Blood-borne Research Articles

The impact of the COVID-19 pandemic on social determinants of health, mental health, and substance use among key populations affected by sexually transmitted and blood-borne infections in Canada

ObjectivesWe assessed the impact of the COVID-19 pandemic on social determinants of health, mental health, substance use, and access to mental health and harm reduction services among key populations disproportionately impacted by sexually transmitted and blood-borne infections (STBBI).MethodsOnline surveys (2021‒2022) were conducted in Canada among people who use drugs or alcohol (PWUD); African, Caribbean, and Black people (ACB); and First Nations, Inuit, and Métis peoples (FNIM). Descriptive analyses were conducted on social determinants of health, substance use, and access to services, stratified by changes in mental health status since the start of the pandemic.ResultsA total of 3773 participants (1034 PWUD, 1556 ACB, and 1183 FNIM) completed the surveys, with 45.6% reporting a major/moderate impact of the pandemic on their ability to pay bills and 53% experiencing food insecurity since the start of the pandemic. Half (49.4%) of participants reported deteriorating mental health. A higher increase in substance use and related behaviours was seen in those with worsening mental health. Among those using substances, two thirds (69.4%) of those with worsening mental health reported increasing their use of substances alone, compared to 46.9% of those with better/similar mental health. Access to mental health and harm reduction services was low.ConclusionThese intersecting health issues are among the risk factors for STBBI acquisition and act as barriers to care. Equitable interventions and policies addressing downstream and upstream determinants of health, with meaningful and sustainable leadership from key populations, may improve their health and well-being, to lower STBBI impact and improve future pandemic responses.

The preoperative testing at laboratories in Najaf are being performed on patients at the time of the surgery in order to do this evaluation of blood-borne viruses

Al-Sadir Teaching Hospital, Najaf, Iraq was the surrounding for this study that was done during the window of time from the 1st of January to the 1st of November of the same year. A descriptive, cross-sectional, hospital-based study of hospitals is investigated. The research was conducted during January, 1st 2023 and November 1, 2023 in the course of studies. The project evlaution was launched on 21st of January and finalized on 1st of November. The purpose of this researched was to determine proportion of patients who were infected with the blood borne diseases such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). All of these viruses are transmitted because the blood carries them. The technique was considered necessary to establish the amount of viral infection in these patients. ELISA testing was among the components, of the pre- surgical virus therapy, which was received by the patient and it was performed on the blood samples collected from the patient.Eventually we came to the conclusion that the procedures were applied as implied in the system. In our investigations, we determined that the Human Papilloma Virus (HPV) is the one virus that had been identified to be infecting the people whose cases were detected by the examination process. The second most well-known virus after Human Virus (HCV) that is also categorized as one of the human viruses is the Human and Human Immune Globaly Viruses complex (HIV). I state emphatically discrimination or age bias was non existent during data collection at any point in time of the whole process. I got the data together in a process which of a ten months' duration and took place solely in this particular educational organization. A total of 125 individuals were tested positive out of which 64 were affected by HBV, 60 (60%) got affected by HCV, and 7 (70%) were affected by HIV. The isolation of the virus was only possible when it was passed on by all male who were tested. The girls had a unique and admirable quality: not a single one of them tested positive for the infection. It was evident among the people affected that about two thirds were male. Actually, only less than 1/3 (30%) of the females getting tested HIV positive, whereas 5 (43.4%) of them had HBV and even 5 (45%) of them showed the HCV result Thus, it is evident with the result seen that the number of cases of women from prevention to men who visited the health center was much lower. We look forward to having 19,925 folks at the donation drive having filled up the collection tubes with their blood. Via the study of a total of 1,330 Hepatitis B virus cases, the test was found positive in (145) of them, and negative only in the (1205) remaining cases. By which implies gives us 19925 which is definitely it is the quantity of blood to be collected

Insights into Standard Precaution Knowledge and Adherence among Healthcare Workers: Evidence from Tertiary Care Hospitals in Peshawar, Pakistan

