Hepatitis B vaccination status and Needle-stick and Sharps-related Injuries among medical school students in Nepal: a cross-sectional study

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Abstract

Background

Hepatitis B is a dreadful infectious disease and a major global health problem. Health-care workers including clinical students are more vulnerable to such infections and non-sterile occupational exposures as their daily activities are closely related to patient’s blood and body fluids.

Methods

A descriptive cross sectional study was conducted at B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal from July till October 2012. All medical, dental and nursing students were surveyed for their Hepatitis B vaccination status and only those students in clinical rotations were surveyed for the prevalence and pattern of Needle-stick and Sharps-related Injuries (NSSIs) using a pre-tested, semi-structured, self-administered questionnaire. Descriptive and inferential statistics was used to analyze the data.

Results

Majority (86.5%) of students were vaccinated against Hepatitis B of which 83.7% had completed full doses. Among non-vaccinated students, 43.2% reported the main reason for non-vaccination as lack of vaccination programs. Out of 210 respondents from clinical rotations, 90 students (42.8%) reported at least one injury. Among those injured, two students reported exposure to Human immunodeficiency virus (HIV) positive cases and four to Hepatitis B virus (HBV) positive cases. Most of the injuries (44%) occurred during Internal Medicine rotation and the most common sharp involved (56.3%) was Hypodermic needle. Most injuries (35.6%) occurred while manipulating needle into patients. Following exposure, only 11.4% took Post exposure prophylaxis and 19.54% went for a Post-exposure serology test.

Conclusions

Needle-stick and Sharps-related Injuries occur frequently among health care workers including trainee students keeping them at high risk for acquiring dreadful infections like HBV, HCV and HIV. They need to be protected from unwarranted hazards by adopting routine Hepatitis B vaccination programs and by reinforcing education regarding universal precautions.

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Most cited references 17

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Occupational exposure to blood and risk of bloodborne virus infection among health care workers in rural north Indian health care settings.

Damien Jolley, M. Thomas, Michelle Kermode … (2005)

Approximately 3 million health care workers (HCWs) experience percutaneous exposure to bloodborne viruses (BBVs) each year. This results in an estimated 16,000 hepatitis C, 66,000 hepatitis B, and 200 to 5000 human immunodeficiency virus (HIV) infections annually. More than 90% of these infections are occurring in low-income countries, and most are preventable. Several studies report the risks of occupational BBV infection for HCWs in high-income countries where a range of preventive interventions have been implemented. In contrast, the situation for HCWs in low-income countries is not well documented, and their health and safety remains a neglected issue. To describe the extent of occupational exposure to blood and the risk of BBV infection among a group of HCWs in rural north India. A cross-sectional survey of HCWs from 7 rural health settings gathered data pertaining to occupational exposure to blood and a range of other relevant variables (eg, demographic information, compliance with Universal Precautions, perception of risk, knowledge of BBVs). A mass action model was used to estimate the risk of occupational BBV infection for these HCWs over a 10-year period. A total of 266 HCWs returned questionnaires (response rate, 87%). Sixty-three percent reported at least 1 percutaneous injury (PI) in the last year (mean no. = 2.3) and 73% over their working lifetime (mean no. = 4.2). Predictors of PI during the last year were hospital site, job category, perception of risk, and compliance with Universal Precautions. The high level of occupational exposure to blood found among this group of rural north Indian HCWs highlights the urgent need for interventions to enhance their occupational safety to prevent unnecessary nosocomial transmission of BBVs.

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Occupational Exposure to Blood and Body Fluids Among Health Care Workers in a Teaching Hospital in Mumbai, India

Samir A. Singru, Amitav Banerjee (2008)

Objective: Exposure to blood and body fluids is one of the hidden hazards faced by health care workers (HCWs). The objective of the present study was to estimate the incidence of such exposure in a teaching hospital. Materials and Methods: A cross-sectional study among a random sample of residents, interns, nurses and technicians (n = 830) was carried out in a teaching hospital to estimate the incidence of exposure to blood and body fluids in the preceding 12-month period. Self-reported occurrence and the circumstances of the same were recorded by face-to-face interviews using a semi-structured questionnaire. Results: The response rate to the study was 89.76%. Occupational exposure to blood and body fluids in the preceding 12 months was reported by 32.75% of the respondents. The self-reported incidence was the highest among the nurses. Needle-stick injury was the most common mode of such exposures (92.21% of total exposures). Index finger and thumb were the commonest sites of exposure. Only 50% of the affected individuals reported the occurrence to concerned hospital authorities. Less than a quarter of the exposed persons underwent post-exposure prophylaxis (PEP) against HIV, although the same was indicated in about 50% of the affected HCWs based on the HIV status of the source patient. Conclusions: Occupational exposure to blood and body fluids was a common occurrence in the study sample. There was gross under-reporting of such incidents leading to a lack of proper PEP against HIV in 50% of those in whom the same appeared to be indicated.

