Gamester C F, Tilzey A J, Banatvala J E
Guy's, King's College, and St Thomas's School of Medicine, St Thomas's Campus, London SE1 7EH.
BMJ. 1999 Jan 16;318(7177):158-60. doi: 10.1136/bmj.318.7177.158.
To determine risks of exposure to and prevention of bloodborne virus infections among medical students during their elective period.
Questionnaire study of students returning from their electives in 1997-8.
Urban teaching hospital.
220 final year medical students.
148 students (67%) returned questionnaires; all had been vaccinated against hepatitis B. 65 respondents (44%) had visited areas of relatively high endemicity for HIV, although 27 (42%) of these, all of whom had visited areas other than sub-Saharan Africa, were unaware of this. All but one had discussed their elective with advisers. Four students experienced percutaneous or mucosal exposure to potentially infectious body fluids, three in areas with a high prevalence of HIV infection. 44 respondents (30%) had experienced at least one such exposure during their clinical training; 75% of these exposures were unreported. 34% (13/38) students who visited areas known to have a high prevalence of HIV infection took with them a starter pack of zidovudine for post-exposure prophylaxis; 53% (20) took latex gloves and 63% (24) a medi-kit. None of the 27 students who were unaware that the areas they visited had a relatively high prevalence of HIV infection took zidovudine; only 15% (4) took gloves and 30% (8) a medi-kit.
Medical schools should produce, regularly update, and implement guidelines regarding protection from bloodborne viruses during clinical studies, including electives. Education and training in infection control should start at the earliest opportunity.
确定医学生选修期间血源性病原体感染的暴露风险及预防措施。
对1997 - 1998年选修归来的学生进行问卷调查研究。
城市教学医院。
220名医学专业最后一年的学生。
148名学生(67%)回复了问卷;所有学生均接种过乙肝疫苗。65名受访者(44%)曾前往HIV感染率相对较高的地区,不过其中27名(42%),他们均未去过撒哈拉以南非洲地区,并不知晓这一情况。除一人外,所有学生都与导师讨论过他们的选修课程。4名学生经历过经皮或黏膜接触可能具有传染性的体液,其中3人接触发生在HIV感染率高的地区。44名受访者(30%)在临床培训期间至少经历过一次此类接触;其中75%的接触未报告。前往已知HIV感染率高的地区的学生中,34%(13/38)携带了齐多夫定起始包用于暴露后预防;53%(20人)携带了乳胶手套,63%(24人)携带了医疗包。27名不知晓自己前往地区HIV感染率相对较高的学生中,无人携带齐多夫定;只有15%(4人)携带了手套,30%(8人)携带了医疗包。
医学院校应制定、定期更新并实施临床研究(包括选修课程)期间预防血源性病原体感染的指南。感染控制方面的教育和培训应尽早开展。