年 1 月至 2017 年 8 月间发表的关于非洲医护人员职业性接触血液或其他体液的研究，使用 Embase、PubMed 和 CINAHL 数据库。使用随机效应荟萃分析估计全非洲的接触率。
在 904 篇文章中，有 65 篇来自 21 个非洲国家的研究被纳入。估计的终生和 12 个月职业性接触体液的总患病率分别为 65.7%（95%可信区间，CI：59.7-71.6）和 48.0%（95% CI：40.7-55.3）。接触主要是由于经皮损伤，12 个月的经皮损伤患病率估计为 36.0%（95% CI：31.2-40.8）。医生（不包括外科医生）、护士（包括助产士和护理助理）和实验室工作人员（包括实验室技术员）的 12 个月职业性接触率的总患病率分别为 46.6%（95% CI：33.5-59.7）、44.6%（95% CI：34.1-55.0）和 34.3%（95% CI：21.8-46.7）。无感染预防培训的医护人员和每周工作超过 40 小时的医护人员接触的风险更高。
现有证据表明，非洲近一半的医护人员每年都有职业性接触体液。然而，一些国家缺乏数据是一个主要的局限性。非洲各国政府和医疗机构应优先努力减少医护人员的职业性接触。
