Transmission Of Blood-borne Pathogens Research Articles

"Politics Versus Policy": Qualitative Insights on Stigma and Overdose Prevention Center Policymaking in the United States.

Federal, state, and municipal governments in the United States have been reluctant to authorize overdose prevention centers (OPCs), which are evidence-based approaches for preventing overdose deaths and blood-borne pathogen transmission. From July 2022 to February 2023, we explored how stigma manifests in OPC policymaking by conducting in-depth interviews with 17 advocates, legislators, service providers, and researchers involved with OPC advocacy and policymaking in Rhode Island, California, Pennsylvania, and New York. We found that although jurisdictions differed in their OPC policymaking experiences, stigma manifested throughout the process, from planning to authorization. Participants described OPCs as a tool for destigmatizing overdose and substance use, yet confronted institutionalized stigma and discriminatory attitudes toward people who use drugs (PWUD) and harm reduction from multiple sources (eg, politicians, media, and members of the public). Opposition toward OPCs and harm reduction approaches more broadly intersected with public discourse on crime, homelessness, and public disorder. Employed stigma-mitigation strategies included humanizing PWUD, publicizing the benefits of OPCs to the wider community, and strategically engaging media. These findings illustrate the importance of understanding stigma at different stages of the policymaking process to better facilitate authorization and eventual implementation of OPCs in the United States.

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.

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.

1805. Tennessee’s Drug Diversion Investigation Team: A Collaborative Approach to a Growing Public Health Problem

Abstract Background Injection drug use using nonsterile equipment can lead to transmission of viral, bacterial, and fungal infections. Frontline healthcare workers (HCW) are at high risk for substance use disorder due to unprecedented job stress and access to injectable controlled substances. The Tennessee Department of Health (TDH) developed a collaborative investigative process to determine the risk of bloodborne pathogen (BBP) transmission from licensed HCWs engaging in drug diversion. This program recommends public health action and provides consultation to improve drug diversion programs. Methods In 2019 TDH formed a drug diversion investigation team (DDIT) consisting of pharmacists, epidemiologists and medical directors from the HAI and HIV/STI/Viral Hepatitis programs. The DDIT responds to notification by the Health-Related Boards (HRB) of a licensed HCW under investigation for diversion of injectable products. The DDIT interviews the investigator and meets the facility drug diversion program to review drug diversion policies and processes. Based on the suspected method(s) and, if known, the individual’s Hepatitis B/C and HIV status, recommendations are made regarding the need for patient notification and testing. Results From 2020–2022 the DDIT received notification of 49 licensed HCWs under investigation for diversion of injectable products. Patient notification and testing was recommended in seven facilities for CDC Category A infection control breaches; in two cases, later HCW testing negated the need for further action. Among the 34 facilities queried, only five (14.7%) had existing policies for for-cause BBP testing. Other recommendations to improve diversion programs include infection prevention participation and releasing “not eligible for rehire” status to other facilities. Conclusion The TDH DDIT facilitates communication with HRB on reported cases of injectable drug diversion. Joint investigations with facilities raise awareness of the risk of BBP transmission and improve facility diversion programs. Tennessee facilities are adding for-cause BBP testing to their investigation procedures. The TDH DDIT model receives mostly positive responses from facility and health system drug diversion teams and may be considered by other public health jurisdictions. Disclosures All Authors: No reported disclosures

Needle-stick Incidents among Nurses: Knowledge, Attitude, and Practices in the Workplace

This cross-sectional study assessed the knowledge, attitudes, and practices of nurses regarding needle-stick injuries (NSIs) in a public hospital in Kuala Lumpur, Malaysia. The majority of nurses exhibited good awareness of NSIs and related infections. Concerns about NSIs and sharps disposal containers were common among nurses. Most nurses practiced safe handling and disposal of needles but had room for improvement in consistent glove usage and adherence to post-exposure prophylaxis. Targeted interventions and educational programs are needed to enhance knowledge, attitudes, and practices, ensuring better workplace safety for healthcare workers and reducing the risk of blood-borne pathogen transmission.

