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Occupational exposure to HIV in Tanzania

 

Clinical bottom line

In Tanzania about 65% of health workers in hospital had inadequate knowledge of risks associated with HIV transmission. The five-year transmission rate, mainly from percutaneous injuries was calculated as 1 in 77 for health workers in general, but 1 in 30 for surgeons.


Reference

B Gumodoka et al. Occupational exposure to the risk of HIV infection among health care workers in Mwanza region, United Republic of Tanzania. Bulletin of the WHO 1997 75: 133-140.

Study

In a number of hospitals in one region of Tanzania, 27 wards, plus labour rooms, operating theatres, outpatient wards, casualty departments and laboratories were surveyed, using observation and interviews. Health workers knowledge about occupational risks of HIV transmission was assessed through a questionnaire. At least 10% of the 3,500 workers in the hospitals were interviewed.

A prick of accident was defines as a prick with a needle or other sharp object occurring during use of the object for patient care. A splash was defined as a splash of any body fluid from a patient onto the skin or mucous membrane of a health worker.

Results

Of 434 questionnaires 403 were returned (93%). Overall 71% of the questions were answered correctly. If 75% of correct answers was taken as an adequate level of knowledge, then 65% of workers had an inadequate knowledge of risk of occupational transmission of HIV.

Prick and splash accidents among the 434 persons interviewed was common. In the previous week about 10% recalled a prick accident and 15% a splash accident.

The incidence of prick accidents experience per health worker per year was calculated as five per year, with nine splash incidents per year in addition.

Using a presumed HIV prevalence of 20% in the general population of this region of Tanzania, the risk of HIV transmission over five years was 1.3% (1 in 77), mainly from percutaneous injuries. The five year risk for surgeons was calculated as 3.5% (about 1 in 30).

Comment

This is a serious paper rich in detail, and is well worth reading as an example of how risks might be explored in any region of the world.