Healthcare workers (HCWs) are at risk of being exposed to blood-borne infections when performing clinical activities, hence conventional measures must be followed. The study conducted in Peshawar was motivated by the inadequate adherence to standards in Pakistan. Objective: To evaluate tertiary care hospitals' healthcare workers' (HCWs) awareness of and adherence to standard precautions. Methods: Over the course of six months, 421 HCWs employed in a variety of public and commercial tertiary healthcare settings in Peshawar, Pakistan, participated in cross-sectional research. Convenient sampling was employed in the selection of participants. Three portions of a standardized questionnaire addressing adherence, knowledge, and demographics were administered. For data analysis SPSS version 27® was used, evaluating adherence and knowledge using scoring methods. Results: The majority of participants (78.1%) were new in their areas, and 68.2% had completed standard precautions training. Although the majority of healthcare workers (HCWs) showed high understanding (67.46%), there were still significant gaps in their knowledge, especially when it came to false beliefs about HIV and Hepatitis patient care. However, there was excellent adherence, particularly for trash disposal (73.6%) and hand hygiene (91.4%). When it came to knowledge and adherence, doctors outperformed lab technicians and nurses. Conclusions: Despite knowledge limitations, healthcare workers (HCWs) in Peshawar displayed outstanding adherence to basic procedures, going beyond theoretical comprehension. This underscores the importance of practical implementation in healthcare settings.

Client and staff perceptions of acceptability of MyCheck: a direct-to-pathology telehealth and e-testing service for comprehensive bloodborne virus and sexually transmissible infection screening.

Background Sydney Sexual Health Centre (SSHC) is the largest sexual health clinic in New South Wales (NSW), servicing clients at high risk of sexually transmissible infections and bloodborne viruses. SSHC piloted a direct-to-pathology pathway that facilitated bloodborne virus/sexually transmissible infection testing at one of the ~500 participating pathology collection centres located across NSW. This qualitative study sought to understand SSHC client and provider perspectives of acceptability of the MyCheck intervention. Methods Semi-structured in-depth interviews were conducted with 11 clients who underwent testing via the MyCheck pathway and eight staff members involved in implementing MyCheck. The seven components of Sekhon's Theoretical Framework of Acceptability informed this analysis. Results Participants broadly conveyed 'affective attitude' toward the MyCheck pathway. The telehealth intervention reduced client 'burden' and 'opportunity cost' through enabling greater testing convenience at a location suitable to them and provided timely results. Issues of 'ethicality' were raised by clients and staff as pathology centre staff were, on a few occasions, regarded as being judgmental of SSHC clients. 'Intervention coherence' issues were largely attributed to pathology centre personnel being unfamiliar with the intervention, with billing issues being a recurrent concern. Participants perceived MyCheck as an 'effective' testing pathway. SSHC staff were able to offer the intervention with ease through seamless IT integration ('self-efficacy'). Conclusion The MyCheck intervention was perceived by both SSHC clients and staff as an acceptable bloodborne virus/sexually transmissible infection testing pathway. However, further work is required to address stigma experienced by some clients when attending pathology collection centres.

Investigation of Presumptive HIV Transmission Associated with Receipt of Platelet-Rich Plasma Microneedling Facials at a Spa Among Former Spa Clients - New Mexico, 2018-2023.

HIV transmitted through cosmetic injection services via contaminated blood has not been previously documented. During summer 2018, the New Mexico Department of Health (NMDOH) was notified of a diagnosis of HIV infection in a woman with no known HIV risk factors who reported exposure to needles from cosmetic platelet-rich plasma microneedling facials (vampire facials) received at a spa in spring 2018. An investigation of the spa's services began in summer 2018, and NMDOH and CDC identified four former spa clients, and one sexual partner of a spa client, all of whom received HIV infection diagnoses during 2018-2023, despite low reported behavioral risks associated with HIV acquisition. Nucleotide sequence analysis revealed highly similar HIV strains among all cases. Although transmission of HIV via unsterile injection practices is a known risk, determining novel routes of HIV transmission among persons with no known HIV risk factors is important. This investigation identified an HIV cluster associated with receipt of cosmetic injection services at an unlicensed facility that did not follow recommended infection control procedures or maintain client records. Requiring adequate infection control practices and maintenance of client records at spa facilities offering cosmetic injection services can help prevent the transmission of HIV and other bloodborne pathogens and ensure adequate traceback and notification in the event of adverse clinical outcomes, respectively.

