A Study To Assess The Atittude Of Healthcare Workers To Infection Prevention And Control In Kampala International University Teaching Hospital, Uganda

ABSTRACT

Introduction

With high prevalence of infectious diseases such as; HIV, HBV, HCV among others; especially in

sub-Saharan Africa, health workers find themselves at the brunt of acquiring these diseases

while they are working. In order to ensure safety within the auspice of their work, infection

prevention and control policies implementation as regards to accidental exposure to bloodborne

viruses are therefore vital. Prevention of blood exposure, through safer practices, barrier

precautions, safer needle devices, and other innovations, is the best way to prevent infection

with HIV and other blood-borne pathogens.

Methodology

Observational cross sectional study was carried out in Kampala International University

Teaching Hospital, located in south western Uganda. Healthcare workers from various

departments were recruited between June and July and questioned concerning various facets

of infection prevention to blood-borne pathogens, management and prophylaxis following

accidental exposure to blood and bodily fluids suspected to habour infectious viruses; HBV and

HIV. Data obtained were coded, tabulated, analyzed to determine means, frequencies and

ranges, and presented using tables, graphs and pie charts.

Results

All the respondents were aware of infection prevent measures particularly as concerning

accidental exposure to blood or body fluid and post exposure prophylaxis. Majority of the

respondents felt that the Personal Protective Equipment were always available (62%).

42% of the respondents reported to have been accidentally exposed to blood or body fluid

between June 2012 to June 2013. Majority of those exposed were students at 33% then

followed by nurses and clinical officers at 28% each. Of those exposed, only 27% reported to

the relevant management. Majority of those who failed to report were students at 100% and

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clinical officers at 80%. Majority of the exposed were by percutaneous means and least by

permucosal means: percutaneous 72%, mucous membrane 11% and non intact skin 17%. Of

those exposed, 89% were exposed blood whereas 11% to bodily fluids. For those

percutaneously exposed, 69%, was by needle, 8% by scalpel and 23% by suture needle. Major

cause of percutaneous injury was unexpected patient movement (31%) and suturing (31%), and

then followed needle recapping at 23% and least causes were disposal of used needles and

IM/IV line insertion at 8% and 7% respectively.

Hepatitis B vaccination rate among the healthcare workers in KIUTH was 54%. 61% of nurses,

43% of clinical officers, 90% of lab technicians and 27% of students were vaccinated against

Reasons for not having vaccination include unavailability at KIUTH (74%), expensive (22%) and

scared of side effects of the vaccine (4%). Routine checking of HBsAg of source person after

occupational exposure stands at 44%.

16% of the respondents have ever been exposed to blood or bodily fluid of a confirmed HIV

positive patient and of those 57% utilized PEP Antiretroviral therapy. Of the remaining 43%, the

reasons for not taking PEP ART was that they never met the criteria for initiation of PEP ART

(50%) and 50% were scared of the stigma associated with it both at work and at home. The ones, who failed to utilize PEP because of the associated stigma, were all students.

Conclusion Prevention of blood exposure, through safer practices, barrier precautions, safe practice, and

other innovations, is the best way to prevent infection with HIV and other bloodborne pathogens.