Skip navigation

Needlestick injuries in South African interns

 

Clinical bottom line

The incidence of exposure to blood was high. One young doctor could be expected to be infected with HIV every 7-8 years in this area with high seroprevalence of HIV.


Reference

AS Karstaedt, L Pantanowitz. Occupational exposure of interns to blood in an area of high HIV seroprevalence. South African Medical Journal 2001 91: 57-61.

Study

The study was carried out over two months at the end of 1998 in Johannesburg and Soweto, and involved 102 interns, who were responsible for most of the venepunctures at two hospitals, and insertion of IV lines. They were invited to complete an anonymous questionnaire concerning percutaneous injuries and mucocutaneous contacts with blood.

The questionnaire concerned all incidents during their intern year and three years of clinical training.

Results

At least one percutaneous injury occurred with 83% of interns, 43% from an HIV positive source. As well, 54% recalled at least one mucocutaneous exposure, 70% from an HIV positive source.

There were about two exposures during the intern year and one during the three student years. Those involving HIV positive needlestick were 0.45 per person during the intern year and 0.24 during the three student years.

Most (69%) of percutaneous injuries occurred with a hollow needle. Phlebotomy and catheterisation accounted for about 60% of these.

Reasons for not reporting the exposures were predominantly no perceived health risk in respondents without HIV exposures, and insufficient time in those with HIV exposures.

Comment

There was a high incidence of exposure to blood, with about half having at least one exposure to blood by the time of graduation, and one fifth exposure to HIV infected blood. The expectation, using a seroconversion of 1 in 300, was that one young doctor would become infected every seven or eight years.