Practice Of Post-exposure Prophylaxis Research Articles

Knowledge, Attitude, and Practice (KAP) of post exposure prophylaxis for fifth year dental students at a private Egyptian university: a cross-sectional study

BackgroundHealth care professionals including dental staff are at greater risk of occupational exposure to life threatened blood-borne pathogens. Occupational exposures will continue to occur despite improved techniques of prevention and using the post exposure prophylaxis (PEP) in these situations are of great importance. Therefore, the aim of this study was to assess the knowledge, attitude, and practice of post exposure prophylaxis for fifth year dental students at a private Egyptian university.MethodsThis cross-sectional study was conducted among 404 dental students in the fifth year at a private Egyptian university from July 2019 to March 2020. Data were collected using self-administrated questionnaires including personal information, knowledge, attitude, and practice questions.ResultsOur study showed that the total mean knowledge score was (0.45 ± 0.50), for attitude (0.70 ± 0.46), and that for practice (0.45 ± 0.50). There was no gender difference regarding PEP (P > 0.05). A total of 213 (47.5%) dental students believed that PEP should be indicated for any needlestick injury in the workplace. A number of 379 of the students (94%) chose “Yes” when asked if they thought PEP is important. While, 143 students (32.5%) were unaware of the existence of PEP service and protocol when asked about the reasons for not taking PEP after occupational exposure.ConclusionsKnowledge and practice of fifth year dental students at a private Egyptian university toward post exposure prophylaxis are not satisfactory. Awareness and curriculum modifications are important regarding PEP.

Çocuk Acil Servise Kuduz Şüpheli Hayvan Teması İle Başvuran Pediatrik Olguların Değerlendirilmesi

Aim: Rabies is a public health problem that can be prevented by vaccination and prophylaxis practices both in our country and in the world. It has a high risk of death if it cannot be prevented. In this study, we aimed to investigate the clinical and epidemiological characteristics of children admitted to the pediatric emergency department of our hospital with the suspicion of rabies. Material and Methods: In this study, patients who applied to the Pediatric Emergency Department of Eskişehir Osmangazi University Faculty of Medicine between January 2013 and June 2021 with contact with an animal with an animal at risk of rabies were evaluated retrospectively. Epidemiological and clinical features of 746 pediatric cases included in the study were evaluated. Results: 55% of 746 patients included in the study were male and the mean age was 102 months (4 months-216 months). 94% of the cases reside in the city and 6% reside in the countryside. There was cat contact in 54% and dog contact in 46% of the cases. Of the contact animals, 84% were stray and 89% were unvaccinated. While 82% of suspected rabies contacts were in category 2, 60% had upper extremity contact, and 21% had lower extremity contact. While wound cleaning was performed in all cases, rabies vaccine was administered to 99%, rabies immunoglobulin to 10%, tetanus prophylaxis to 32%, and antibiotic treatment to 21%. Immunoglobulin, antibiotics, tetanus prophylaxis, suturing and hospitalization were higher in the dog contact group than in the cat contact group. Compliance with the rabies vaccination schedule was high in both groups. Conclusion: Our study shows that the contact cases with suspected rabies are mostly with stray and unvaccinated animals, and precautions such as vaccination and housing of stray animals should be increased. Rabies, which is still a deadly public health problem for the whole world and for our country, can be prevented by vaccination, post-exposure prophylaxis practices, and community education.

Assessment of knowledge, attitude and practice of post exposure prophylaxis for HIV among nurses at Jigme Dorji Wanghuck National Referral Hospital, Bhutan.

Nurses are managing huge number of patients infected with human immunodeficiency virus (HIV), which made them highly vulnerable to HIV infection through occupational exposure such as needle stick injuries and splashing of blood/bodily fluids on mucosal surface. This made the practice of post exposure prophylaxis (PEP) for HIV crucial among nurses. Therefore, our study aimed to assess knowledge, attitude and practice of PEP for HIV among nurses in Bhutan. A cross-sectional study was conducted among 221 registered nurses working at Jigme Dorji Wangchuck National Referral Hospital, Bhutan between April and June 2017. A structured self-administered questionnaire was used to collect data and analysed using SPSS version 21. Majority (80.1%) of our participants had poor knowledge regarding PEP for HIV. Although half (51.1%) of our participants had heard about PEP, only 3 (1.4%) attended a formal training on PEP for HIV. However, a significant proportion of nurses (92.3%) had positive attitude towards PEP for HIV. Out of 221 respondents, 95(43%) had been exposed to needle stick injuries and splashing of blood/bodily fluids while managing patients. Despite significant number of exposures, only 2 (2.1%) of them took PEP and completed 28 days of prophylaxis. Lack of protective barriers at work place (56.8%) and poor knowledge on personal protective equipment (14.7%) were major perceived causes of exposure among study participants. No PEP service (30.2%) and lack of support to report incidents (22.6%) were two major reasons leading to failure of PEP practice among exposed individuals. Despite positive attitude exhibited by majority of our respondents, the level of knowledge and practice of PEP for HIV among nurses was very low. Therefore, a formal training on PEP and 24 hours accessible PEP service with proper guidelines are recommended to improve the overall knowledge and practice of PEP against HIV among nurses.

