History Of Needle Stick Injury Research Articles

Blood borne infections and Hepatitis B virus immunization levels among medical students in India

BackgroundMedical students are actively involved in direct patient care during their training and subsequent medical practice, making them susceptible to acquiring blood-borne pathogens, including HBV. This study aimed to assess the occurrence of blood-borne infections and the Hepatitis B immunization status among medical students. Furthermore, it sought to identify gaps in risk assessment for blood-borne pathogens among medical students at a Medical College in New Delhi. MethodsThe study included 108 medical students who participated in a blood donation camp. Blood samples collected from these individuals underwent testing for blood-borne pathogens in accordance with standard screening protocols at the blood bank. The quantitative estimation was performed for anti-HBs IgG using ELISA. ResultsAll 108 participants were pursuing their undergraduate or postgraduate medical degrees. All students tested negative for HBsAg and HIV markers and showed no reactivity to Syphilis and Malaria. However, one student tested positive for HCV. Two postgraduate students had a history of needlestick injuries. Eighty-one (75%) students had received Hepatitis B vaccination. Among the vaccinated students, 34 (41.97%) were immunized before the age of five years, 22 (27.16%) after the age of five years, while 25 (30.86%) couldn't recall the exact age of their Hepatitis B vaccination. Protective anti-HBs titer of anti-Hepatitis B antibodies (>10 mIU/ml) were detected in 48.15% (52/108) of students. ConclusionsOver 50% of medical students did not possess sufficient immunity against HBV infection, putting them at a heightened risk of acquiring HBV during their active participation in patient care in the near future. It is imperative to establish a policy for routine anti-HBs titer assessment and ensure easy access to Hepatitis B immunization for medical students, thereby enhancing their protection against this infectious agent.

Knowledge, Attitude and Practice Among Palestinian Healthcare Workers in the Gaza Strip Towards Hepatitis B: Cross-sectional survey.

Healthcare workers are at high risk of contracting hepatitis B virus (HBV). This survey aimed to identify the gaps and strengths in the knowledge, attitudes and practices of healthcare workers towards HBV to drive appropriate health interventions. This cross-sectional study was conducted between March and April 2022. A convenience sample of three at-risk healthcare professions from the major health facilities in Gaza was surveyed. A 40-item self-administered questionnaire was used. Statistical data analysis was conducted using Statistical Package for Social Sciences version 25 to obtain descriptive and inferential statistics via various nonparametric, correlation and regression tests (with P <0.05). A total of 447 healthcare workers participated in the study. Overall, 105 of the participants (23.5%) demonstrated poor knowledge (below 14/20 points) of HBV, 284 (63.5%) had moderate knowledge (14-17 points) and 58 (13%) showed good knowledge. The majority (n = 367, 82.1%) expressed an excellent attitude. Finally, 287 (64.2%) demonstrated a good level of practice regarding HBV infection. A history of needlestick injury was reported by 233 (52.1%) participants, 170 (73.3%) of whom reported taking appropriate preventive actions after exposure. The majority of the participants demonstrated overall good knowledge regarding HBV infection. Nonetheless, significant gaps remain in the different aspects of the knowledge, attitude and practice construct that require appropriate awareness campaigns to further limit the spread of this preventable viral infection.

Serological Evidence and Associated Factors of Hepatitis B Virus and Hepatitis C Virus Among Waste Handlers: A Cross-Sectional Study from Northeastern Ethiopia.

The World Health Organization (WHO) has identified viral hepatitis, caused by hepatitis B virus (HBV) and hepatitis C virus (HCV), as one of the main global public health issues. People who work in the collection of waste materials, from either household or medical environments, are at greatest risk. To determine the prevalence of and factors associated with HBV and HCV among medical and domestic waste handlers in Northeast Ethiopia. A comparative cross-sectional study was conducted from January to April 2021 at selected healthcare facilities and municipal settings in Dessie town, Northeast Ethiopia. The sample size was determined using a double population proportion formula, and a simple random sampling technique was employed to select 70 individuals in the medical waste handlers (MWHs) group and 206 in the domestic waste handlers (DWHs) group. Five milliliters of venous blood was collected from each participant and tested for HBV and HCV using an enzyme-linked immunosorbent assay. Data were analyzed using SPSS version 23; the prevalence was computed, Fisher's exact test was used, and logistic regression was applied. A total of 276 study participants were enrolled and the overall seroprevalence of hepatitis virus was 5.1%. The seroprevalence of HBV infection among MWHs and DWHs was 8.6% and 1.9%, respectively. The overall seroprevalence of HCV infections among MWHs and DWHs was 4.3% and 0.5%, respectively. Medical waste handling, having a history of needle stick injury, and not using personal protective equipment were factors significantly associated with HBV infection. The overall seroprevalence of viral hepatitis was high. The prevalence of HBV infection among MWHs was in line with the high endemicity classification of the WHO, and there was a significant difference in prevalence between DWHs and MWHs. Both groups of waste handlers should receive proper attention to protect them from HBV and HCV infection.