Seroprevalence of SARS-CoV-2 and Hepatitis B Virus Coinfections among Ethiopians with Acute Leukemia.

SARS-CoV-2 and blood-borne viral coinfections are well reported. Nevertheless, little is known regarding the seroprevalence of SARS-CoV-2 and coinfection with blood-borne viruses in hematologic malignancy patients in Ethiopia. We aimed to assess the seroprevalence of SARS-CoV-2 and associated infections with hepatitis B and other viruses among adolescent and adult acute leukemia patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. A cross-sectional study was conducted from July 2020 to June 2021. Blood samples were tested for the presence of anti-SARS-CoV-2, HBV, HCV, and HIV with ELISA kits and occult hepatitis B infection with a real-time polymerase chain reaction assay. Out of a total 110 cases, the SARS-CoV-2 seroprevalence was 35.5%. The prevalence showed a significant increment from July 2020 to the end of June 2021 (p = 0.015). In 22.7% and 2.7% of leukemia cases, HBV and HIV, respectively, were detected. No HCV was identified. The rate of SARS-CoV-2 coinfection with HBV and HIV was 28% (11/39) and 2.6% (1/39), respectively; however, there was no statistically significant association between SARS-CoV-2 seropositivity with HBV and HIV (p > 0.05). There is a need for viral screening in leukemia cases to monitor infections and inform management.

Completion of three-dose hepatitis B vaccination cycle and associated factors among health care workers in the Greater Accra Region of Ghana.

Despite the availability of a safe and effective vaccine coupled with the awareness of the potential risk of Healthcare Workers acquiring Hepatitis B Virus infection, some HCWs never get vaccinated. Generally, hepatitis B vaccination coverage globally is below the expected level as adherence has remained poor in various healthcare settings, especially in developing countries. The objective of this study was to assess the completion of a three-dose Hepatitis B virus vaccination cycle and associated factors among healthcare workers in the Greater Accra Region of Ghana. An analytical cross-sectional study was conducted and included 363 healthcare workers selected using probability sampling procedures. The participants were recruited from five facilities within the Greater Accra Region in the first half of 2018. A pretested questionnaire was used to collect data which was analyzed using SPSS version 21. The proportion of healthcare workers receiving the recommended 3 doses of the hepatitis vaccine was computed. The multivariable analysis procedure identified the factors associated with adherence to the receipt of three doses of the hepatitis B vaccine. Odds ratios were estimated with corresponding confidence intervals with the level of significance set at 0.05. A total of 340 sample units were included in the analysis. Most of the participants (252/340, 74.1%) were females, mainly nurses/midwives (162/340, 47.6%) with a mean age of 34.5 (SD ±7.7). A high proportion of the participants (82.7%) have tertiary/post-tertiary level education and ever participated in at least one training workshop on the prevention of blood-borne infections (80.6%). Overall vaccination uptake was 60.9% (207/340) (95% CI = 55.7%-66.1%). Complete vaccination coverage (three doses) was 46.8% (159/340). High-risk perception (AOR = 4.0; 95% CI = 1.3-12.5), and previous training in infection prevention (AOR = 2.8; 95% CI = 1.1-7.5) were significantly associated with adherence to receipt of three doses of hepatitis B vaccine. Adherence to three-dose hepatitis B vaccination cycles is not universal among the healthcare workers in the Greater Accra Region. Receipt of the three-dose regimen is significantly associated with high-risk perception and attendance of training in infectious disease prevention. Interventions to increase risk perception and training in the prevention of blood-borne infections could improve adherence to complete/full vaccination protocol among healthcare workers who are at constant risk of exposure to the hepatitis B virus.

Risk factors for hepatocellular carcinoma associated with hepatitis C genotype 3 infection: A systematic review.

