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      Occupational Post-Exposure Prophylaxis (PEP) against Human Immunodeficiency Virus (HIV) Infection in a Health District in Cameroon: Assessment of the Knowledge and Practices of Nurses

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          Abstract

          Background

          Health care providers are at risk of acquiring human immunodeficiency virus (HIV) infection from occupational exposure, with nurses being the most vulnerable. There is no data on the awareness of post-exposure prophylaxis (PEP) among nurses in Cameroon. This study aimed to assess the knowledge, practices of nurses regarding PEP for HIV and their determinants in Cameroon.

          Methods

          A cross-sectional study was conducted between April and July 2013, and involved 80 nurses in a rural health district in the North West Region of Cameroon. Data was collected using a structured questionnaire and analysed using the SPSS software version 20.

          Results

          In all, 73.7% of the participants had poor knowledge about PEP for HIV. Though many (83.8%) had heard about PEP, just 10 (12.5%) had received formal training on PEP for HIV. Only 24 (30%) and 20 (25%) knew the correct drug regimen and duration of treatment respectively. The majority (85%) considered themselves to be at risk of acquiring HIV at work, with 54 (67.5%) having experienced an exposure in the past, mainly while setting up intravenous lines (57.4%), recapping needles (37.0%) and during delivery (24.1%). Of those exposed, ten (18.9%) received PEP, which was started after 24 hours in 50%. In multivariable regression analyses, awareness of hospital policy [OR: 0.043 (0.005–0.404), p-value = 0.006] was associated with Good knowledge on PEP for HIV.

          Conclusions

          The knowledge and practice of nurses on PEP for HIV in Cameroon is low. There is urgent need for training programmes and workshops to increase awareness, improve practice, and reduce the risk of HIV acquisition from work related activities among health care providers.

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          Most cited references11

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          Risks to health care workers in developing countries.

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            Assessment of knowledge, attitude and practice towards post exposure prophylaxis for HIV among health care workers in Gondar, North West Ethiopia

            Background HIV/AIDS infection in health care facility has become a major health problem. Especially in resource poor setting health care workers are managing huge number of HIV infected patients that made them to be more exposed to HIV infection. This situation makes the use of post exposure prophylaxis for HIV very important. Therefore the aim of the study was to assess knowledge, attitude and practice of health care workers towards post exposure prophylaxis for HIV. Methods Cross-sectional study was conducted among 195 health care workers from February 15 to June 20, 2012. Data was collected using self-administered questionnaire and entered and analyzed using SPSS-20 version. Results were summarized in percentages and presented in tables. Results Significant proportions of respondents, 72 (36.9%), were found to have inadequate knowledge about post exposure prophylaxis for HIV. However the majority of respondent 147 (75.4%) had good attitude toward the PEP and significant number of the respondents, 66 (33.8%), had been exposed to blood, body fluids, needles or sharp objects once or more times while giving care for patients. Among these exposed, 49 (74.2%) took PEP but the rest 17 (25.7%) didn’t take PEP. From these exposed respondents that took PEP, 23 (46.9%) correctly started taking of PEP at exact initiation time, but the rest started after the recommended initiation time. Among those who took PEP, 39 (79 .6%) completed taking the drug, however 10 (20.4%) didn’t complete the PEP regimen. Conclusion As a conclusion, significant proportion of study subjects had less knowledge and practice even though the majority of respondents had favorable attitude towards PEP. Therefore, a formal training for all HCWs regarding PEP for HIV and also establishing a 24 hour accessible formal PEP centre with proper guideline is recommended.
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              Preparing for PrEP: Perceptions and Readiness of Canadian Physicians for the Implementation of HIV Pre-Exposure Prophylaxis

              Recent evidence has demonstrated the efficacy of pre-exposure prophylaxis (PrEP) for HIV prevention, but concerns persist around its use. Little is known about Canadian physicians' knowledge of and willingness to prescribe PrEP. We disseminated an online survey to Canadian family, infectious disease, internal medicine, and public health physicians between September 2012–June 2013 to determine willingness to prescribe PrEP. Criteria for analysis were met by 86 surveys. 45.9% of participants felt “very familiar” with PrEP, 49.4% felt that PrEP should be approved by Health Canada, and 45.4% of respondents were willing to prescribe PrEP. Self-identifying as an HIV expert (odds ratio, OR = 4.1, 95% confidence interval, CI = 1.6–10.2), familiarity with PrEP (OR = 5.0, 95%CI = 1.3–19.0) and having been asked by patients about PrEP (OR = 4.0, 95%CI = 1.5–10.5) were positively associated with willingness to prescribe PrEP on univariable analysis. The latter two were the strongest predictors on multivariate analysis. Participants cited cost and efficacy as major concerns. 75.3% did not feel that information had been adequately disseminated among physicians. In summary, Canadian physicians demonstrate varying levels of support for PrEP and express concerns about its implementation. Further research on real-world effectiveness, continuing medical education, and clinical support is needed to prepare physicians for this prevention strategy.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                16 April 2015
                2015
                : 10
                : 4
                : e0124416
                Affiliations
                [1 ]Department of Medicine, Faculty of Health Sciences, University of Buea, Buea, Cameroon
                [2 ]Global Health Systems Solutions, Limbe, Cameroon
                [3 ]Department of Medicine, Faculty of Health Sciences, University of Buea, Buea, Cameroon and Department of Internal Medicine, General Hospital Douala, Douala, Cameroon and Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
                [4 ]Department of Medicine, Faculty of Health Sciences, University of Buea and Baptist Hospital, Mutengene, Cameroon
                [5 ]Tubah District Hospital, Bambui, Cameroon
                [6 ]Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON, Canada
                [7 ]Hatter Institute of Cardiovascular Research in Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
                Alberta Provincial Laboratory for Public Health/ University of Alberta, CANADA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: LNA AD. Performed the experiments: LNA NFT NMB. Analyzed the data: LNA. Contributed reagents/materials/analysis tools: LNA AD DT GA LM KS. Wrote the paper: LNA NFT AD.

                Article
                PONE-D-14-46481
                10.1371/journal.pone.0124416
                4400151
                25879442
                5144ea85-4869-4295-9c09-fdcb418f0711
                Copyright @ 2015

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

                History
                : 16 October 2014
                : 13 March 2015
                Page count
                Figures: 0, Tables: 5, Pages: 12
                Funding
                The authors have no support or funding to report.
                Categories
                Research Article
                Custom metadata
                All relevant data are within the paper.

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