The predictors of occupationally related injury in employees of Pasteur Institute of Iran

Background: Needlestick Injuries (NSI) are a critical occupational risk for healthcare workers. Therefore, the present study investigated the incidence and risk factors of NSI among employees of the Pasteur Institute of Iran, one of the largest and oldest biological research institutes in the country, who are at high risk of occupational exposure to biological agents. Methods: This cross-sectional study included all personnel (565 individuals) of the Pasteur Institute of Iran. Participants answered some questions related to demographic and occupational characteristics as well as occupational exposure to blood and biological products, and occupational protection. Findings: A total of 448 questionnaires were completed. The mean age (SD) and work experience of the participants were 35.62 (9.20) and 9.72 (1.30) years, respectively. A total of 150 individuals had a history of NSI. The mean (SD) ages of participants with and without a history of NSV were 37.40 ± 9.03 and 34.41 ± 8.80 years, respectively (p &lt; 0.001). The occurrence of NSI was related to work experience of more than five years and drinking, eating, or smoking while working. In addition, changing gloves while using the telephone was significantly related to reporting the occurrence of NSI to the department manager. Conclusion: Our findings indicated the relatively high frequency of NSI among the respondents. Despite the importance of personnel training, we did not find the occurrence of NSI or reporting it to be related to attending training courses. Hence, designing efficient preventive and protective measures requires the assessment of the attitudes of the mentioned institute’s personnel toward NSI and its prevention and management.

Hepatitis B Vaccination Coverage among Bangladeshi Healthcare Workers: Findings from Tertiary Care Hospitals.

Healthcare workers (HCWs) are at a four-fold higher risk of being infected with the hepatitis B virus in hospital settings. This study investigated the hepatitis B vaccination coverage among Bangladeshi HCWs in selected tertiary care hospitals. Between September 2020 to January 2021, a multicenter cross-sectional study was conducted in 11 hospitals across Bangladesh. Participants included physicians, nurses, cleaners, and administrative staff. A semi-structured questionnaire was used to collect data through face-to-face interviews. Descriptive and multivariate statistics were used to analyze the data. The overall hepatitis B vaccination coverage was 66.6% (1363/2046) among HCWs, with cleaning staff having the lowest at 38.8%. Among the unvaccinated, 89.2% of HCWs desired to receive the free vaccine in the near future. In the last year, over one-fourth of staff (27.9%) had at least one history of needlestick injury. Only 9.8% HCWs were found to have attended training on hepatitis B virus prevention and management in the previous two years. Multivariate analysis revealed that physicians (AOR: 7.13, 95% CI: 4.94-10.30) and nurses (AOR: 6.00, 95% CI: 4.09-8.81) were more likely to be vaccinated against hepatitis B than cleaners and administrative staff. Low uptake of hepatitis B vaccination among HCWs suggests policies that require vaccination are needed to achieve optimum vaccine coverage.

Occupational exposure to hepatitis C virus infection and associated factors among healthcare workers in Fattouma Bourguiba University Hospital, Tunisia.

BackgroundHealthcare workers (HCWs) are at high risk of hepatitis C virus (HCV) infection. Indeed, they are exposed to blood and body fluid which put them at an important risk of transmission of various blood borne pathogens including HCV. The goal of this study was to determine the magnitude of occupational exposure to hepatitis C virus infection as well as the factors associated to this exposure among HCWs at a Tunisian University Hospital in 2017.MethodsA hospital-based cross-sectional study was carried out at Fattouma Bourguiba University Hospital in Monastir Governorate (Tunisia) from 01 June 2017 to 31 August 2017. Data were collected using an anonymous questionnaire. To determine factors associated with occupational exposure to hepatitis C virus infection, we performed multivariate analysis.ResultsAmong the 1493 included participants, more than half (56.7) had at least one exposure to blood or body fluid. A history of needle stick injury was reported by 48.3% of the respondents. Exposure to blood or body fluid splash into the face was announced by 32.1% HCWs. Doctors had the highest risk of exposure (AOR = 12.425; 95% CI: [05.310–29.075]). Participants working at surgical departments were the most exposed comparing to workers at others departments (AOR = 7.440; 95% CI: [4.461–12.408]). Two exposed female HCWs were tested positive corresponding to a HCV infection prevalence of 0.13% (95% IC: [0.11–0.16%]).ConclusionOccupational exposure to hepatitis C virus infection was high at the university hospital of Monastir. Despite the low magnitude of HCV infection, preventive actions should be taken to promote the safety of health care personnel.