Hepatitis C virus (HCV) is a blood-borne virus which globally affects around 79 million people and is associated with high morbidity and mortality. Chronic infection leads to cirrhosis in a large proportion of patients and often causes hepatocellular carcinoma (HCC) in people with cirrhosis. Of the 6 HCV genotypes (G1-G6), genotype-3 accounts for 17.9% of infections. HCV genotype-3 responds least well to directly-acting antivirals and patients with genotype-3 infection are at increased risk of HCC even if they do not have cirrhosis. To systematically review and critically appraise all risk factors for HCC secondary to HCV-G3 in all settings. Consequently, we studied possible risk factors for HCC due to HCV-G3 in the literature from 1946 to 2023. This systematic review aimed to synthesise existing and published studies of risk factors for HCC secondary to HCV genotype-3 and evaluate their strengths and limitations. We searched Web of Science, Medline, EMBASE, and CENTRAL for publications reporting risk factors for HCC due to HCV genotype-3 in all settings, 1946-2023. Four thousand one hundred and forty-four records were identified from the four databases with 260 records removed as duplicates. Three thousand eight hundred and eighty-four records were screened with 3514 excluded. Three hundred and seventy-one full-texts were assessed for eligibility with seven studies included for analysis. Of the seven studies, three studies were retrospective case-control trials, two retrospective cohort studies, one a prospective cohort study and one a cross-sectional study design. All were based in hospital settings with four in Pakistan, two in South Korea and one in the United States. The total number of participants were 9621 of which 167 developed HCC (1.7%). All seven studies found cirrhosis to be a risk factor for HCC secondary to HCV genotype-3 followed by higher age (five-studies), with two studies each showing male sex, high alpha feto-protein, directly-acting antivirals treatment and achievement of sustained virologic response as risk factors for developing HCC. Although, studies have shown that HCV genotype-3 infection is an independent risk factor for end-stage liver disease, HCC, and liver-related death, there is a lack of evidence for specific risk factors for HCC secondary to HCV genotype-3. Only cirrhosis and age have demonstrated an association; however, the number of studies is very small, and more research is required to investigate risk factors for HCC secondary to HCV genotype-3.

Differentiated impacts of short-term exposure to fine particulate constituents on infectious diseases in 507 cities of Chinese children and adolescents: A nationwide time-stratified case-crossover study from 2008 to 2021

This study assesses the association of short-term exposure to PM2.5 (particles ≤2.5 μm) on infectious diseases among Chinese children and adolescents. Analyzing data from 507 cities (2008–2021) on 42 diseases, it focuses on PM2.5 components (black carbon (BC), ammonium (NH4+), inorganic nitrate (NO3−), organic matter (OM), and sulfate (SO42−)). PM2.5 constituents significantly associated with incidence. Sulfate showed the most substantial effect, increasing all-cause infectious disease risk by 2.72 % per interquartile range (IQR) increase. It was followed by BC (2.04 % increase), OM (1.70 %), NO3− (1.67 %), and NH4+ (0.79 %). Specifically, sulfate and BC had pronounced impacts on respiratory diseases, with sulfate linked to a 10.73 % increase in seasonal influenza risk and NO3− to a 16.39 % rise in tuberculosis. Exposure to PM2.5 also marginally increased risks for gastrointestinal, enterovirus, and vectorborne diseases like dengue (7.46 % increase with SO42−). Sexually transmitted and bloodborne diseases saw an approximate 6.26 % increase in incidence, with specific constituents linked to diseases like hepatitis C and syphilis. The study concludes that managing PM2.5 levels could substantially reduce infectious disease incidence, particularly in China's middle-northern regions. It highlights the necessity of stringent air quality standards and targeted disease prevention, aligning PM2.5 management with international guidelines for public health protection.

The public health impacts of supervised injection sites in Canada: Moving beyond social acceptability and impacts on crime.

Canada has been a pioneer in adopting a harm reduction approach to address risks associated with drug use for people who inject drugs. Today, Canada is home to 39 supervised injection sites spread throughout the country. The scientific literature demonstrates, unequivocally, that these sites have numerous health benefits for people who inject drugs, namely by decreasing risks of blood-borne diseases, overdose, and mortality. Yet, a lack of clear guidelines on optimal locations for the implementation of such sites and NIMBYISM ("Not In My Back Yard") have been stumbling blocks for planned and operating sites. Various Canadian governments have introduced their own policies to overcome the lack of national public health guidelines on community planning. Namely, policies aim to limit the exposure to sites and drug use for vulnerable populations, such as children. However, there is a veritable lack of research on the public health impacts of supervised injection sites for local communities, who tend to be disadvantaged. The existing literature fails to address the broader and differential impacts of such sites for local vulnerable and disadvantaged populations, including use of active transportation, psychological distress, perceived safety, and social cohesion. Moreover, existing research, largely focusing on assessing pre-implementation social acceptability and post-implementation impacts on crime, faces important methodological limitations. The following commentary reviews the existing literature and makes recommendations for future public health research on the impacts of supervised injection sites.

Knowledge, Attitudes, and Practices of Dental Students from Romania Regarding Self-Perceived Risk and Prevention of Infectious Diseases.

University education is a leading source of information for dental practitioners. Particular emphasis should be given to determining the extent to which students acquire positive knowledge, attitudes, and practices (KAP) and positive metacompetences beyond the scope of each studied dental discipline. We performed a cross-sectional questionnaire-based study among dentistry students from Romania to assess self-perceived risk of infectious diseases and their KAP on topics related to infectious disease prevention. The surveyed students presented good knowledge regarding personal protective equipment (PPE), and their PPE practices significantly correlated with the perceived usefulness of PPE. Only 45.1% correctly recognized all vaccine-preventable diseases (VPDs), but knowledge regarding VPDs significantly improved with increasing year of study (τb = 0.298, p = 0.001), confirming a positive education effect. Awareness regarding the need for screening for bloodborne viruses is poor; the majority of students had never performed a test for hepatitis C virus infection (HCV) (59.4%) or for human immunodeficiency virus (HIV) infection (60.4%). Furthermore, most respondents incorrectly considered themselves at high or very high risk of acquiring BBV, and perceived risk was inversely correlated with willingness to treat patients with hepatitis B virus (HBV) infection (τb = -0.214, p = 0.018), HCV infection (τb = -0.234, p = 0.013), or HIV infection (τb = -0.242, p = 0.006). This led to 3.0% of respondents stating that they would hypothetically deny dental treatment to a patient with HBV infection, 5.0% for HCV infection, and 10.9% for HIV infection, the proportion being significantly higher for HIV (z = -2.2, p = 0.026). In conclusion, better knowledge is needed among dental students regarding their own vaccination history, screening for bloodborne viruses, accurate estimates for their risk of acquiring bloodborne viruses during routine dental practice, and the existence of post-exposure measures following occupational exposure. Improving student knowledge and awareness could translate into a higher willingness to treat patients with chronic viral infections and into a safer and more inclusive dental practice. We propose an adaptation to the university curriculum to cover these key areas for targeted focus to empower future dental practitioners and to facilitate the improvement of across-discipline metacompetences for infection prevention and control.

EFFECTIVENESS OF DOUBLE-GLOVING METHOD ON PREVENTION OF SURGICAL GLOVE PERFORATIONS AND BLOOD CONTAMINATION: A PROSPECTIVE STUDY

Objectives: To evaluate efficacy of double gloving to provide mechanical barrier against communicable diseases and also to evaluate different parameters affecting glove perforation rate. Methods: This prospective study was performed in department of General Surgery at tertiary care teaching hospital of Gujarat. This study involved a group of surgeons and operation theatre nursing staff. Randomization of the participants was done with the closed envelope method in two groups: single gloving and double gloving. Glove perforation rate and hand contamination rate was calculated and compared between both the groups. Participants of double gloving groups were also asked for discomfort using double gloves and compromised tactile sensations. Results: There was no statistically significant difference in the glove perforation rate between single gloves and double outer gloves. (p=0.55) But, the glove perforation rate was significantly low in double inner gloves than single gloves. (p=0.004) The hand contamination rate was significantly lower amongst perforated double gloves than perforated single gloves. (p=0.00001) Awareness of glove perforation was absent in majority of the participants in both the groups. All the participants in the double gloving group were comfortable with using double gloves and their tactile sensations were not compromised. Conclusion: This study concluded that double gloving efficiently prevented hand contaminations during a surgery. There was no significant difference noted in glove perforation rates in both single and double gloving groups. Double gloving is recommended for the surgeons and nursing staff to protect them from blood borne infections and eliminate the chances of surgical site infections in the patients.

Perspectives on digital testing services for sexually transmitted and blood-borne infections from Two-Spirit, gay, bisexual, transgender, and other queer Black, Indigenous, people of colour living in Ontario, Canada

ABSTRACT Objectives Increased sexually transmitted and blood-borne infections (STBBI) testing can reduce the burden of disease among Two-Spirit, gay, bisexual, transgender, and other queer Black, Indigenous, people of colour (2SGBTQ+ BIPOC). However, this population encounters barriers, such as discrimination, when accessing in-person STBBI testing services. Digital STBBI testing, such as self-testing/collection kits ordered online and digital requisitions, may address some of these barriers. Our aim was to understand acceptability of free digital STBBI testing among 2SGBTQ+ BIPOC living in Ontario, Canada. Design We approached this analysis using Implementation Science and Critical Race Theory. We conducted interviews and focus groups with 21 2SGBTQ + BIPOC individuals from 2020–2021. Participants were asked about their perceptions of the benefits and drawbacks of digital STBBI testing, populations that would benefit from using these services, and recommendations for how these services may be implemented in Ontario. Interviews and focus groups were transcribed verbatim and analyzed using reflexive thematic analysis. Results Six themes emerged. Digital STBBI testing services: (1) May reduce oppression experienced by 2SGBTQ + BIPOC when testing in-person; (2) Should address the unique needs that 2SGBTQ + BIPOC experience due to other intersecting identities they possess; (3) Should adapt their services to suit the varying cultural contexts and living circumstances of 2SGBTQ + BIPOC; (4) Should be accessible to 2SGBTQ + BIPOC who hold diverse or no documentation; (5) Should be offered in multiple languages; (6) May be inaccessible to those without Internet access or devices. Conclusion Digital STBBI testing is one strategy that may reduce discrimination experienced by 2SGBTQ + BIPOC when getting tested in-person. However, digital STBBI testing services may not address all the needs of 2SGBTQ + BIPOC. Racism and other forms of oppression embedded into in-person and digital testing services will need to be addressed to meet the needs of this diverse population.

A Case Series on Intestinal Tapeworms Infections from Eastern Part of India

Introduction: Intestinal worm infestations are widely prevalent in tropical and subtropical countries and occur where there is poverty and poor sanitation. Gastrointestinal helminths cause significant disease in both humans, soil transmitted helminths, blood and food borne liver flukes affect more than 1.5 billion people globally, most of whom live on disadvantaged and neglected communities. Case Series: We report here 3 cases of abnormal passage of long segments in stool during various times of day for a prolonged period with various comorbidities. The worms were identified in our parasitology department and then required treatment given and patients were cured. Conclusion: T saginata infestation has got a global distribution and is endemic in this part of world and a study conducted by even et al in rural areas of Kashmir, shows prevalence of the helminths reported to be7.69% possibly due to consumption of undercooked beef. Beef contains the larval forms of this helminth known as cysticercosis and after activation in the upper intestine the cysticercosis attaches to the wall of the small intestine by means of solices and becomes a mature tapeworm and this takes 10-12 weeks. Treatment with praziquantel is beneficial

Trends in immunological markers of transfusion transmissible infections among blood donors in Mamfe District Hospital, Southwest Cameroon