Knowledge and Practice of Injection Safety among Nurses Working in Tertiary Health Science Institute of Eastern Nepal

Background: Injections are among the nursing procedures which are commonly performed worldwide. Unsafe injections occur routinely in most developing world regions, implying a significant potential for the transmission of blood borne pathogen. Unsafe injections currently account for a significant proportion of all new hepatitis B and C infections. This study was done to explore the factors affecting knowledge and practices and to carry out observation in selected sample. Material and Methods: A descriptive cross-sectional study design was used to conduct the study among 143 nurses working at selected wards of BPKIHS using self-administered questionnaire. The Medical, Surgical, Emergency, Orthopedic, ICU, SICU, Gynecology, Antenatal and Postnatal wards were selected purposively and the nurses were selected using population proportionate stratified random sampling. Observation of the 30 injection procedure was carried out .Collected data was analyzed using various descriptive and inferential statistics. Results: The mean age of the respondents was 25.48±3.66 years. Poor knowledge was seen among 33.6% and good knowledge was seen among 66.4% of the respondents. Similarly, good practice was observed among 11.2% and excellent practice was observed among 88.6% of the respondents. Significant association was found between knowledge and socio-demographic variables i.e. total work experience (p 0.023), vaccination against hepatitis B (p<0.001) Conclusion: The study concluded that one third of the nurses had good knowledge regarding injection safety and majority of the nurses had excellent practice. The major lacking was seen related to the steps to be taken immediate after needle stick injury, practices of recapping of the syringes and coverage of the Hepatitis B vaccination. We recommend the authority of the study setting to prioritize these components. Further participatory observation studies are required to explore factors related to the knowledge and practices of safe injection practices.

Photocatalytic Synthesis of a Polydopamine-Coated Acellular Mega-Hemoglobin as a Potential Oxygen Therapeutic with Antioxidant Properties.

Hemoglobin-based oxygen carriers (HBOCs) are being developed to overcome limitations associated with transfusion of donated red blood cells (RBCs) such as potential transmission of blood-borne pathogens and limited ex vivo storage shelf-life. Annelid erythrocruorin (Ec) derived from the worm Lumbricus terrestris (Lt) is an acellular mega-hemoglobin that has shown promise as a potential HBOC due to the large size of its oligomeric structure, thus overcoming limitations of unmodified circulating cell-free hemoglobin (Hb). With a large molecular weight of 3.6 MDa compared to 64.5 kDa for human Hb (hHb) and 144 oxygen-binding globin subunits compared to the 4 globin subunits of hHb, LtEc does not extravasate from the circulation to the same extent as hHb. LtEc is stable in the circulation without RBC membrane encapsulation and has a lower rate of auto-oxidation compared to acellular hHb, which allows the protein to remain functional for longer periods of time in the circulation compared to HBOCs derived from mammalian Hbs. Surface coatings, such as poly(ethylene glycol) (PEG) and oxidized dextran (Odex), have been investigated to potentially reduce the immune response and improve the circulation time of LtEc in vivo. Polydopamine (PDA) is a hydrophilic, biocompatible, bioinspired polymer coating used for biomedical nanoparticle assemblies and coatings and has previously been investigated for the surface coating of hHb. PDA is typically synthesized via the self-polymerization of dopamine (DA) under alkaline (pH > 8.0) conditions. However, at pH > 8.0, the oligomeric structure of LtEc begins to dissociate. Therefore, in this study, we investigated a photocatalytic method of PDA polymerization on the surface of LtEc using 9-mesityl-10-methylacridinium tetrafluoroborate (Acr-Mes) to drive PDA polymerization under physiological conditions (pH 7.4, 25 °C) over 2, 5, and 16 h in order to preserve the size and structure of LtEc. The resulting structural, biophysical, and antioxidant properties of PDA surface-coated LtEc (PDA-LtEc) was characterized using various techniques. PDA-LtEc showed an increase in measured particle size, molecular weight, and surface ζ-potential with increasing reaction time from t = 2 to 16 h compared to unmodified LtEc. PDA-LtEc reacted for 16 h was found to have reduced oxygen-binding cooperativity and slower deoxygenation kinetics compared to PDA-LtEc with lower levels of polymerization (t = 2 h), but there was no statistically significant difference in oxygen affinity. The thickness of the PDA coating can be controlled and in turn the biophysical properties can be tuned by changing various reaction conditions. PDA-LtEc was shown to demonstrate an increased level of antioxidant capacity (ferric iron reduction and free-radical scavenging) when synthesized at a reaction time of t = 16 h compared to LtEc. These antioxidant properties may prove beneficial for oxidative protection of PDA-LtEc during its time in the circulation. Hence, we believe that PDA-LtEc is a promising oxygen therapeutic for potential use in transfusion medicine applications.