Incidence, Knowledge, Attitude and Practice Toward Needle Stick Injury Among Health Care Workers in Abha City, Saudi Arabia.

BackgroundA needle stick injury is a serious occupational health hazard in health care settings. Health care workers are at risk of bloodborne diseases and the psychological consequences of these injuries. This study aims to estimate the incidence of needle stick injuries among healthcare workers during the previous 12 months and to assess their knowledge, attitude, and practice toward these injuries.MethodsThis cross-sectional study was conducted from 1st August 2019 till 15th February 2020, and included 786 healthcare workers in Abha city, Saudi Arabia. A structured questionnaire was used to collect the data.ResultsThe incidence of needle stick injury among healthcare workers during the previous 12 months was (91/786) 11.57%. Nurses, females, and Saudis reported most needle stick injuries. More than half (52.7%) of the injuries went unreported. About 52.7% of needle stick injuries occurred during using sharp devices, and 42.9% of injuries happened in the patient room. The incidence of needle stick injury was significantly higher among those working at the secondary healthcare level (p = 0.003) and those practicing surgery (p < 0.001). Out of 786 participants, 94.7% knew the definition of needle stick injury, and 81.0% were aware of the procedure and guidelines to follow on sustaining a needle stick injury. Only 61.2% recognized that the recap of the needle is not recommended. Almost half of the participants (47.1%) agreed, and 33.6% strongly agreed that needle stick injury is preventable. A majority of healthcare workers (89.1%) had been vaccinated against Hepatitis B. Nearly 27.5% of healthcare workers incorrectly practiced recapping the needles with two hands and 8.7% bent needles before disposal. Recapping the needles was statistically significantly higher among healthcare workers who had a history of needle stick injury (p = 0. 046).ConclusionNeedle stick injury and its under reporting among healthcare professionals is still a prevalent risk. Raising awareness among healthcare workers and improving the reporting systems for needle stick injuries to ensure more protection and early use of post-exposure prophylaxis is required. Implementation of safety precautions and safe injection practices and providing engineered safety devices may further reduce the risk.

“Egg in the eye appearance” of traumatic pre-existing posterior capsular defect presenting as near-total cataract

A 10-year-old girl was brought by her parents with complaints of a sudden drop in vision in the left eye (LE) with the appearance of a white reflex for a 1-month duration. There was a history of needle stick injury to the LE 5 years ago which was conservatively managed elsewhere. Previously, she had a vision of 6/9, N6 LE, with glasses as per her old records. The best corrected visual acuity (BCVA) was 6/6, N6 right eye (RE), hand motion (HM), and <N36 LE at the time of presentation. There was a small corneal scar at the 3 o'clock position in the peripheral cornea of the LE. Dilated examination of LE revealed near-total cataract, an intact anterior lens capsule, and a large elliptical area of pre-existing posterior capsular defect (PPCD) resembling an “egg in the eye appearance” [Figure 1]. Ultrasonography (USG) B scan of the LE showed the characteristic “fishtail sign” and confirmed the herniation of the lens matter through posterior capsular dehiscence into the anterior vitreous cavity [Figures 2 and 3] with an intact retina.Figure 1: Intra-operative picture of the LE taken after nicking the anterior capsule showing the fibrosed edges of the large elliptical posterior capsular dehiscenceFigure 2: Ultrasound B scan of the LE showing conical protrusion of the breached posterior lens capsuleFigure 3: Ultrasound B scan of the LE showing “fishtail sign” with herniation of the lens matter into the anterior vitreous cavity through the posterior capsular dehiscenceThe patient underwent a careful continuous curvilinear capsulorhexis (CCC), bimanual irrigation–aspiration of the lens matter, and anterior vitrectomy with reduced parameters of low bottle height, low irrigation, and aspiration, taking care to avoid hydro-dissection and shallowing of the anterior chamber. Intra-operatively, the large posterior capsular dehiscence [Figure 4] was carefully evaluated and cleared off any vitreous incarceration. A foldable three-piece intraocular lens (IOL) was implanted in the ciliary sulcus [Figure 5]. Post-operatively, the patient did well and regained 6/6, N6 vision in the LE, and remained the same until the last follow-up after 1 year [Figure 6].Figure 4: Intra-operative picture of the LE showing the large elliptical posterior capsular defect after lens aspirationFigure 5: Intra-operative picture after intraocular lens implantation into the LEFigure 6: Clear visual axis on follow-up after 1 yearDISCUSSION The history of past needle stick injury in our patient with sudden transformation into near mature cataract later points toward the presence of a PPCD which gradually caused microleakage and rapid maturation of the cataract. A dilated examination using a slit lamp and under an operating microscope helped to identify the thick, well-demarcated, elliptical borders of the PPCD, through the near-total cataract simulating an “egg in the eye” appearance. The thickened and fibrosed margins of the PPCD have been attributed to the migration of the hyperplastic epithelial cells to this region.[1] USG B scan confirmed the PPCD with lenticular matter hanging in the vitreous cavity (fishtail sign).[2] Other clinical signs which have been described in the literature include white demarcation lines and white crystalline particles floating in the vitreous, but they may not be evident in all white cataracts with PPCDs.[2] A relatively smaller CCC, closed-chamber bimanual irrigation–aspiration with reduced parameters (low bottle height, irrigation, and aspiration), avoiding hydro-dissection and shallowing of AC, controlled anterior vitrectomy, and switching between the cut and aspiration modes to remove the prolapsed lens matter and vitreous are essential to ensure a clear visual axis and safe IOL implantation.[2] CLINICAL SIGNIFICANCE All total cataracts are not the same, and surgery without a thorough history, careful examination, and proper planning could be catastrophic to the patient. Surgical management in pediatric cataracts with PPCD remains a challenge due to the increased risk of lens matter drop in the vitreous cavity. Identifying the PPCD, explaining the potential risks to the patient, and taking adequate precautions to avoid lens matter drop are vital steps to a successful outcome. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient and her parents have given their consent for images and other clinical information to be reported in the journal. The patient and her parents understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest. Acknowledgements The patient and her parents are acknowledged.

