1Health Research Union, Tbilisi, Georgia; 2Tbilisi State Medical University, Georgia.
1Health Research Union, Tbilisi, Georgia.
Georgian Med News. 2022 Jan(322):21-25.
The prevalence of viral hepatitis B and C in Georgia is among the highest in the region. US Centers for Disease Control and Prevention (CDC) has selected Georgia as a pilot country for hepatitis C elimination program. Since 2015, Georgia launched a multi-year program of HCV elimination, including treatment of infected individuals with Direct Acting Antivirals (DAAs) and implementation of prevention programs, including infection control in health care facilities. The objective of this study was to evaluate the attitude and knowledge of blood borne infections (HIV, HCV, HBV) among Georgian Health Care Workers (HCWs). HCWs were recruited from six participating multi-profile hospitals and dental care institutions in three large cities of Georgia (Batumi (Western Georgia), Rustavi (Eastern Georgia) and the capital city, Tbilisi). A self - administered questionnaire included sections regarding sociodemographic and professional characteristics; awareness of blood-borne infections; practice for transmission risk reduction and perceived educational interventions acceptable among HCWs. The selection of HCWs was done through simple random sampling from the list of staff as a sampling frame. HCW's survey results were compared to the one from Dental health care workers (DHCWs). The total number of surveyed individuals was 442. Among them, 246 (55.6%) were HCWs (physicians, nurses, physician assistants and residents) from different departments, including family medicine (38.6 %), surgery (21.7%), gynecology (23.4%) and intensive care (13.9%) and 196 DHCWs (44.6%). Only few respondents (15.6%) correctly identified the prevalence of HIV infection in Georgia. HCWs have better understanding about the prevalence of viral hepatitis compared to DHCWs (Prevalence of HBsAg was correctly identified by 33.2 % vs 22.3%; prevalence of HCV- by 18.9 % vs 17.3%). Knowledge regarding transmission risks of blood-borne infections (HIV, HCV, HBV) among HCWs is higher compared to DHCWS (for HIV 73% vs 45.3%, for HCV 49.2% vs 37.9% and for HBV 54.8% vs 33.7%) (p<0.005). Vast majority of DHCWs as well as HCWs believed that probability of transmission of blood-borne infections after contaminated needle stick is 50-70% (p<0.05). There was a poor knowledge on availability of post exposure prophylaxis (42.9% of HCWs compare to 36.1% DHCWs believed that HCV post-exposure prophylaxis is available) (p<0.005). The practice of using facemasks (81% vs 74.4% always use, respectively), protective clothes (96.8% vs 83.3% always use) and eyewears (46.9% vs 27.4% always use) was reported by DHCWs and HCWs. Some nosocomial risk events were reported by higher proportion of DHCWs, compared to HCWs and included accidental needle stick injuries (65.1% vs 45.5%) and blood splashes (48.3% vs 28.2%). Cuts with contaminated instruments was more common among HCWs compared to DCHWs (41.4% vs 35.1%) during medical procedures. The study suggests that level of knowledge on blood borne infections among both HCWs and DHCWs is not adequate. Data from this study can be utilized to design educational programs for Georgian HCWs/DHCWs to improve knowledge and practice about blood borne diseases.
格鲁吉亚的乙型和丙型病毒性肝炎流行率在该地区属于最高之列。美国疾病控制与预防中心 (CDC) 已选择格鲁吉亚作为丙型肝炎消除计划的试点国家。自 2015 年以来，格鲁吉亚启动了一项多年丙型肝炎消除计划，包括使用直接作用抗病毒药物 (DAAs) 治疗感染个体以及实施预防计划，包括医疗机构的感染控制。本研究的目的是评估格鲁吉亚卫生保健工作者 (HCWs) 对血液传播感染（HIV、HCV、HBV）的态度和知识。HCWs 从格鲁吉亚三个大城市的六家参与多专业医院和牙科医疗机构中招募（西部的巴统、东部的鲁斯塔维以及首都第比利斯）。一份自我管理的问卷包括社会人口统计学和职业特征部分；对血液传播感染的认识；降低传播风险的实践以及 HCWs 认为可接受的感知教育干预措施。通过从员工名单中简单随机抽样选择 HCWs 作为抽样框架。将 HCW 的调查结果与牙科保健工作者 (DHCWs) 的结果进行比较。共调查了 442 人。其中，246 人（55.6%）是来自不同科室的 HCWs（医生、护士、医生助理和住院医师），包括家庭医学科（38.6%）、外科（21.7%）、妇产科（23.4%）和重症监护室（13.9%），196 人是 DHCWs（44.6%）。只有少数受访者（15.6%）正确识别出格鲁吉亚艾滋病毒感染的流行率。HCWs 对病毒性肝炎的流行率的了解要好于 DHCWs（HBsAg 的流行率分别为 33.2%和 22.3%；HCV 的流行率为 18.9%和 17.3%）。HCWs 对血液传播感染（HIV、HCV、HBV）的传播风险的认识要高于 DHCWS（HIV 为 73%，而 DHCWS 为 45.3%；HCV 为 49.2%，而 DHCWS 为 37.9%；HBV 为 54.8%，而 DHCWS 为 33.7%）（p<0.005）。大多数 DHCWs 和 HCWs 都认为，被污染的针头刺伤后血液传播感染的概率为 50-70%（p<0.05）。对于 HCV 暴露后预防是否可用，HCWs（42.9%）和 DHCWs（36.1%）的认知都很差（p<0.005）。DHCWs 和 HCWs 都报告了使用口罩（81%和 74.4%，分别总是使用）、防护服（96.8%和 83.3%，总是使用）和护目镜（46.9%和 27.4%，总是使用）。与 HCWs 相比，DHCWs 报告了更高比例的医院感染风险事件，包括意外针刺伤（65.1%和 45.5%）和血液喷溅（48.3%和 28.2%）。在医疗过程中，与 DCHWs 相比，HCWs 更常发生与污染器械相关的切割伤（41.4%和 35.1%）。研究表明，HCWs 和 DHCWs 对血液传播感染的知识水平都不足够。本研究的数据可用于为格鲁吉亚 HCWs/DHCWs 设计教育计划，以提高他们对血液传播疾病的知识和实践水平。