Evaluation of post-exposure prophylaxis practices to improve the cost-effectiveness of rabies control in human cases potentially exposed to rabies in southern Bhutan

BackgroundRabies is endemic in southern Bhutan, associated with 1–2 human deaths and high post exposure prophylaxis (PEP) costs annually. Evaluation of clinicians’ management of human cases potentially exposed to rabies could contribute to improving PEP prescribing practices to both reduce unnecessary costs associated with PEP and reach the target of zero human deaths due to rabies by 2023.MethodsA cross-sectional survey of 50 clinicians’ management of human cases potentially exposed to rabies was conducted in 13 health centers in high-rabies-risk areas of Bhutan during February–March 2016.ResultsData were collected on clinicians’ management of 273 human cases potentially exposed to rabies. The 50 clinicians comprised health assistants or clinical officers (55%) and medical doctors (45%) with a respective median of 19, 21 and 2 years’ experience. There was poor agreement between clinicians’ rabies risk assessment compared with an independent assessment for each case based on criteria in the National Rabies Management Guidelines (NRMG). Of the 194 cases for which clinicians recorded a rabies risk category, only 53% were correctly classified when compared with the NRMG. Clinicians were more likely to underestimate the risk of exposure to rabies and appeared to prescribe PEP independently of their risk classification.. Male health assistants performed the most accurate risk assessments while female health assistants performed the least accurate. Clinicians in Basic Health Units performed less accurate risk assessments compared with those in hospitals.ConclusionsThis study highlights important discrepancies between clinicians’ management of human cases potentially exposed to rabies and recommendations in the NRMG. In particular, clinicians were not accurately assessing rabies risk in potentially exposed cases and were not basing their PEP treatment on the basis of their risk assessment. This has significant implications for achieving the national goal of eliminating dog-mediated human rabies by 2030 and may result in unnecessary costs associated with PEP. Recommendations to improve clinician’s management of human cases potentially exposed to rabies include: reviewing and updating the NRMG, providing clinicians with regular and appropriately targeted training about rabies risk assessment and PEP prescription, and regularly reviewing clinicians’ practices.

Assessment on knowledge and practice of postexposure prophylaxis of human immuno-deficiency virus among staff nurses and paramedical workers at a tertiary care hospital in South India.

INTRODUCTION:Adequate knowledge about the presence of postexposure prophylaxis (PEP) against human immuno-deficiency virus (HIV) is imperative for health-care workers. This study focuses on the evaluation of the present knowledge and practice of nurses and paramedical workers on the post exposure prophylaxis against HIV.AIM:The aim of this study is to assess and compare the knowledge and practice of PEP against HIV among Staff Nurses and Paramedical workers.SUBJECTS AND METHODS:A descriptive cross-sectional questionnaire study about the knowledge and practice of PEP against HIV among Staff nurses and Paramedical workers done at a tertiary care hospital in South India. The analysis of the data was performed using SPSS software version 24. The statistical tests used to compare the knowledge between nurses and paramedical workers was Chi-square test. P < 0.05 was considered statistically significant.RESULTS:About 339 nurses and 66 paramedical workers participated in the study. An overall of 65.4% of the study participants had a good level of knowledge, higher (P = 0.000) among nurses (71.1%) compared to paramedical workers (36.3%). However, only 23% of nurses and 14.3% of paramedical workers received PEP after a needle prick injury.CONCLUSION:This study revealed a low-level practice of HIV PEP among staff nurses and paramedical workers despite their good knowledge. This can be improved by providing formal training sessions to the health care workers.

Knowledge, Attitude, and Practice of Postexposure Prophylaxis against HIV Infection among Healthcare Workers in Hiwot Fana Specialized University Hospital, Eastern Ethiopia.