Sero-Prevalence of HBV and its Associated Factors Among Healthcare Providers in Public Health Facilities in Eastern Ethiopia.

Background:Healthcare providers are in high occupational risk of Hepatitis B virus infection than that of the general population because of the high risk of occupational exposure to patients’ body fluids and accidental sharp injuries. There are no large facility-based studies conducted on the prevalence of HBV infection and its associated factors among health care providers in eastern Ethiopia.Objective:This study aimed at investigating the seroprevalence of Hepatitis B Virus and its associated factors among the healthcare providers in public health facilities in eastern Ethiopia.Methods:A facility-based cross-sectional study was conducted among 438 randomly selected healthcare providers in eastern Ethiopia from March to June 2018. Pretested structured questionnaire was used to collect data on socio-demographic characteristics and other risk factors. In addition, a 2.5 ml blood was collected and the serum was analyzed for Hepatitis B surface antigen using the Instant Hepatitis B surface antigen kit. Data were entered using Epidata version 3.1 and analyzed using SPSS statistical packages version 22. Descriptive summary measures were used. Bivariate and multivariable logistic regression was conducted at 95% CI. An association at P-value <.05 was considered statistically significant.Results:A total of 438 (92.02% response rate) health care providers have participated in this study. The prevalence of hepatitis B virus infection was 9.6%. There were no significant differences in the HBV infection rates among healthcare providers with respect to socio-demographic characteristics (P-value >.05). After adjusting for some variables, the following variables remained statistically significantly associated with HBsAg positive result in the multivariable analysis: exposure to body fluids (AOR = 3.0; 95% CI [1.25, 7.05]), history of needle stick injury (AOR = 4.70; 95% CI [2.10, 10.55]), history of operation/surgery (AOR = 4.88, 95% CI [1.43, 16.62]), history of multiple sexual partner (AOR = 7.48; 95% CI [2.08, 26.96]), and being unvaccinated (AOR = 6.09; 95% CI [2.75, 13.51]).Conclusion:This study showed a high prevalence of HBV infection among health care providers in eastern Ethiopia. This is significant because health professionals may be at increased risk of chronic complications and may also be source of infection for their clients and general population during their healthcare practice. Management commitment that should focus on occupational safety and health promotions is necessary.

