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      Needle-Stick Injury among Health Care Workers in Hemodialysis Units in Nigeria: A Multi-Center Study

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          Abstract

          Background:

          Needle-stick and sharps injuries carry the risk of infection and are occupational hazards for all health care professionals involved in clinical care.

          Objective:

          To determine the frequency and factors contributing to needle-stick injury (NSI) among health care workers of dialysis units in Lagos, Nigeria.

          Methods:

          Data were obtained by anonymous, self-reporting questionnaire from staff of 4 hemodialysis units between October and December 2011. Information on demographics, job category and duration, details of NSI in the past, kind of activity and procedure under which the NSI occurred, if injury was reported, vaccination status of staff, and post-exposure treatment received were obtained.

          Results:

          The study population included 38 (37.3%) doctors, 42 nurses (41.2%), 14 (13.7%) dialysis technicians and 8 (7.8%) ancillary staff. There were 39 (38.2%) males. The mean±SD age of the study population was 34.4±8.3 years. 25 (24.5%) staff had suffered NSI in the last 12 months and 41 (40.2%) in their entire working career. The most common activity leading to NSI was recapping of needles (45%), improper disposal of needles (30%), and venous cannulation and setting of drips (27.5%). NSI was significantly (p=0.016) higher among those with work experience between 6 and 10 years than others. Hollow bore needles were responsible for 82.9% of the NSIs. Only 15 (37%) respondents reported their NSI to their unit head or designated officer in order to get medical advice.

          Conclusion:

          In Lagos, Nigeria, NSI is common among hemodialysis staff and is underreported. Many NSIs can be prevented by adhering to the practice of universal precautions as well as education of staff on such precautionary methods.

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          Most cited references23

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          Estimation of the global burden of disease attributable to contaminated sharps injuries among health-care workers.

          The global burden of hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) infection due to percutaneous injuries among health care workers (HCWs) is estimated. The incidence of infections attributable to percutaneous injuries in 14 geographical regions on the basis of the probability of injury, the prevalence of infection, the susceptibility of the worker, and the percutaneous transmission potential are modeled. The model also provides the attributable fractions of infection in HCWs. Overall, 16,000 HCV, 66,000 HBV, and 1,000 HIV infections may have occurred in the year 2000 worldwide among HCWs due to their occupational exposure to percutaneous injuries. The fraction of infections with HCV, HBV, and HIV in HCWs attributable to occupational exposure to percutaneous injuries fraction reaches 39%, 37%, and 4.4% respectively. Occupational exposures to percutaneous injuries are substantial source of infections with bloodborne pathogens among health-care workers (HCWs). These infections are highly preventable and should be eliminated. 2005 Wiley-Liss, Inc.
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            Preventing needlestick injuries among healthcare workers: a WHO-ICN collaboration.

            Effective measures to prevent infections from occupaonal exposure of healthcare workers to blood include mmunization against HBV, eliminating unnecessary injections, implementing Universal Precautions, eliminating needle recapping and disposing of the sharp into a sharps container immediately after use, use of safer devices such as needles that sheath or retract after use, provision and use of personal protective equipment, and training workers in the risks and prevention of transmission. Post-exposure prophylaxis with antiretroviral medications can reduce the risk of HIV transmission by 80%. In 2003, the World Health Organization and the International Council of Nurses launched a pilot project in three countries to protect healthcare workers from needlestick injuries. The results of the pilot will be disseminated worldwide, along with best policies and practices for prevention.
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              Needle stick injuries among nurses in sub-Saharan Africa.

              Despite a heavy burden of HIV/AIDS and other blood borne infections, few studies have investigated needle stick injuries in sub-Saharan Africa. We conducted a cross-sectional study at Mulago national referral hospital in Kampala, Uganda, to assess the occurrence and risk factors of needle stick injuries among nurses and midwives. A total of 526 nurses and midwives involved in the direct day-to-day management of patients answered a questionnaire inquiring about occurrence of needle stick injuries and about potential predictors, including work experience, work load, working habits, training, and risk behaviour. A 57% of the nurses and midwives had experienced at least one needle stick injury in the last year. Only 18% had not experienced any such injury in their entire career. The rate of needle stick injuries was 4.2 per person-year. Multiple logistic regression analysis showed that the most important risk factor for needle stick injuries was lack of training on such injuries (OR 5.72, 95% CI 3.41-9.62). Other important risk factors included working for more than 40 h/week (OR 1.90, 95% CI 1.20-3.31), recapping needles most of the time (OR 1.78, 95% CI 1.11-2.86), and not using gloves when handling needles (OR 1.91, 95% CI 1.10-3.32). The study showed a high rate of needle stick injuries among nurses and midwives working in Uganda. The strongest predictor for needle stick injuries was lack of training. Other important risk factors were related to long working hours, working habits, and experience.
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                Author and article information

                Journal
                Int J Occup Environ Med
                Int J Occup Environ Med
                Int J Occup Environ Med
                IJOEM
                The International Journal of Occupational and Environmental Medicine
                Shiraz: NIOC Health Organization
                2008-6520
                2008-6814
                January 2014
                01 January 2014
                : 5
                : 1
                : 1-8
                Affiliations
                1Department of Medicine, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
                2Department of Medicine, College of Medicine, Lagos State University, Ikeja Lagos, Nigeria
                Author notes
                Correspondence to Christiana Oluwatoyin Amira, MD, Department of Medicine, College of Medicine, University of Lagos, PMB 12003, IdiAraba, Lagos, Nigeria Tel: +234-802-855-4566 E-mail: toyinamira@ 123456yahoo.com
                Article
                7767588
                24463795
                cc59b0ed-fcaa-4bbe-86d4-e7634c72876e
                Copyright @ 2014

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 31 January 2013
                : 13 August 2013
                Page count
                Figures: 1, Tables: 2, References: 24, Pages: 8
                Categories
                Original Article

                needle-stick injuries,blood-borne pathogens,health personnel,vaccination,infection control,safety,occupational exposure

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