Estimation of the Prevalence of Occupational Exposure to Biological Fluids among Anesthesiologists: A Survey Study.

Percutaneous injuries caused by sharps and exposure to biological fluids are a serious concern for anesthesiologists and pose a significant risk of transmission of blood-borne pathogens. The aim of this study was to estimate the prevalence of exposure to biological fluids among anesthesiologists. A questionnaire designed initially was validated after it was sent to 10 anesthesiologists with more than 5 years' experience. The validated questionnaire was then administered using Google Forms and the link was circulated electronically (e-mail, WhatsApp, and Telegram). This self-administered questionnaire was completed by 100 anesthesiologists. The various types and methods of body fluid years of exposure were also identified. The prevalence of occupational exposure to body fluids was 100%. Exposure to either blood or cerebrospinal fluids by sharps was seen in 82%. Majority of the pricks were encountered during recapping of used needles followed by pricks during intravenous cannulation. Body fluid exposure onto the bare skin most frequently encountered was blood, mostly obtained during intravenous cannulation. There were 8% patients who had exposure to human immunodeficiency virus (HIV) and hepatitis B or C patients for which they had taken postexposure prophylaxis. Prevalence of exposure to biological fluids among anesthesiologists is alarmingly high. This poses a high risk for transmission of diseases. The use of protective gears and changing our casual attitude can prevent majority of the exposures. The practice of recapping of used needles should be stopped.

At-home disposal practices of used insulin needles among patients with diabetes in China: A single-center, cross-sectional study.

Most insulin injections for people with diabetes are administered at home, thus generating many used needles. Unsafe disposal of these at-home needles can lead to needle stick injuries, blood-borne disease transmission, and environmental contamination. Previous studies have shown varying results on the prevalence of and factors associated with safe sharps disposal practices of people with diabetes. To assess the prevalence of and the factors associated with the safe disposal of used insulin needles among patients with diabetes. We collected data from 271 insulin-using patients at a tertiary care hospital in China. A self-designed instrument was used to assess sociodemographic data, disease- and treatment-related characteristics, sharps disposal practices, education on diabetes self-management and sharps disposal, and awareness of the potential risks associated with unsafe sharps disposal. Multivariate logistic regression analysis was used to explore factors associated with safe sharps disposal practices. Only 10.3% (28/271) of participants disposed of used at-home insulin needles in a safe manner, and 14.8% (45/271) of participants had received previous instruction on sharps disposal. Previous sharps disposal instruction (AOR = 4.143, 95% CI = 1.642-10.450) and awareness of the risk of blood-borne pathogen transmission (AOR = 3.064, 95% CI = 1.332-7.046) were associated with safe disposal of used insulin needles. In our study, the prevalence of safe sharps disposal practices was low, and a minority of respondents had received previous instruction on sharps disposal. Participants who had previously received instruction and were aware of the risk of blood-borne pathogen transmission were more likely to handle sharps safely. Our study findings suggest that health care professionals should pay attention to sharps disposal practices of patients with diabetes and conduct diabetes education programs that include information on safe sharps disposal methods and potential hazards of unsafe sharps disposal.