Hepatitis B virus infection among patients with Rheumatoid Arthritis in Suez Canal University Hospital

Background: About 350 million individuals are considered having hepatitis B virus (HBV) infections worldwide, and 6.8% of cases have been observed of a reactivation of HBV triggered by immunosuppressive medications. Due to HBV reactivation, biologic or non-biological Synthetic antirheumatic disease-modifying drugs may be involved. For rheumatologists, HBV infection is a big concern. Patients and Methods: A descriptive cross-sectional study was carried out at Rheumatology outpatient clinic at Suez Canal University Hospital, Ismailia, during the period from 22 of January to 30 of July 2020 and included 200 patients with a history of Rheumatoid Arthritis. Patients were asked about their demographics and possible risk factors, and blood samples were collected for detection of HBV markers. Results: Evidence of present or past HBV infection with positive anti-HBc was found in 12% of patients (n=24). Among them, 4 patients had Overt HBV infection with positive HBsAg (2%) and another 4 patients had Occult hepatitis B, with negative HBsAg and positive HBV DNA (2%). Regarding HBV vaccination status, we found that 4 patients (16.7%) of HBc Ab positive patients were vaccinated and 69 patients (39.2%) of HBc Ab negative patients were vaccinated. Conclusion: This research indicates that HBV among rheumatoid arthritis patients is comparatively prevalent. Moreover, HBV carriers experience rheumatological symptoms. Risk factors for HBV infection in patients with Rheumatoid Arthritis included history of needle stick injury, dental visits, and prior surgical procedures.

Hepatitis B virus infection and associated risk factors among medical students in eastern Ethiopia.

BackgroundHepatitis B virus (HBV) is a highly contagious pathogen that has become a severe public health problem and a major cause of morbidity and mortality, particularly in developing countries. Medical students are at high occupational risk during their training. However, no facility-based studies were found among medical students in eastern Ethiopia. Thus, this study aimed to investigate the seroprevalence of Hepatitis B Virus and associated factors among medical students in eastern Ethiopia.MethodsA facility-based cross-sectional study was conducted among 407 randomly selected medical students from March to June 2018. A pretested and structured questionnaire was used to collect data on socio-demographic characteristics and other risk factors. A 5ml blood was collected, and the serum was analyzed for Hepatitis B surface antigen (HBsAg) using the Instant Hepatitis B surface antigen kit. Data were entered using Epidata version 3.1 and analyzed using SPSS statistical packages version 22. Outcome and explanatory variables were described using descriptive summary measures. Binary and multivariable logistic regression was conducted at 95% CI and an association at P-value < 0.05 was declared statistically significant.ResultsThe seroprevalence of hepatitis B virus surface antigen was 11.5% (95%CI = 8.6, 14.7). Poor knowledge of universal precaution guideline (AOR = 2.58; 95% CI = [1.35–4.93]), history of needle stick injury (AOR = 2.11; 95% CI = [1.07–4.18]) and never been vaccinated for HBV (AOR = 2.34; 95% CI = [1.17–4.69]) were found statistically significantly associated with HBsAg positivity after multivariate analysis.ConclusionHepatitis B virus infection rate is high among health care trainees in eastern Ethiopia. Improvement at health care practice centers safety through training on universal precaution guidelines, and scaling up HBV vaccination is mandatory.

Magnitude and Associated Risk Factor of HBV Virus Among Pregnant Mothers Attending Antenatal Care in Debre Tabor Referral Hospital; Northwest Ethiopia

<i>Background</i>: Hepatitis is a contagious liver disease caused by Hepatitis B virus. When a pregnant mother infected, the Hepatitis B virus can stay in the body and Vertical transmit to baby and develop chronic liver disease. In regarding to this Neonatal immunization interrupts this vertical transmission and used to take preventive action. For that reason, this study was undertaken with the aim of determine the magnitude and predisposing factors of HBV infections among pregnant women. An institutional based cross-sectional study was conducted 333 pregnant women attending ANC from September 2020 to November 2020 at Debre Tabor Referral Hospital antenatal care clinic. Appropriate sample was collected; serum separated and tested with ELISA test for the detection of HBsAg. Fishers exact test was employed to see the association between variables as well as Logistic regression were applied to identify potential risk factors (P-value < 0.05) was considered as statistically significant. A total of 333 pregnant women within 100% response rate; were enrolled in this study and the magnitude of HBV infections found to be were (22.2%). among the potential risk factors multiple sexual behavior (AOR 3.096), 95% CI=1.469-6.525, <i>P-value</i>=0.003), shaving habit (AOR 3.375, 95% CI=1.511-7.538, <i>P-value</i>=0.003), a history of needle stick injury (AOR 4.080, 95% CI=2.041-8.156, <i>P-value</i>=0.000), history of common usage of Sharpe materials (AOR 8.229, 95% CI=3.991-16.967, <i>P-value</i>=0.000) and history of home delivery by traditional attendants were (AOR 1.557, 95% CI=0.621-3.899, <i>P-value</i>=0.000) were significantly associated with important predictors of hepatitis B infection. <i>For that reason</i> this study showed high endemicity of HBV infection among pregnant women. Multiple sexual practices, history of home delivery, needle stick injury, common usage of Sharpe materials and shaving habit were major factors for hepatitis B virus transmission. Thus, scaling up of screening pregnant women for HBV infection and provision of health education about risk factors and testing all pregnant mothers for hepatitis B virus should be a regular feature of the ANC service. Other community studies, as well as screening HBV antigen marker conducting, will play an important role in accurately determining the true spread of hepatitis B virus in the general population.

