OCCUPATIONAL EXPOSURE TO HIV AMONG HEALTHCARE WORKERS IN PREVENTION OF MATERNAL TO CHILD TRANSMISSION OF HIV SITES, PORT HARCOURT, RIVERS STATE

Abstract

Exposures to pathogen infecting blood and or body fluids of patient either by accidental needle prick, sharps or splash into mucous membranes are attributable to occupational infections among healthcare workers. Rivers State has the highest HIV prevalent rate in Nigeria. This poses a high risk of occupational exposure and transmission to healthcare workers. This study was carried out to determine prevalence and the factors associated with occupational exposures to HIV among healthcare workers in private and public Prevention of Mother to Child Transmission of HIV (PMTCT) sites within Port Harcourt. A descriptive cross-sectional study was conducted from identified PMTCT sites using multi stage sampling technique. In stage one 44 PMTCT sites was selected from 56 sampled by simple random sampling, in stage two the sample size of 337 was allocated equally among 44 facilities which yielded 6 participants per facility, while in stage three one participant was drawn from each professional cadre, then two participants was drawn randomly among doctors, nurses, laboratory scientist and environmental healthcare workers which were professional cadre of interest. Data was collected using interviewer administered questionnaire after obtaining informed consent. Socio-demographics of healthcare workers, organizational and behavioral related variables were assessed relative to occupational exposures. Data were analyzed using descriptive statistics, Chi-square and logistic regression models (a = 0.05). Mean age of the respondents was 35.9 SD± 8.4 years and 67 (19.9%) were males and 270 (80.1) were females. Participants from the public health facilities were 171(50.7) while 166(49.3) participants were drawn from the private facility. In the prevalence of 45.0% (n = 337), needle stick prick accounted for 32.6% (n= 153) while contact with potentially infectious body fluid was 33.3%. Sixty three point three percent (63.3%) experienced exposure more than once. Safety information for safety precautions was at the disposal of 56.1 % of participants. Reporting system was not in existence in some facilities as reported by 38.9% of study participants. Majority (98%) of participants required training on infection prevention while 16% of sampled PMTCT sites do not practice waste separation. Poor supply of PPE was reported by 32.8% of participants. Doctors have 46.1 % less likelihood of experiencing occupational exposure than nurses. The odds of occupational exposure among doctors were two times higher than other healthcare workers [AOR=0.4; C.I = 0.195 - 0.929], environmental health workers has about 42 times more likelihood of experiencing occupational exposures than nurses (AOR = 11.2; C.I =2. 190 - 56.777]. while laboratory scientists are about 1.2 times more likely to experience occupational exposure than nurses [AOR=l .04;C.l=0.525-2.078]. Working more than 40 hours per week was associated with higher risk of occupational exposure [AOR=0.30; C.I = 0.301 -0.919]. Occupational exposure to HIV infection is prevalent among healthcare workers in PMTCT sites in Port Harcourt. Extended working hours and inadequate PPE supplies increases the risk of occupational exposure. Adherence to universal precautions, proper handling of occupational exposure related cases, adequate medical waste disposal and regular training/retraining of health care workers should be encouraged.