BackgroundBlood transfusion is associated with exposure to blood Transfusion Transmissible Infection (TTIs). The threat posed by the blood-borne pathogens is disproportionately distributed in different healthcare facilities in Cameroon. Thus, there is a need for continuous surveillance of TTIs in the country. This study aimed to assess the screening procedure for blood transfusion and determine the trend in immunological markers of TTIs among blood donors at the Mamfe District Hospital.MethodsA prospective descriptive, cross-sectional and analytical study was conducted at Mamfe District Hospital from March to May 2022. A total of 165 blood donors were recruited by the consecutive sampling method. Donors were screened using both Rapid diagnostic tests,T. pallidum haemagglutination test and indirect enzyme-linked immunosorbent assay (ELISA) for the detection of TTIs. Data generated was entered into an Excel spreadsheet and analysed using the statistical software R, version 4.2.0. Statistical analysis included descriptive statistics of percentages, means ± standard deviation, and student t-test was used to compare both diagnostic techniques, and was considered significant when p < 0.05.ResultsA hundred and sixty-five donors were enrolled in the study with a male preponderance giving a male-female sex ratio of 22.5 and a mean age of 32.23 ± 8.60 years. The majority (75.2%) of the donors were of the O-positive blood type, repeat donors (69.1%) and were mainly family replacement and paid donors as against the voluntary blood donors (39.4% and 37.0% vs. 23.6% respectively). overall TTIs prevalence was 18.78% (31/165) (), with HBsAg being the most predominant marker at 12.12% (20/165) followed by Treponema pallidum, HCV and HIV antibodies at 4.85 (8/165), 1.21%(2/165), 0.60% (1/165) respectively. Except for the HBV, The prevalence of TTIs was higher when using a single RDT than the ELISA test, and the difference was significant (p < 0.05).ConclusionBloodborne pathogens remain a major menace to safe blood transfusion practice in Mamfe district hospital and their detection could be easily missed if the RDT method alone is used for donor screening. Therefore, the donor screening protocol in Mamfe District Hospital should systematically incorporate a confirmation diagnostic test such as ELISA.

Accidental Exposure to Body Fluids Among Healthcare Workers in a Referral Hospital in the Security-Challenged Region of South West Cameroon

Introduction: Accidental exposure to body fluids (AEBs) increases the risk of blood-borne infections among susceptible healthcare workers (HCWs). While 90% of the AEB reported occur in developed nations, they bear 90% of the burden of healthcare associated infections, sub-Saharan Africa. Social insecurity may contribute further to the vulnerability of HCWs. Our study sought to prevalence, reporting and management of AEBs among HCWs in the South-West Cameroon Region of Cameroon, that experiences security challenges since the year 2016. Methods: A cross-sectional study was carried out from February 2023 to April 2023, at the Buea Regional Hospital. Following informed consent, a 28-items questionnaire was administered to HCW. Data was entered and analyzed using R Statistics version 4.3.1. Results: Out of the 230 HCWs that were approached, 200 responded for a participation rate of 85%. The prevalence of AEB was high (93%). Exposures occurred while administering injections (37%), during blood sample collection (16%), delivery (11%), surgery (10.2%) and washing. The main risk factors for AEB included female gender (aOR=2.86) and in working the medical (aOR=5.95), pediatrics (aOR=10.5), obstetrical (aOR=22.6), and dental (aOR=26.3) units. Despite their high prevalence, only 46.8% of AEBs were reported. Post-exposure management was carried out for 67.2% of the reported cases. Most HCWs were unaware of the existence of an Infection Control Committee within the study setting, corroborating gaps in the observance of Standard Precautions. Conclusions: Most HCWs experienced AEBs over the last year. The study underscores a critical gaps in awareness and adherence to standard precautions. There is a need to sensitize and enforce the observance of Standard precautions for infection and control among HCWs of the Buea Regional Hospital. Such measures should be extended to other satellite health facilities.

Experiences of the National Post-Exposure Prophylaxis Hotline (PEPline): Occupational PEP consultation needs and trends, 2014 to 2022

The National Clinician Consultation Center operates the Post-Exposure Prophylaxis Hotline (PEPline), a federally-funded educational resource providing bloodborne pathogen exposure management teleconsultation to US clinicians. Sixty-seven thousand one hundred nine occupational post-exposure prophylaxis (PEP) consultations (January 2014 to December 2022) were retrospectively analyzed to describe PEPline utilization and common inquiries addressed by National Clinician Consultation Center consultants. Most calls involved percutaneous incidents (70%); blood was the most common body fluid discussed (60%). Inpatient units were the most common exposure setting (35%) and licensed nursing professionals were the most common category of exposed workers (28%). Of 2,295 calls where workers had already initiated PEP for human immunodeficiency virus (HIV) prevention and time to first dose was known, 9% had initiated HIV PEP within 2hours of exposure; almost 80% had initiated HIV PEP between 2 and 24hours; 3% after 24 to 36hours; 5% after 36 to 72hours; and 2% after 72hours. Calls from urgent care providers increased by 10% over time. Overall, more than 90% of callers requested support on risk assessment, including source person testing; other common questions involved PEP side effects and follow-up care. PEPline consultations can help raise awareness about PEP availability and timely initiation, and reduce stigma by addressing common misperceptions about bloodborne pathogen transmission mechanisms and likelihood, particularly regarding HIV.