Assessment of Knowledge, Attitude and Practice among House Officers in UKM Medical Centre on Needle Stick Injuries

Needle stick injury is one of the most serious occupational hazards among house officers in which it may lead to possible severe consequences such as HIV, Hepatitis B, and C infection. The aim of the study was to explore and compare the knowledge, attitude and practice (KAP) among house officers of UKM Medical Centre (UKMMC) regarding needle stick injury. A cross-sectional study was conducted with the total of 151 self-administered questionnaires from house officers in UKMMC within the period of five months. The data was collected via universal sampling method. Components evaluated were prevalence, demographic data and scores on KAP concerning needle stick injury among house officers. Out of the 151 house officers recruited for the study, 34.9% of them had a history of needle stick injury during their practice, with 6.7% of the injury that occurred in their current posting department. There was a significant association (p<0.05) between history of needle stick injury and the practice of house officers (p=0.035). House officers with a history of needle stick injury had a lower mean score of practice (8.65 ± 2.00) compared to those without history (9.40 ± 1.09). This study also demonstrated that there were significant correlations between Knowledge-Practice (r=0.194, p=0.018) and Attitude-Practice (r=0.182, p=0.026) of UKMMC house officers. These findings demonstrated that a good level of knowledge and attitude results in better practice of house officers hence reducing the incidence of needle stick injury. Therefore, suitable health education programs with regards to needle stick injury and preventive measures should be intensively implemented on all house officers prior to and during their practice.

Occupational exposures to blood and body fluids among health care workers in Tunisia

Abstract Background Occupational exposures to blood and body fluid are among the most frequent occupational accidents in healthcare. They put healthcare workers (HCWs) at high risk of transmission of many blood borne pathogens mainly hepatitis B virus (HBV), hepatitis C virus HCV and HIV. The aim of this study was to determine the prevalence of occupational exposures to blood and body fluids and its associated factors among HCWs at the university hospital of Monastir (Tunisia) in 2017. Methods An exhaustive cross-sectional study was conducted from 01 June 2017 to 31 August 2017 at the university hospital in Monastir Governorate (Tunisia). An anonymous self-administered questionnaire was used to collect data on demographic characteristics, self-reported exposures and their circumstances. We performed a multivariate analysis to determine the associated factors to these occupational exposures. Results A total of 1493 HCWs (34.6% nurses 22% technicians and 21.6% doctors) were included corresponding to a response rate of 74%. The median age of the participants was of 36 years (IQR: 31- 46 years). The sex ratio was of 0.36. Responders from medical and surgical departments represented respectively 40.5% and 39%. Among interviewed HCWs, 56.7% reported having at least one exposure to blood or body fluid with 35.4% of them exposed twice or more. Almost half (48.3%) of the respondents had a history of needle stick injury and 32.1% had a history of blood or body fluid splash into the face.The multivariate analysis showed that doctors had the highest risk of exposure comparing to other HCWs with (AOR = 12.425; 95% CI: 05.310 - 29.075) and participants working at surgical departments were at higher risk of exposure than those at others departments (AOR=7.440; 95% CI: 4.461 - 12.408). Conclusions Health occupational exposures to blood and body fluids are a serious problem at the university hospital of Monastir. Preventive measures should be strengthened to alleviate this problem. Key messages Doctors had the highest risk of exposure to blood and body fluids comparing to other HCWs at the university hospital of Monastir. Preventive measures should be strengthened to alleviate this problem.

Screening and linkage to care for medical students with hepatitis B virus infection in Sierra Leone

PurposeHepatitis B virus (HBV) infection is considered a major public health concern for Sierra Leone. Although medical students are at increased occupational risk for HBV infection, little is known about the burden of HBV infection amongst medical students in Sierra Leone. MethodsAs part of a screening and vaccination campaign, a cross-sectional study on prevalence of HBV among medical students in Freetown was conducted in December 2019. Antigen point of care test was used for HBV screening and data on students' risk history and demographics were collected. Additionally, for students diagnosed positive with HBV, linkage to care and initial assessment data after diagnosis was collected from the HBV clinic they were linked to. ResultsOne hundred and fifty-seven medical students (77.3%) from year three to six were screened for HBV infection. Almost all students (98.1%) had never been vaccinated against HBV and more than half (56.7%) reported a history of needle stick injuries. The prevalence of HBV infection (Hepatitis B surface antigen (HBsAg) positivity) was 10.2% (n = 16). Among HBsAg positive students, 75% (n = 12) were successfully enrolled at chronic HBV clinic within three months of diagnosis. Only one student had evidence of liver cirrhosis and was started on treatment with Tenofovir diproxil fumarate. ConclusionThe prevalence of HBV infection is high among medical students in Sierra Leone. Despite the high prevalence, most of the students linked to care had no evidence of severe liver disease.

An investigation of insulin injection-related needlestick injuries among clinical nurses in Hunan, China

Objective: To investigate the incidence rate of insulin injection-related needlestick injuries, links causing such injuries, and reporting of occupational exposure among nurses in the wards of general hospitals in Hunan, China. Methods: From January 2017 to March 2019, stratified cluster sampling was performed to select 4368 nurses as respondents from 54 hospitals at different levels in 14 prefectures and cities of Hunan. The current status of insulin injection-related needlestick injuries was investigated, including the high-risk links causing insulin injection-related needlestick injuries during the use of insulin syringe (pen) , time and number of needlestick injuries, infection after needlestick injuries, and reporting of needlestick injuries, and a statistical analysis was performed. Continuous data were described as mean±standard deviation, and categorical data were described by percentage (%) . Results: Among the 3697 nurses who were investigated, 1419 (38.4%) once had needlestick injuries related to insulin injection, among whom 413 (29.1%) had needlestick injuries in the past 1 year. The mean number of insulin injection-related needle stick injuries was 1.92±1.80, with a mean number of 0.57±1.18 caused by insulin syringe, 1.30±1.15 caused by the anterior segment of insulin pen, and 0.32±0.81 caused by the posterior end of insulin pen. Among the 1419 nurses with a history of needlestick injuries, 90 (6.3%) had related infection, mainly HBV infection, and after the occurrence of needlestick injuries, 26.0% (369/1419) of these nurses reported it every time and 15.2% (215/1419) never reported it. "Fear of trouble" was the main reason for no reporting (69.1%, 980/1419) , followed by "the thought of no risk" (43.2%, 613/1419) and "no related policy in hospital" (10.9%, 154/1419) ". Among these 1419 nurses, 49.8% (706/1419) were treated according to the standard process for needlestick injuries in hospital every time, and 3.6% (51/1419) did not know such process or there was no such standard process. Conclusion: The current situation of insulin injection-related needlestick injuries is not optimistic among clinical nurses in Hunan, and the incidence rate of needlestick injuries cannot be ignored.

Knowledge, attitude, and practice towards Hepatitis B infection among nurses and midwives in two maternity hospitals in Khartoum, Sudan

BackgroundHepatitis B virus (HBV) infection creates a global health burden with significant morbidity and mortality. Healthcare workers, including nurses and midwives, are at higher risk of acquiring the disease. While health-related behaviours are affected by different aspects of knowledge, attitude, and practices (KAP), there are few studies examining the KAP level of healthcare workers towards HBV infection in Sudan. The purpose of this study was to examine the KAP level of nurses and midwives towards HBV virus infection in Khartoum, Sudan.MethodsA cross-sectional descriptive hospital-based study was conducted in two public maternity hospitals (Saudi and Saad Abul-Eleella hospitals) in Khartoum state of, Sudan. A pre-tested structured questionnaire was constructed and implemented to examine KAP towards HBV infection. Statistical Package for Social Sciences (SPSS) version of 21 was utilized to conduct statistical analysis and examine the data at hand. Chi-square test was used implemented to determine the relationship between categorical variables.ResultsA total of 110 nurses and midwives from the both hospitals participated in this study. More than half of the respondents (58.2%) had an average level of knowledge, two-third of the respondents had a safe practice, and the majority of the respondents had a favourable attitude towards HBV preventive measures. Approximately half of the participants (51.8%) had a history of needle stick injuries. Half of the participants had inaccurate concepts about post exposure prophylaxis to HBV infection, while more than half of the nurses and midwives didn’t complete the vaccination schedule for HBV.ConclusionMost of the nurses and midwives in Saudi and Saad Abul-Eleella hospitals were aware of HBV infection. However, a significant proportion of the participants lack the requisite knowledge about post exposure management. The study revealed a low level of HBV vaccination coverage rate and a high rate of needle stick injuries. Further strategies for preventing workplace exposure, training programs on HBV infection, including post exposure prophylaxis, and increasing vaccination coverage rate of all HCWS are highly recommended.