Background Postexposure chemoprophylaxis can prevent human immunodeficiency virus (HIV) infection in risk health care workers; however routine adoption of these practices by the workers has been limited. Methods A cross-sectional study was conducted on 311 health care workers of Hiwot Fana Specialized University Hospital between February and March 2016. Data was collected using a structured self-administered questionnaire and analysed using STATA 12. Results In all, 83% of the participants had adequate knowledge of postexposure prophylaxis for HIV. All the respondents had heard about postexposure prophylaxis for HIV; however, only 37 (22.4%) workers know the definition of the postexposure prophylaxis. Among study participants, the majority of them, 272 (87.5%), knew the preferable time to initiate postexposure chemoprophylaxis. A significant number of the workers (43.4%) had an unfavorable attitude towards postexposure prophylaxis. Among 53 workers with a potential exposure to HIV, 38 (71.7%) took postexposure chemoprophylaxis and only 26 (44.8%) completed taking postexposure prophylaxis correctly. Conclusion In all, most of the health care workers had adequate knowledge about postexposure prophylaxis against HIV/AIDS. The result shows that a significant number of individuals had a negative attitude and poor practice with regard to postexposure prophylaxis. Therefore, formal training that aims to improve attitudes and support to improve postexposure prophylaxis implementation and completion are needed. We would recommend the establishment of appropriate guidelines and the supply chain to ensure the availability of postexposure prophylaxis drugs for the protection of healthcare workers with potential high risk exposure to HIV.

Determinants of appropriate knowledge on human immunodeficiency virus postexposure prophylaxis among professional health-care workers in Sokoto, Nigeria.

Introduction:The prevention of human immunodeficiency virus (HIV/AIDS) among health-care workers (HCWs) has remained a major topical issue worldwide. Accidental transmission of HIV infection to HCWs during occupational exposure is a real threat today. The study aimed to assess the knowledge, attitude, and practice of postexposure prophylaxis (PEP) among HCWs in a tertiary health institution in Sokoto, Northwestern Nigeria.Methodology:The study was carried out at Usmanu Danfodiyo University Teaching Hospital, Sokoto, through a cross-sectional descriptive study design; a total of 156 participants were recruited using a stratified sampling technique. Data were collected using a semi-structured, self-administered questionnaire and analyzed using SPSS computer software after obtaining ethical clearance from the Health Ethics and Research Committee of the teaching hospital.Results:A total of 87.2% (136) of the respondents had heard of PEP and 71.8% (112) thought that HIV/AIDs could be prevented through PEP. A total of 71.2% (111) had good knowledge about PEP, whereas 86.8% (118) had a positive attitude toward PEP.Conclusion:Although the study demonstrated high knowledge and positive attitude toward PEP, the observance of safety measures against needlestick injuries that could result in HIV infections was abysmally low. There is the need to create more awareness and strengthen the use of PEP protocol by all cadres of health workers as this will go a long way in minimizing blood-borne infections.

Assessment of knowledge, attitude and practice of post-exposure prophylaxis against blood-borne viral infection among dental surgeons in a teaching hospital

Background: This study was aimed at assessing the level of knowledge, attitude and practice of dental surgeons on human immunodeficiency virus (HIV) and hepatitis B virus (HBV) post-exposure prophylaxis (PEP).Methods: A descriptive, cross-sectional study was conducted among all the consenting dental surgeons at the University of Benin Teaching Hospital, Benin City, Nigeria, between May and July, 2015. The survey was carried out using a self-administered, anonymous, twenty-five item, and structured questionnaire.Results: A total of 40 (74.1%) males and 14 (25.9%) females responded in the study. The majority, 37 (68.5%), of the dental surgeons had inadequate knowledge about PEP. Majority of the dental surgeons, 44 (81.5%), had a good attitude towards PEP for HIV/HBV. From the study participants, 52 (96.3%) agreed on the importance of PEP for HIV/HBV in the work place. A high proportion of the respondents, 47 (87.0%), had been vaccinated against HBV. Among all of the respondents, 25 (46.3%) were exposed to HIV/HBV risky conditions. Sixteen of the 25 exposed dental surgeons, 16/25 (64.0%), did not take PEP. Among the respondents who did not take PEP, 15 of those 16 (93.6%) stated that their reason for not taking PEP was due to fear of stigma and discrimination.Conclusion: This study shows that knowledge and practice of dental surgeons towards PEP for HIV/HBV is inadequate. A formal PEP training centre with proper guidelines is recommended for dental surgeons.

