Risk factors for bloodborne viral hepatitis in healthcare workers of Pakistan: a population based case-control study.

Autor:	Gorar ZA; Health Services Academy, Chak Shahzad, Islamabad, Pakistan., