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Working with risk: occupational safety issues among healthcare workers in Kenya.
AIDS Care. 2008 Mar; 20(3):304-10.AC

Abstract

The objective of this study was to explore knowledge of, attitudes towards and practice of post-exposure prophylaxis (PEP) among healthcare workers (HCWs) in the Thika district, Kenya. We used site and population-based surveys, qualitative interviews and operational research with 650 staff at risk of needlestick injuries (NSIs). Research was conducted over a 5-year period in five phases: (1) a bio-safety assessment; (2) a staff survey: serum drawn for anonymous HIV testing; (3) interventions: biosafety measures, antiretrovirals for PEP and hepatitis B vaccine; (4) a repeat survey to assess uptake and acceptability of interventions; in-depth group and individual interviews were conducted; and (5) health system monitoring outside a research setting. The main outcome measures were bio-safety standards in clinical areas, knowledge, attitudes and practice as regards to PEP, HIV-sero-prevalence in healthcare workers, uptake of interventions, reasons for poor uptake elucidated and sustainability indicators. Results showed that HCWs had the same HIV sero-prevalence as the general population but were at risk from poor bio-safety. The incidence of NSIs was 0.97 per healthcare worker per year. Twenty-one percent had had an HIV test in the last year. After one year there was a significant drop in the number of NSIs (OR: 0.4; CI: 0.3-0.6; p<0.001) and a significant increase in the number of HCWs accessing HIV testing (OR: 1.55; CI: 1.2-2.1; p=0.003). In comparison to uptake of hepatitis B vaccination (88% of those requiring vaccine) the uptake of PEP was low (4% of those who had NSIs). In-depth interviews revealed this was due to HCWs fear of HIV testing and their perception of NSIs as low risk. We concluded that Bio-safety remains the most significant intervention through reducing the number of NSIs. Post-exposure prophylaxis can be made readily available in a Kenyan district. However, where HIV testing remains stigmatised uptake will be limited - particularly in the initial phases of a programme.

Authors+Show Affiliations

Liverpool VCT, Care and Treatment, Nairobi, Kenya. miriam@liverpoolvct.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18351477

Citation

Taegtmeyer, M, et al. "Working With Risk: Occupational Safety Issues Among Healthcare Workers in Kenya." AIDS Care, vol. 20, no. 3, 2008, pp. 304-10.
Taegtmeyer M, Suckling RM, Nguku PM, et al. Working with risk: occupational safety issues among healthcare workers in Kenya. AIDS Care. 2008;20(3):304-10.
Taegtmeyer, M., Suckling, R. M., Nguku, P. M., Meredith, C., Kibaru, J., Chakaya, J. M., Muchela, H., & Gilks, C. F. (2008). Working with risk: occupational safety issues among healthcare workers in Kenya. AIDS Care, 20(3), 304-10. https://doi.org/10.1080/09540120701583787
Taegtmeyer M, et al. Working With Risk: Occupational Safety Issues Among Healthcare Workers in Kenya. AIDS Care. 2008;20(3):304-10. PubMed PMID: 18351477.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Working with risk: occupational safety issues among healthcare workers in Kenya. AU - Taegtmeyer,M, AU - Suckling,R M, AU - Nguku,P M, AU - Meredith,C, AU - Kibaru,J, AU - Chakaya,J M, AU - Muchela,H, AU - Gilks,C F, PY - 2008/3/21/pubmed PY - 2008/7/11/medline PY - 2008/3/21/entrez SP - 304 EP - 10 JF - AIDS care JO - AIDS Care VL - 20 IS - 3 N2 - The objective of this study was to explore knowledge of, attitudes towards and practice of post-exposure prophylaxis (PEP) among healthcare workers (HCWs) in the Thika district, Kenya. We used site and population-based surveys, qualitative interviews and operational research with 650 staff at risk of needlestick injuries (NSIs). Research was conducted over a 5-year period in five phases: (1) a bio-safety assessment; (2) a staff survey: serum drawn for anonymous HIV testing; (3) interventions: biosafety measures, antiretrovirals for PEP and hepatitis B vaccine; (4) a repeat survey to assess uptake and acceptability of interventions; in-depth group and individual interviews were conducted; and (5) health system monitoring outside a research setting. The main outcome measures were bio-safety standards in clinical areas, knowledge, attitudes and practice as regards to PEP, HIV-sero-prevalence in healthcare workers, uptake of interventions, reasons for poor uptake elucidated and sustainability indicators. Results showed that HCWs had the same HIV sero-prevalence as the general population but were at risk from poor bio-safety. The incidence of NSIs was 0.97 per healthcare worker per year. Twenty-one percent had had an HIV test in the last year. After one year there was a significant drop in the number of NSIs (OR: 0.4; CI: 0.3-0.6; p<0.001) and a significant increase in the number of HCWs accessing HIV testing (OR: 1.55; CI: 1.2-2.1; p=0.003). In comparison to uptake of hepatitis B vaccination (88% of those requiring vaccine) the uptake of PEP was low (4% of those who had NSIs). In-depth interviews revealed this was due to HCWs fear of HIV testing and their perception of NSIs as low risk. We concluded that Bio-safety remains the most significant intervention through reducing the number of NSIs. Post-exposure prophylaxis can be made readily available in a Kenyan district. However, where HIV testing remains stigmatised uptake will be limited - particularly in the initial phases of a programme. SN - 1360-0451 UR - https://www.unboundmedicine.com/medline/citation/18351477/Working_with_risk:_occupational_safety_issues_among_healthcare_workers_in_Kenya_ L2 - https://www.tandfonline.com/doi/full/10.1080/09540120701583787 DB - PRIME DP - Unbound Medicine ER -