Assessment of knowledge, attitude and practice of post-exposure prophylaxis against blood-borne viral infection among dental surgeons in a teaching hospital

Background: This study was aimed at assessing the level of knowledge, attitude and practice of dental surgeons on human immunodeficiency virus (HIV) and hepatitis B virus (HBV) post-exposure prophylaxis (PEP).Methods: A descriptive, cross-sectional study was conducted among all the consenting dental surgeons at the University of Benin Teaching Hospital, Benin City, Nigeria, between May and July, 2015. The survey was carried out using a self-administered, anonymous, twenty-five item, and structured questionnaire.Results: A total of 40 (74.1%) males and 14 (25.9%) females responded in the study. The majority, 37 (68.5%), of the dental surgeons had inadequate knowledge about PEP. Majority of the dental surgeons, 44 (81.5%), had a good attitude towards PEP for HIV/HBV. From the study participants, 52 (96.3%) agreed on the importance of PEP for HIV/HBV in the work place. A high proportion of the respondents, 47 (87.0%), had been vaccinated against HBV. Among all of the respondents, 25 (46.3%) were exposed to H...

A Cross-sectional Study on Hepatitis B Vaccination Status and Post-exposure Prophylaxis Practices Among Health Care Workers in Teaching Hospitals of Mangalore

BackgroundHealth care workers (HCWs) are at high risk for acquiring hepatitis B virus infection because of needle stick injury (NSI) and occupational exposures to potentially infectious bodily fluids. Hepatitis B vaccination confers protection against the infection. Very little information is available in India about current vaccination status and postexposure prophylaxis (PEP) practices among HCWs. ObjectivesThis study had 2 objectives. The first was to characterize current vaccination coverage among HCWs, and the second was to define PEP practices among HCWs after NSI and exposures to potentially infectious bodily fluids. MethodsA questionnaire-based, cross-sectional study was conducted in hospitals attached to Kasturba Medical College, Mangalore. We selected 297 individuals. A pretested, semistructured questionnaire was devised to collect information from study participants. After obtaining permission from the Institutional Ethics Committee, data were collected by interviewing HCWs in the hospitals. Analysis was done using SPSS. FindingsNearly all (93.8%) of the HCWs surveyed had taken 1 dose of hepatitis B vaccine. However, only 57.1% completed the primary series of 3 doses and only 26.4% had taken 1 or more booster doses. Of the HCWs questioned, 24.8% had experienced NSIs, exposure to potentially infectious bodily fluids, or both. Local measures were the PEP practices most commonly used (85.5%) by the HCWs. ConclusionThe present study demonstrated that there is a need in Mangalore to improve the vaccination coverage and train HCWs in appropriate PEP practices. This will protect the workers from acquiring hepatitis B infection.

Needle stick injuries and awareness towards post exposure prophylaxis for HIV among private general practitioners of Davangere city

Background: Health care workers are at increased risk of infection with blood borne pathogens. Most exposures among health care workers are caused by percutaneous injuries with sharp objects contaminated with blood or body fluids. HIV post-exposure prophylaxis (PEP) is effective in preventing potential HIV infection following accidental exposure. The objective of the study was to determine the prevalence of needle stick injuries (NSI) and factors affecting NSI among private general practitioners, awareness towards post exposure prophylaxis for HIV among private general practitioners, practice of post exposure prophylaxis for HIV among private general practitioners.Methods:The Cross-sectional, questionnaire-based study was conducted among private general practitioners of Davangere city.Results: The prevalence of needle stick injures (NSI) in the life time of private general practitioners was 92.4%. In our study all participants had heard of HIV post exposure prophylaxis (PEP). Out of 150, 12 (8 %) had accidental exposure and 8 (67%) received HIV-PEP after exposure. Out of 8, 3(38%) completed the full HIV-PEP course.Conclusions:Majority of the respondents had needle stick injuries at least once in their life time. Majority of respondents had NSI while recapping needle. Majority of the participants had good level of awareness on PEP. Despite of good level of awareness they fail to practice HIV PEP.