Determinants of Needle Stick Injuries Among Healthcare Providers at a Tehran University Hospital in 2016: A Descriptive Report.

Needle Stick Injuries (NSIs) are the most common occupational injuries among HCWs. The aim of this study was to explore the prevalence and distribution of determinants for such injuries in a university hospital in Tehran, Iran, in 2016. We conducted a descriptive cross-sectional study in Ziaeian Hospital, a teaching hospital of Tehran University. The medical records of 55 Health Care Workers (HCWs) who experienced NSIs in 2016, were extracted from the hospital registry and analyzed using SPSS version 22. Available data of 55 HCWs with a history of NSIs were extracted from the hospital registry. The highest number of NSIs belonged to registered nurses (34.6%), licensed practical nurses (14.5%) and medical doctors (12.7%), respectively. The majority of the NSIs occurred in the morning shift (50.9%) followed by night shift (36.4%) and evening shift (12.7%). Most of the NSIs occurred in the emergency department (38.1%) and operating room (18.2%). The healthcare workers reported fatigue as the most common reason for being injured by needles (67.4%). All the HCWs were trained and familiarized with the safety and risk control measures after needle stick exposures in the hospital. The present study described the determinants of NSIs among HCWs in a university hospital. The fatigue and working overload were the main reasons for NSIs. The results of this study could be used to address the shortcoming in the guidelines and protocols to ensure the sustainable safety measures that could reduce the occurrence of the NSIs in hospitals in Iran.

Knowledge, attitudes and behaviour towards needlestick injuries among junior doctors.

Needlestick injuries (NSIs) are common healthcare-related injuries and possible consequences include blood-borne infections. Despite that, a large proportion of NSIs are not reported. To estimate the prevalence of under-reporting of NSIs and to evaluate the knowledge, attitude and behaviour towards NSIs among junior doctors in a tertiary hospital in Singapore. An explanatory sequential mixed-methods design was employed. Quantitative data were collected through questionnaires completed by 99 junior doctors. Descriptive statistics and bivariate analysis were performed to evaluate socio-demographic characteristics, NSI history and NSI reporting practices. Qualitative data were collected through 12 in-depth interviews. Participants were purposively recruited, and semi-structured topic guides were developed. Data were analysed using a thematic approach. Fifty-two per cent of respondents had history of NSI. Of those with history of NSI, 31% did not report injury. NSI reporters were 1.52 times as likely to be aware of how to report injury (P < 0.05), and 1.63 times as likely to feel that reporting benefits their health (P < 0.01) compared with non-reporters. NSI reporters were 83% more likely to report a clean NSI (P = 0.05). For non-reporters, the main reasons for not reporting were perceived low risk of transmission (41%) and lack of time to report (35%). Themes identified in the qualitative data include perceived benefits, perceived barriers, perceived threats, cues to action and organizational culture. Under-reporting of NSIs may have significant implications for patients and healthcare workers. Addressing identified factors and instituting targeted interventions will help to improve reporting rates.

Knowledge and practice of injection safety among healthcare workers in a Nigerian secondary healthcare facility

Injection safety is important in today’s healthcare delivery particularly in settings with a high burden of blood-borne viruses. A safe injection protects the patient, the healthcare worker and the community from avoidable infections. In Nigeria, the national policy on injection safety and healthcare waste management were developed in 2007. The development of the policy was followed by series of training on safe injection and behavioural change. Despite this, high burden of unsafe injections was reported in many parts of the country. This study assessed the level of knowledge and practice of injection safety among healthcare workers in a secondary healthcare facility in north-western Nigeria. The study targeted all the healthcare workers employed in the hospital. A self-administered questionnaire was distributed to all the available healthcare workers. &#x0D; A total of 80/88 questionnaires were returned and analysed. Majority of the respondents were male in their early career who were within the age range of 31-40years. The results showed that 88.75% of the healthcare workers correctly described injection safety as defined by the WHO. However, only 18.75% and 40.0% had good knowledge of risks associated with, and diseases that can be transmitted through unsafe injections respectively. In addition, only 25.0% reported safe injection practices. Reuse of syringe was reported by 37.50% of the respondents and over 88% recap used needles. Majority of the healthcare workers reported a previous history of needlestick injury which was not associated with their professional cadre p-value = 0.146.&#x0D; Despite injection safety training, inadequate knowledge with poor injection practice was found among the surveyed healthcare workers. The reuse of syringes and needles underscores the need for adequate and safe injection commodities at all levels of healthcare delivery. &#x0D; &#x0D; Keywords: healthcare workers, injection safety, knowledge, practice