非洲卫生专业人员对HIV/AIDS暴露后预防的知识与接受情况：系统评价与荟萃分析

HIV/AIDS post-exposure prophylaxis knowledge and uptake among health professionals in Africa: Systematic review and meta-analysis.

作者信息

Tekalign Tiwabwork, Awoke Nefsu, Eshetu Kirubel, Gelaw Walle Belete, Teshome Guta Mistire

机构信息

School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Sodo, Ethiopia.

出版信息

HIV Med. 2022 Sep;23(8):811-824. doi: 10.1111/hiv.13271. Epub 2022 Mar 30.

DOI:10.1111/hiv.13271

PMID:35355388

Abstract

BACKGROUND

Healthcare workers in developing countries are at particularly increased risk of infections from blood-borne pathogens because of the high prevalence of such pathogens in their communities as well as the lack of basic personal protective equipment, such as gloves, gowns and goggles. For those exposed healthcare workers, the immediate administration of antiretroviral drugs following exposure to potentially infected blood or other bodily fluids is essential in order to minimize the risk of acquiring HIV infection. This review is aimed at estimating the pooled prevalence of knowledge and uptake of post-exposure prophylaxis among healthcare providers in Africa.

METHODS

We accessed PubMed, Science Direct, Google Scholar, SCOPUS, African Journals Online (AJOL), Journal Storage (JSTOR) and EMBASE. The search for unpublished studies included Google and institutional repositories were also used. This meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of studies was assessed using the modified Newcastle-Ottawa Scale (NOS). Meta-analysis was carried out with a random-effects method using STATA v.14 software.

RESULTS

Out of 654 692 studies retrieved, 37 studies from four African regions involving 6482 healthcare providers were included in this meta-analysis. The overall estimated pooled uptake and knowledge of HIV/AIDS post-exposure prophylaxis among healthcare providers in Africa using a random-effects model were 40.09% (95% CI: 30.14-50.04) and 57.67% (95% CI: 44.32-71.01) respectively, whereas the highest uptake and knowledge were 45.48% (95% CI: 24.79-66.17) and 61.37% (95% CI: 46.39-76.36) in the southern and eastern regions, respectively.

CONCLUSIONS

The results of this meta-analysis indicated that the knowledge and uptake of post-exposure prophylaxis, one of the best approaches to tackling HIV/AIDS transmission, are significantly low. Therefore, healthcare organizations should work on strategies to increase knowledge and uptake of post-exposure prophylaxis among healthcare providers.

REGISTRATION

Prospero (ID: CRD42021244003).

摘要

背景

由于发展中国家社区中血源性病原体的高流行率以及缺乏手套、隔离衣和护目镜等基本个人防护设备，这些国家的医护人员感染血源性病原体的风险尤其高。对于那些暴露的医护人员，在接触潜在感染的血液或其他体液后立即给予抗逆转录病毒药物对于将感染艾滋病毒的风险降至最低至关重要。本综述旨在估计非洲医护人员中暴露后预防的知识知晓率和使用率的合并患病率。

方法

我们检索了PubMed、科学Direct、谷歌学术、SCOPUS、非洲期刊在线（AJOL）、期刊存储库（JSTOR）和EMBASE。对未发表研究的检索还包括谷歌和机构知识库。本荟萃分析遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南。使用改良的纽卡斯尔-渥太华量表（NOS）评估研究质量。使用STATA v.14软件采用随机效应方法进行荟萃分析。

结果

在检索到的654692项研究中，本荟萃分析纳入了来自非洲四个地区的37项研究，涉及6482名医护人员。使用随机效应模型估计，非洲医护人员中艾滋病毒/艾滋病暴露后预防的总体合并使用率和知晓率分别为40.09%（95%CI：30.14-50.04）和57.67%（95%CI：44.32-71.01），而南部和东部地区的最高使用率和知晓率分别为45.48%（95%CI：24.79-66.17）和61.37%（95%CI：46.39-76.36）。