Assessment of attitude and practice toward post-exposure prophylaxis for HIV among healthcare workers at a tertiary care hospital

Background: Prevention and control of AIDS are now a major problem as there is no vaccine or effective-curative treatment for this disease. Health care workers (HCWs) are at increased risk for HIV infection. There were inadequate studies about post-exposure prophylaxis (PEP) of HIV among HCWs in southern India. Hence, we are conducting this study to assess the attitude and practice of PEP toward HIV among HCWs. Methods: The cross-sectional study was done among HCWs (doctors, surgeons, nurses, and dentists). Pre-tested questionnaire was given and requested to fill it after explaining the purpose of the study. About 65% and above correct answers was considered as adequate response. Values expressed as mean, proportions and analyzed by SPSS version 17. Results: Overall 6 (66%) of the total 9 questions in attitude were answered satisfactorily, and thus can be said to have good attitude regarding PEP in HIV. Only 16 people (10%) of the participants had taken PEP regimen. Among those who took PEP, the responses for the questions about the time of initiation of regimen, completion of prescribed duration of therapy and checking of HIV status after completion of regimen were unsatisfactory. Among the professions, surgeons were exposed more compared to other professions. Conclusion: Overall attitude toward PEP was positive among all the HCWs. The practice of PEP was not satisfactory even after exposure to risks. Informing HCWs about completing treatment course and post-treatment testing is important to prevent HIV transmission. Awareness of PEP should be improved among health professionals, by regular training meetings and introducing the guidelines of the safe practices in the academic syllabus of all the professions.

Awareness and practice of post-exposure prophylaxis (PEP) of HIV among health-care workers in tertiary care hospital of Haldwani, Nainital, Uttarakhand, India

Background: Human immunodeficiency virus (HIV) is a major global public health problem. Health-care workers (HCWs) are persons working in health-care setting. They are potentially exposed to infectious materials such as blood, tissue, and specific body fluids and are very vulnerable to infections mediated by blood and blood products. Objective: The aim and objective of this study is to assess the awareness and practice toward post-exposure prophylaxis (PEP) for HIV, which is an important strategy for prevention of HIV among HCWs. Material and Methods: A cross-sectional study was conducted from August 2014 to January 2015 among HCWs in tertiary care hospital. Data were collected using pre-designed, semi-structured questionnaire from study participants. Data were entered in MS Excel sheet and analyzed using SPSS v 16. Results are presented in frequencies and percentages. Results: About one-third (65.5%) of participants have heard of PEP for HIV. Ninety-nine (45%) respondents knew when to initiate PEP for HIV. Approximately, one-fourth (23.2%) of the respondents knew the maximum acceptable delay to take PEP for HIV and about half of the participants (52.7%) had knowledge regarding the duration of PEP to prevent HIV. Among all HCWs, 47 (21.4%) were ever exposed to blood or body fluids or needle stick injury and out of these only 7 (14.9%) had taken PEP. Conclusion: Awareness as well as practice of PEP for HIV among HCWs is inadequate. A training and regular sensitization of all HCWs regarding PEP for HIV is recommended to improve their knowledge.

How do Primary Health Care Workers Perceive and Practice Post Exposure Prophylaxis for HIV in Enugu State?

Background: Healthcare providers are in constant risk of exposure to Human Immunodeficiency Virus (HIV)during their routine practice. This makes it paramount to evaluate their knowledge, attitude and practice of Post-Exposure Prophylaxis (PEP). Since this will determine their likely line of action if exposed to HIV. Therefore, this study aimed to determine their level of knowledge, altitude and practice of PEP among Primary health care workers in Enugu State. Method: The study was a descriptive cross sectional study conducted in Enugu state, South East Nigeria. Data were collected from 129 health workers in 10 primary health centers using questionnaire adopted from the US guideline for the management of occupational exposure. Data was analysed using SPSS Result: About 86% (111/129) had knowledge of PEP, 92.2% (119/129) agreed that PEP reduces the risk of occupational HIV and 29% (38/129) treated themselves with PEP on exposure aggressively, while 71% (91/129) were not serious with PE treatment. On their practice of PEP, 17.8% (23/129) were frequent, 26.4% (34/129) practice is sometimes, 27.9% (36/129) were regular and 27.9% (36/129) do not practice PEP. Conclusion: The gap between the impressive knowledge or attitude on PEP by the healthcare workers and their poor practices is unacceptable. A study to determine factors that contribute to the poor practices can provide solution on how to improve on their practice and therefore, reduces the risk of getting infected when exposed to HIV.