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Needlestick and sharps injuries among health care workers at public tertiary hospitals in an urban community in Mongolia

Mayo Kakizaki, Nayu Ikeda, Moazzam Ali … (2011)

Background Needlestick and sharps injuries (NSSIs) are one of the major risk factors for blood-borne infections at healthcare facilities. This study examines the current situation of NSSIs among health care workers at public tertiary hospitals in an urban community in Mongolia and explores strategies for the prevention of these injuries. Findings A survey of 621 health care workers was undertaken in two public tertiary hospitals in Ulaanbaatar, Mongolia, in July 2006. A semi-structured and self-administered questionnaire was distributed to study injection practices and the occurrence of NSSIs. A multiple logistic regression analysis was performed to investigate factors associated with experiencing NSSIs. Among the 435 healthcare workers who returned a completed questionnaire, the incidence of NSSIs during the previous 3 months was 38.4%. Health care workers were more likely to report NSSIs if they worked longer than 35 hours per week (odds ratio, OR: 2.47; 95% confidence interval, CI: 1.31-4.66) and administered more than 10 injections per day (OR: 4.76; 95% CI: 1.97-11.49). The likelihood of self-reporting NSSIs significantly decreased if health care workers adhered to universal precautions (OR: 0.34; 95% CI: 0.17-0.68). Conclusions NSSIs are a common public health problem at public tertiary hospitals in Mongolia. The promotion of adequate working conditions, elimination of excessive injection use, and adherence to universal precautions will be important for the future control of potential infections with blood-borne pathogens due to occupational exposures to sharps in this setting.

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Author and article information

Contributors

Suraj Bhattarai: surajbpkihs2012@gmail.com

Smriti KC: smriti_memory18@yahoo.com

Pranil MS Pradhan: pranil.pradhan@gmail.com

Sami Lama: samilama2002@yahoo.com

Suman Rijal: sumanrijal2@yahoo.com

Journal

Journal ID (nlm-ta): BMC Res Notes

Journal ID (iso-abbrev): BMC Res Notes

Title: BMC Research Notes

Publisher: BioMed Central (London )

ISSN (Electronic): 1756-0500

Publication date (Electronic): 3 November 2014

Publication date PMC-release: 3 November 2014

Publication date Collection: 2014

Volume: 7

Issue: 1

Electronic Location Identifier: 774

Affiliations

[ ]B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal

[ ]Ishan Children and Maternity Hospital, Kathmandu, Nepal

[ ]BPKIHS, HIV & SRHR Coalition, Lalitpur, Nepal

[ ]Influenza Surveillance Project, Department of Community Health Sciences, Patan Academy of Health Sciences, Lalitpur, Nepal

[ ]School of Nursing, BPKIHS, Dharan, Nepal

[ ]Internal Medicine, Tropical and Infectious Diseases Division, BPKIHS, Dharan, Nepal

Article

Publisher ID: 3313

DOI: 10.1186/1756-0500-7-774

PMC ID: 4236428

PubMed ID: 25366873

SO-VID: 53454b07-2d0f-45ac-a6b0-bc01a55ba07c

License:

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 19 February 2014

Date accepted : 21 October 2014

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ScienceOpen disciplines: Medicine

Keywords: hepatitis b vaccination,needle-stick and sharps-related injuries,universal precautions

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ScienceOpen disciplines: Medicine

Keywords: hepatitis b vaccination, needle-stick and sharps-related injuries, universal precautions

Hepatitis B vaccination status and Needle-stick and Sharps-related Injuries among medical school students in Nepal: a cross-sectional study

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Most cited references 17

Occupational exposure to blood and risk of bloodborne virus infection among health care workers in rural north Indian health care settings.

Occupational Exposure to Blood and Body Fluids Among Health Care Workers in a Teaching Hospital in Mumbai, India

Needlestick and sharps injuries among health care workers at public tertiary hospitals in an urban community in Mongolia

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