Factors influencing use of post exposure prophylaxis among health care workesr after occupational; exposure to human immunodeficiency virus, Mbeya region, Tanzania 2009

Abstract

Background: Occupational exposure to blood or other body fluids in healthcare settings constitutes a small but significant risk of transmission of the Human Immune deficiency Virus (HIV) to Health Care Workers (HCWs). It is estimated that up to 1000 HIV infections are transmitted annually to HCWs worldwide. Tanzanian HCWs experience one to nine needle stick injuries (NSIs) per year, yet use of post-exposure prophylaxis (PEP) to reduce the risk of HIV transmission is undocumented. Use of PEP reduces the rate of HIV infection from workplace exposures by 81 %. To better understand this phenomenon the factors influencing use of PEP among HCWs after occupational exposure to HIV were assessed. Methods: A cross-sectional study was conducted in Mbeya referral hospital, Mbozi and Mbarali District hospitals from December 2009 to January 2010. A structured questionnaire was administered to HCWs at risk of exposure to body fluids and NSIs. Participants were randomly selected from a list of eligible HCWs in these hospitals. Data were analysed using Epi Info version 3.5.1. Stepwise logistic regression was used to evaluate factors associated with PEP use. Results: A total of 291 HCWs participated in the study with 19.2% non-response proportion. Out of291 HCWs, 102 (35.1%) were exposed to body fluids, of which needle stick injuries accounted for 62.7% (94/150). Prevalence of exposure was high among medical attendants 38.8 % (33/85). Out of exposed HCWs, 23/102 (22.5%) used HIV PEP; with females more likely to use PEP than males (1:2, M: F). Reporting of exposures (AOR=21.1, CI=3.85- 115.62), and having PEP knowledge (AOR =6.5, CI=1.78-23.99) were significant factors for PEP use. However, working departments, type of injury, age, educational level and accessibility of PEP service were not statistically significant in this study. Conclusion and recommendations: Despite the high rate of occupational exposure to HCWs in Tanzania, use of PEP is still low even though PEP drugs were available. Reporting of occupational exposures and having PEP knowledge were the factors influenced use of PEP among HCWs. Given the shortage of HCWs in Tanzania, effective prevention against HIV

IX infection in work places is required with proper training of HCWs on PEP and emphasis on timely reporting of exposures. Efforts to reduce rate of NSls among HCWs should be conducted routinely in hospitals.