Knowledge, attitude and practice of Post-Exposure Prophylaxis (PEP) to HIV among doctors in a Nigerian Tertiary Health Institution

Introduction: The HIV/AIDS pandemic still ranks one of the foremost causes of death in developing world. The present prevalence of HIV/AIDS is 5.0% for Sub-Saharan Africa and the Nigerian figure is 3.01%. The rate of infection of a previously non-infected individual in this sub-region is set at 160,000 individuals daily. With such a high prevalence, it of importance that caregivers and particularly medical doctors arm themselves with sufficient knowledge of postexposure prophylaxis.Design: Cross sectional descriptive study.Participants: The study took place among 81 doctors in a tertiary health institute in Nigeria, the University of Calabar Teaching Hospital.Methodology: A semi-structured questionnaire was administered to the subjects using a random sampling method. These questionnaires highlighted their departments, ages and ranks. Their levels of knowledge and indications for PEP as well as their attitudes to this procedure using a modification of the Likert Attitude Scale were also assessed. There were 15 attitude parameters and each attracted a maximum score of 5 points with a total of 75 points. Respondents were scored and the attitude scores were graded thus; negative attitude - &lt;35 points; bare positive – 36 – 50 points; positive – 51 – 65 points; super-positive - &gt;65 points. The subjects were also given an opportunity to suggest ways of improving on the practice of PEP in their various practices.Results: This showed that the knowledge of PEP was satisfactory, however only about half of the respondents mentioned specific indications for PEP. The doctors’ source of information about PEP was also too medically oriented and not broadminded enough for his position as the decision maker / head of the medical team. Respondents attitude towards PEP was positive and very important suggestions were made for better implementation of PEP.Conclusion: The knowledge of PEP is satisfactory in UCTH, Calabar and issues that need to be addressed in our practice border on of information dissemination and measures aimed at increasing the awareness of PEP in our society.KEYWORDS: Knowledge, Attitude, Post-Exposure Prophylaxis Knowledge, Attitude and Practice of post-exposure prophylaxis to HIV

Knowledge and Practice of Post-Exposure Prophylaxis (PEP) against HIV Infection among Health Care Providers in a Tertiary Hospital in Nigeria

To assess the knowledge and practice of post exposure prophylaxis (PEP) against HIV infection among health care providers in University of Abuja Teaching Hospital (UATH). A cross-sectional survey conducted on 230 health care providers in UATH. Majority (97.0%) of the respondents have heard about PEP, but only a few (30.9%) of them could correctly identify the drugs used and duration of PEP. A third of respondents have had one form of accidental exposure or the other. HIV test was carried out in about two-thirds (64.8%) of the source patients. Thirteen (28.3%) of the source patients were HIV-positive. Of the 13 respondents that were exposed to HIV-positive patients, only 3 (23.1%) received PEP, and these three completed PEP, while majority, 10/13 (76.9%) did not receive PEP in spite of their exposure to HIV-positive sources. The study shows that the knowledge and practice of PEP among health care providers are very poor.

Working with risk: Occupational safety issues among healthcare workers in Kenya

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.

EMERGEncy ID NET: an emergency department-based emerging infections sentinel network.

Acute infectious disease presentations among many at-risk patient groups (eg, uninsured, homeless, and recent immigrants) are frequently seen in emergency departments. Therefore EDs may be useful sentinel sites for infectious disease surveillance. This article describes the background, development, and implementation of EMERGE ncy ID NET, an interdisciplinary, multicenter, ED-based network for research of emerging infectious diseases. EMERGE ncy ID NET was established in cooperation with the National Center for Infectious Diseases, Centers for Disease Control and Prevention (CDC) as part of the CDC's strategy to expand and complement existing disease detection and control activities. The network is based at 11 university-affiliated, urban hospital EDs with a combined annual patient visit census of more than 900,000. Data are collected during ED evaluation of patients with specific clinical syndromes, and are electronically stored, transferred, and analyzed at a central receiving site. Current projects include investigation of bloody diarrhea and the prevalence of Shiga toxin-producing Escherichia coli, animal exposures and rabies postexposure prophylaxis practices, seizures and prevalence of neurocysticercosis, nosocomial ED Mycobacterium tuberculosis transmission, and hospital isolation bed use for adults admitted for pneumonia or suspected tuberculosis. EMERGE ncy ID NET also was developed to be a mechanism for rapidly responding to new diseases or epidemics. Future plans include study of antimicrobial use, meningitis, and encephalitis, and consideration of other public health concerns such as injury and national and international network expansion.