Prevalence of HIV, HBV and HCV among livestock merchants and slaughterhouse workers in Ibadan, Nigeria.

Most studies on viral infections among livestock handlers have focused on occupational exposure from inadvertent contact with infected animals. Consequently, little emphasis is given to the effect of their lifestyle on the acquisition of other blood-borne viruses. To determine the prevalence and assess risk factors for HIV, HBV and HCV infections among livestock handlers in Ibadan, Nigeria. Blood samples were collected from 265 livestock handlers between October 2016 to April 2017 in Ibadan. The samples were tested for the presence of antibodies to HIV and HCV; and surface antigen to HBV using ELISA. Structured questionnaire was administered to collect information on risk factors associated with the transmission of these viruses. Data analysis was carried out using Chi-square test and logistic regression to determine the association between risk factors and predictors of infection (p < 0.05). Of 265 participants, 11 (4.2%), 29 (10.9%) and 13 (4.9%) individuals tested positive for HIV, HBV and HCV infections respectively. Two (0.8%) of the participants were coinfected with HIV and HBV while 1(0.4%) was coinfected with both HBV and HCV. Individuals who travelled frequently in the course of Livestock trades had a higher rate of HIV infection. A high Infection with HIV, HBV and HCV is common among the study participants. There is a need for continued surveillance and awareness creation on preventive measures against these viruses.

The prevalence of pulmonary and extrapulmonary tuberculosis in forensic autopsies in a teaching hospital in South India.

An autopsy is a valuable tool for finding the cause of death, exploring the clinical diagnosis, documenting unexpected findings, and resolving diagnostic questions. However, this may subject the forensic pathologist and other workers to a wide variety of blood-borne and aerosolized pathogens. Tuberculosis (TB) is the most common cause of illness and death, resulting in infection transmission in the autopsy room. Our objective in this study was to estimate the prevalence of pulmonary and extrapulmonary tuberculosis among forensic autopsies in a tertiary care hospital in South India. We identified positive TB cases from acid-fast bacteria staining and culture (Mycobacterium Growth Indicator Tube and Lowenstein-Jensen medium) out of 380 autopsy cases. The prevalence of tuberculosis was 2.4% (n = 9), among which 2.1% of cases were positive for only pulmonary tuberculosis (n = 8), and 0.3% of cases had both pulmonary and extrapulmonary involvement (n = 1). In the bivariate analysis of TB cases, sex, occupation, family history of TB, habit of smoking, BCG vaccine scar, period of hospital stay, and cause of death were potentially significant. The prevalence of TB in forensic autopsy cases were similar to forensic autopsy-based studies, and it was less as compared to the prevalence of TB in the general population.

IJCM_321A: Circumstances and Distribution of Needle Stick Injuries among Healthcare Workers in a Medical College of Kolkata

Background: Needle-stick injuries (NSI) are common among Health- Care workers (HCWs) during execution of their patient care services and have been recognized as an important source of exposure to blood-borne pathogens. Considerable number of NSIs are not reported which prevents injured HCWs from receiving post exposure prophylaxis (PEP) against HIV, Hepatitis B and C. Objective: To assess the circumstances and reporting of Needle -stick Injuries and its association with service related and demographic variables of healthcare workers in a tertiary level hospital of Eastern India. Methodology: Descriptive, cross-sectional, hospital-based study. The study was conducted among 108 healthcare workers from 20th July to 20th August. Data were collected on Socio-demographic, Service related and events of Needle Stick Injuries and their reporting by an interviewer administered schedule. Results: About 72% study participants suffered from needle stick injury in last one year, 53.85% of them had a single event of NSI and 64% of NSI victims reported the event. Gender, educational status, occupation, vaccination status against Hep B, shift of duty during last NSI, place of last NSI were significantly associated (p value). Conclusion: Incidents of needle stick injuries were more among doctors. Participants completely vaccinated with Hep B vaccine suffered lower number of NSI.