Needle Sticks Injuries (NSIs) and Hepatitis B Vaccination status among Health Care Workers (HCWs) at Asia’s Largest Trauma Care Centre in Bengaluru

Background: Needle stick injuries (NSIs) are the most common workplace-related health hazards responsible for the transmission of blood-borne pathogens among the HCWs where safety measures have not already been established. Injuries mostly occur during needle recapping, operative procedures, blood sample collection, intravenous line administration and poor waste disposal practices. Following NSIs, more than 20 blood-borne pathogens can be transmitted through body fluids. However, the most common diseases that can be potentially transmitted through body fluids are HIV, HBV, and HCV. Moreover, among the three important pathogens transmitted through NSIs, only HBV has an effective vaccine. The HBV vaccination coverage among HCWs has also been generally less, putting them at greater risk for HBV infections. This study aims to analyze the swing of voluntary reporting of NSIs among HCWs and also the HBV vaccination status among those HCWs reporting NSIs in our tertiary health-care center. Materials and Methods: A retrospective study was conducted between January 2018 and March 2020 at Asia’s Largest Trauma Care Centre in Bangalore. A standard proforma was filled by all HCWs reporting NSIs and a record of the same was maintained. Testing for HIV, hepatitis B virus surface antigen (HBsAg) and HCV was provided to the HCWs and also to the sources. HIV testing, HBsAg testing, and HCV testing were done by using rapid standard kits. All the tests were performed and interpreted according to the manufacturer's instructions. The testing for HIV 1 and 2 was done according to the National AIDS Control Organization Guidelines. The HCWs were tracked up to 6 weeks, 3 months, and 6 months for HIV and at 3 months and 6 months for HBV and HCV, consecutively after guidance, counseling and appropriate interventions. Results: A total of 34 incidents of NSIs were reported between January 2018 and March 2020 in that 11 were reported in 2018, 17 and 06 in 2019 and 2020 respectively. Majority of the HCWs 50 % had complete course of HBV vaccination, 41.17% had incomplete (1 or 2 doses) and 8.82% had not taken any course of HBV vaccination. Conclusion: The study disclosed that the collective prevalence of NSI among HCWs was high. The inadequate training of HCWs among the health care facilities might make HCWs more susceptible to injury. Therefore, the current study recommends the following measures to reduce NSIs - adequate training, simulation training to mimic everyday situations of junior staff, compulsory HBV vaccination for all the HCWs, System in place for reporting, adequate first aid facility and provision of safe working environment.

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.

Planning for injecting drug use as a means to prevent risky injection behavior

ABSTRACT Objective People who inject drugs (PWIDs) are at risk of exposure to blood borne pathogens. India has a large PWID population and the highest HIV transmission is among PWIDs. Interventions to prevent risky injection is constantly tested by the scientific community and innovations are required in this area. Methods 3748 male PWIDs were recruited into a longitudinal study. 2509 PWIDs who participated in the end of study survey, also responded to multiple open ended questions asked by the interviewers. The qualitative interviews were analyzed focusing on identifying themes and relationship among themes. Results 35.6% of the cohort had engaged in risky injection at least once. Although the project activities promoted safe injection practices among majority of the study participants; 35% is a substantial population at risk. Gaining knowledge about blood borne pathogen transmission, motivated participants to be careful about not sharing injection or paraphernalia. The belief that friends are safe made many share among themselves. Not prepared when the withdrawal set in was the main reason for sharing injection. Conclusion The project intervention had stimulating effect on the PWIDs and they tried to stop injection and follow safe injection practices. However, a failure at least once is an exposure to blood borne pathogens. Hence teaching PWIDs to plan for their injection practice and keeping materials ready at hand is important.

Needle-Stick and Sharp Injuries among Hospital Healthcare Workers in Saudi Arabia: A Cross-Sectional Survey.

