尼日利亚北部医护人员的知识水平及艾滋病病毒暴露婴儿免疫接种咨询实践的相关因素

Correlates of Health Care Workers' Knowledge and HIV-Exposed Infant Immunization Counseling Practice in Northern Nigeria.

作者信息

Iliyasu Zubairu, Hassan-Hanga Fatimah, Ajuji Sadiq Isah, Bello Musa M, Abdulkadir Safiyya S, Nass Nafisa S, Salihu Hamisu M, Aliyu Muktar H

机构信息

Department of Community Medicine, Bayero University, Kano, Nigeria.

Departments of Pediatrics, Bayero University, Kano, Nigeria.

出版信息

Int J MCH AIDS. 2021;10(1):55-65. doi: 10.21106/ijma.432. Epub 2020 Dec 30.

DOI:10.21106/ijma.432

PMID:33442492

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7792747/

Abstract

BACKGROUND

Human Immunodeficiency Virus (HIV)-exposed and HIV-infected infants are at increased risk of vaccine-preventable diseases. However, little is known about health care workers' knowledge and immunization counseling practices in this population. We determined the predictors of health care workers' knowledge of vertical transmission risks, HIV exposed/infected infant immunization, and counseling practices in a tertiary center in Northern Nigeria.

METHODS

A cross-section of 297 health workers were interviewed using a structured, validated questionnaire. Knowledge and HIV-exposed infant immunization counseling practices were analyzed, and adjusted odds ratios for predictors were derived from logistic regression models.

RESULTS

Of the 297 participating health care workers, (32.3%, 96) had adequate knowledge of HIV-exposed/infected infant immunization. Two-thirds (67%, 199) of the participants appropriately identified the timing of infant diagnosis, while (73%, 217) and (56.2%, 167) correctly categorized infants as HIV-exposed and HIV-infected, respectively. Only (19.5%, 58) participants had ever counselled a HIV-positive mother on infant immunization. Knowledge was predicted by work unit (HIV clinic vs. Obstetrics & Gynecology clinic), (Adjusted Odds Ratio (AOR) =3.78, 95% CI: 1.27-5.54), age (30-39 vs. <30 years), (AOR=2.24, 95% CI:1.19-5.67), years of experience (≥10 vs. <5), (AOR=1.76, 95% CI: 1.15-6.04), number of children (1 vs. 0), (AOR=1.73, 95% CI:1.14-4.23), infant immunization training (yes vs. no), (AOR=1.57, 95% CI:1.12-5.43), female sex (AOR = 1.17, 95% CI:1.06-2.21), profession (nurse/midwife vs. physician), (AOR=0.44, 95% CI:0.21-0.94) and previous HIV test (no vs. yes), (AOR=0.67, 95% CI:0.21-0.83).

CONCLUSION AND GLOBAL HEALTH IMPLICATIONS

Knowledge of HIV-exposed infant immunization was low and counseling practices were sub-optimal. Both immunization knowledge and counseling practices were predicted by demographic, professional, and training variables. Our findings indicate the need for educating health care workers on HIV exposed/infected infant immunization policy and improving counseling skills through capacity-building programs.

摘要

背景

暴露于人类免疫缺陷病毒（HIV）和感染HIV的婴儿患疫苗可预防疾病的风险增加。然而，对于医护人员在这一人群中的知识水平和免疫接种咨询实践了解甚少。我们确定了尼日利亚北部一家三级医疗中心医护人员对垂直传播风险、暴露于HIV/感染HIV婴儿免疫接种的知识以及咨询实践的预测因素。

方法

采用结构化、经过验证的问卷对297名医护人员进行了横断面调查。分析了知识水平和对暴露于HIV婴儿的免疫接种咨询实践情况，并从逻辑回归模型中得出预测因素的调整比值比。

结果

在297名参与调查的医护人员中，（32.3%，96人）对暴露于HIV/感染HIV婴儿的免疫接种有足够的知识。三分之二（67%，199人）的参与者正确识别了婴儿诊断的时间，而（73%，217人）和（56.2%，167人）分别正确地将婴儿分类为暴露于HIV和感染HIV。只有（19.5%，58人）的参与者曾就婴儿免疫接种问题为HIV阳性母亲提供过咨询。知识水平的预测因素包括工作单位（HIV诊所与妇产科诊所），（调整比值比（AOR）=3.78，95%置信区间：1.27 - 5.54）、年龄（30 - 39岁与<30岁），（AOR = 2.24，95%置信区间：1.19 - 5.67）、工作年限（≥10年与<5年），（AOR = 1.76，95%置信区间：1.15 - 6.04）、子女数量（1个与0个），（AOR = 1.73，95%置信区间：1.14 - 4.23）、婴儿免疫接种培训（有与无），（AOR = 1.57，95%置信区间：1.12 - 5.43）、女性（AOR = 1.17，95%置信区间：1.06 - 2.21）、职业（护士/助产士与医生），（AOR = 0.44，95%置信区间：0.21 - 0.94）以及之前的HIV检测情况（无与有），（AOR = 0.67，95%置信区间：0.21 - 0.83）。