Prevalence, correlates of occupational percutaneous injuries and use of post exposure prophylaxis against HIV, Hepatitis B among health workers in Kampala, Uganda-May 201

Abstract

Introduction: Of the 3 million percutaneous exposures that occur annually among health workers (HWs), 90% are in low-income countries. The estimated average prevalence of percutaneous exposures among health workers in Uganda was 70% in 2009. However, utilization of post exposure prophylaxis (PEP) following percutaneous exposure remains largely undetermined. We determined the utilization of PEP for HIV and Hepatitis B (Hep B) following percutaneous injuries (PIs) among clinical health workers in Kampala. Methods: In a cross-sectional study, 709 HWs were selected and enrolled using multi-stage sampling from seven health facilities in Kampala City. Data were collected using a semi-structured questionnaire and a facility checklist. Modified Poisson regression modelling was used to estimate prevalence ratios (PRs) of PEP utilization. Results: One hundred and ninety-seven (28%) HWs had sustained PIs in the preceding 12 months with a Hep B vaccination prevalence of 18%. Twenty-nine (15%) of exposed HWs initiated HIV-PEP and one (0.5%) Hepatitis B-PEP. Factors associated with PEP uptake were 1-5years of professional experience (PR= 0.29 95% confidence interval (CI) (0.1-0.92)) compared to less than a year. Being an intern doctor (PR= 0.02 95% CI (<0.01-0.15)), laboratory technologist (PR= 0.05 95% CI (<0.01- 0.51)), nurse (PR= 0.09 95% CI (0.01-0.6)), medical/paramedical student (PR= 0.03 95% CI (<0.01-0.17)) compared to being a consultant. Twenty (69%) completed HIVPEP treatment and one (100%) completed Hepatitis B-PEP treatment. Six of seven health facilities lacked a reporting procedure following percutaneous injury.Conclusion: The prevalence of percutaneous injuries among clinical health workers in Kampala's public health facilities is high while the uptake of PEP therapy is still low. Kampala Capital City Authority should step up measures to ensure HW safety including mandatory Hepatitis B vaccination, occupational exposure surveillance especially targeting lower-level health facilities and HWs with a year or less of clinical experience.