Needle-stick or sharp injuries (NSIs) are critical occupational hazards for healthcare workers. Exposure to blood and body fluids through NSIs increases the risk of transmission of blood-borne pathogens among them. The objectives of this study were to estimate the annual incidence of NSIs and investigate the associated factors of NSIs among the healthcare workers in Saudi Arabia. A cross-sectional online survey was conducted between October and November 2021. A total of 361 healthcare workers participated in the survey from all over Saudi Arabia. The one-year incidence of at least one event of NSIs among the healthcare workers is estimated at 22.2% (95% CI: 18.0, 26.8). More than half of the injury events (53.8%) were not reported to the authority by the healthcare workers. Incidence of NSIs was highest among the physicians (36%) and was followed by nurses (34.8%), dentists (29.2%), and medical technologists (21.1%). The odds of NSIs was higher among the healthcare workers aged 26–30 years compared to the 20–25 years age group (OR: 2.51; 95% CI: 1.04, 6.03), as well as among the workers who directly dealt with needles or other sharp objects while working compared to those who did not (OR: 5.9; 95% CI: 2.69, 12.97). The high incidence and low rate of reporting of NSIs highlights the need of education and awareness raising programs targeting healthcare providers with higher risk of injury.

Nucleic acid testing identifies high prevalence of blood borne viruses among approved blood donors in Mozambique.

BackgroundAlthough blood transfusion is an intervention that saves lives, it poses significant risks to the blood receivers, including the transmission of bloodborne pathogens. We aimed at determining the prevalence of Human Immunodeficiency Virus (HIV), Hepatitis B virus (HBV), and Hepatitis C virus (HCV) in candidates approved for blood donation, and in samples considered to be negative in reference blood banks in Mozambique.MethodsA cross-sectional study was performed between November 2014 and October 2015 in Maputo and Beira cities. Demographic information was obtained from all consenting blood donors using a structured questionnaire. Plasma samples were screened for HIVAb/Ag combinations, HBsAg and Anti-HCV. Blood donors considered to be negative by serological testing were re-tested in pools of six plasma samples using nucleic acid testing (NAT).ResultsMost blood donors were male 2,320 (83.4%) with an age range of 18 to 34 years. The overall seroprevalence of HIV, HBV and HCV infections among blood donors approved for donation was 4.6% (127; 95% CI 3.8–5.4), 4.5% (124; 95% CI 3.7–5.3) and 0.4% (11; 95% CI 0.2–0.7), respectively. The overall frequency by NAT of HIV RNA, HBV DNA, and HCV RNA in serologically negative blood donor samples was 2.6 per 1000 blood donors (7; 95% CI 1.1–5.4); 12.5 per 1000 blood donors (33; 95% CI 8.6–17.5) and 2.6 per 1000 blood donors (6; 95% CI 1.0–5.7), respectively.ConclusionOur results show high seroprevalence of HIV and HBV infections in blood donors approved for donation, and high frequency of molecular biomarkers of HIV, HBV, and HCV in blood considered to be safe. These results suggest the need for a new blood screening policy in Mozambique, including the use of NAT to detect infectious blood donations during the immunologically negative window.

SCIG administration: A promising and patient convenient alternative for those receiving long-term IVIG.

Background: Intravenous immunoglobulin (IVIG) therapy has been used as antibody replacement therapy in primary immunodeficiency diseases (PID) for more than 50 years. In this study, we aimed to define IVIG usage and adverse reactions and complications in PID and explain how subcutaneous immunoglobulin (SCIG) replacement therapy is an alternative that improves the patient experience. In addition, the additional nursing responsibilities associated with this service were also identified.Methods: Data and service satisfaction surveys for the last 10 years were reviewed from the Allergy and Immunology Division log registry for those on IVIG and SCIG.Results: IVIG practice: Most patients currently on IVIG in our unit have PID. Adverse reactions occur during the initial 30 to 60 minutes of the infusion and are mild and self-limited. Infusion reactions are more likely to occur in patients receiving IVIG for the first time. Infusion-related complications included pyrogenic reactions, allergic reactions, and vasomotor symptoms. Complications reported in the literature such as the transmission of blood-borne pathogens and other serious complications, including thrombotic events, renal adverse events, and aseptic meningitis were never reported. Pyrogenic reactions occurred at a rate ≥ 100 mL/hr in at least 3 patients, and a slower infusion rate of ≤ 75 mL/hr mitigated this rate-related complication.SCIG program: This program started in Qatar in 2017. Usually, the clinician assesses and evaluates several factors to help select candidates for this therapy, including the perceptions of inconvenience and/or pain of IV infusions, presence of difficult vein access, and other relevant clinical and social factors. Once training in the appropriate techniques has been accomplished (3–6 sessions), it is most often self-administered in the home setting by the patient or a parent for a child. Table 1 summarizes patients on SCIG.Additional nursing responsibilities: The nursing role in subcutaneous IgG administration is primarily that of an educator and to help the patient/family become independent. This can be achieved by the assessment of appropriate patient selection for self-administration. Determining which patients are suitable include adequate patient education with return demonstration of the necessary skill set, monitoring parameters, educating patients about their medication, and providing educational resources and support.Conclusion: SCIG administration can be a convenient alternative for patients with PID receiving long-term IVIG.

A Survey on Awareness among Dentists Treating HIV Affected Patients

Aim: The aim of the present study is to create awareness among Dentists treating HIV patients.
 Introduction: Healthcare workers including physicians, dentists, nurses and laboratory workers are considered to be among the groups at the risk of blood-borne pathogen transmission. Dental treatment procedures frequently involve exposure to blood and saliva that may be contaminated with HIV. Dental care of HIV-positive individuals plays a vital role in improving their nutritional intake, medication tolerance and effectives, treatment success rate, and quality of life. The main motive of the present study was to assess the knowledge, attitude and practice towards HIV patients among dentists.
 Materials and Methods: A descriptive cross-sectional study survey was conducted among 101 dentists practicing in and around the area. It was done as an online survey. The data was collected using pre-tested self administrated 11 item questionnaire and was statistically analyzed using SPSS software version-23.
 Results: The results show that the majority of the subjects in the study population were males (55%) and remaining were females (44%).There were no significant differences between males and females in the knowledge and attitude scores.
 Conclusion: The results of the survey demonstrated a satisfactory level of knowledge and attitude of dentists about HIV/AIDS infections but some general population suggesting that higher knowledge level of dentists plays a very important role in forming the attitude and practices regarding patients with HIV/AIDS.

Prevalence of Blood-Borne Infection Among Healthcare Workers

Objectives: Needlestick and sharps injuries are a major cause of transmission of blood borne pathogens in health-care workers. The present study aims to examine the yearly incidence and causes of sharps injuries and assess the prevalence of blood-borne infection in provincial healthcare workers in Mongolia. Methods: A cross-sectional study enrolling 21 province hospitals across Mongolia was conducted from 2015 to 2019. Descriptive data presented as absolute numbers with percentage and a multivariate analysis was employed to identify the association between risk factors and occupational exposure to blood-borne factors. Results: Of the 20546 health care workers, 12.5% (n = 2566) employees were infected with hepatitis. Approximately 4.4% were infected with hepatitis B; 7.5% with hepatitis C; and 0.6% with hepatitis B, C or B, D. Among health care workers detected with hospital-acquired infection, most were women (n = 84.1%), aged between 41-55 years old (58.9%). Having sharp needlestick injuries, blood and body liquids splash, and a dental service was found to be associated with hospital-acquire infection in the study. Conclusion: Our study results demonstrated that 12 out of 100 health care workers were infected with HAI in Mongolia. This indicates that there be might serious occupational hazards. Public health authorities should consider increasing provision of public health programs such as vaccination, safety equipment and adjusted workload. Health care workers in Mongolia should be informed about the risks and consequences, as well as undertake preventive measures.

The prevalence of bloodborne infections (hepatitis B and C, human immunodeficiency virus) among pediatric patients with oncological and hematological diseases and immunodeficiencies

Patients with oncological and hematological diseases are at high risk of acquiring bloodborne infections due to multiple blood transfusions and frequent parenteral exposure. In order to evaluate the prevalence of bloodborne infections (i. e., hepatitis B, hepatitis C, and human immunodeficiency virus (HIV)), we analyzed data on the seroprevalence of these viruses in patients admitted to the D. Rogachev NMRCPHOI from 2014 to 2020. We also performed a comparative analysis between these data and the prevalence of these infections in the total child population in Russia. The study was approved by the Independent Ethics Committee and the Scientific Council of the D. Rogachev NMRCPHOI. Among patients admitted to the D. Rogachev NMRCPHOI, the mean seroprevalence was 1.7% for hepatitis C, 0.2% for hepatitis B, and 0.1% for HIV. The seroprevalence of hepatitis B and C among our patients was 6 and 50 times higher than the prevalence among Russian children and adolescents, respectively. The prevalence of HIV among patients treated at the D. Rogachev NMRCPHOI was 3 times higher than that among the child and adolescent population in Russia. In patients with oncological and immunological diseases, the detection of HBV DNA, HCV RNA, and Anti-HBc is considered clinically useful and plays an important role in the diagnosis of occult hepatitis infections which cannot be identified with routine diagnostic tests. Our study with pediatric patients with oncological, hematological, and immunological diseases highlights the problem of nosocomial transmission of bloodborne pathogens. HCV transmission in medical facilities is the most pressing issue that requires the implementation of healthcare programs aimed at preventing parenteral transmission and at ensuring the safety of donated blood.

Plasma virome and the risk of blood-borne infection in persons with substance use disorder

There is an urgent need for innovative methods to reduce transmission of bloodborne pathogens like HIV and HCV among people who inject drugs (PWID). We investigate if PWID who acquire non-pathogenic bloodborne viruses like anelloviruses and pegiviruses might be at greater risk of acquiring a bloodborne pathogen. PWID who later acquire HCV accumulate more non-pathogenic viruses in plasma than matched controls who do not acquire HCV infection. Additionally, phylogenetic analysis of those non-pathogenic virus sequences reveals drug use networks. Here we find first in Baltimore and confirm in San Francisco that the accumulation of non-pathogenic viruses in PWID is a harbinger for subsequent acquisition of pathogenic viruses, knowledge that may guide the prioritization of the public health resources to combat HIV and HCV.

A Study of Needle Stick Injuries among Nursing College Students in a Tertiary Care Hospital in Chengalpattu District, Tamil Nadu

Introduction: Needle stick injuries (NSIs) are the most potential occupational hazards among nursing personnel with possible transmission of blood borne pathogens. As nursing students are in the learning stage, they might be at higher risk of acquiring the injuries.Objectives: Todetermine the prevalence of needle stick injuries and to assess the awareness, attitude and practices followed with regard to NSIs.Methodology: An online cross-sectional study was conducted from October to December 2020 among 175 students in a nursing college in Chengalpattu district Tamil Nadu, using a pretested semi- structured questionnaire, adopting universal sampling technique. Data was analyzed using SPSS version 23. Categorical variables were summarized as Percentages and chi square test was used for statistical analysis. Results: The overall prevalence of needle stick injury among nursing college students was 16%.Final year studentsweremore exposed to the injuries(35.7%). Majority (96.57%) of the students were aware about universal precaution guidelines, 57% of students were aware about the diseases transmitted by NSI, 97.71% were aware about safety devices and 67.43% of students were aware about the post-exposure prophylaxis in management of NSIs.Among the students, 71.43% had used gloves regularly, 72% were immunized against Hepatitis B, only 25.71% of students attended Integrated Counselling Testing Centre(ICTC) and more than half of the students always practiced recapping needle after giving injections. Conclusion: Majority of the students in this study were aware about NSIs, their attitude towards NSIs was agreeable. The practices reported though assessed through online survey was found to be deficient.Periodic education and training need to be done to avoid injuries in future.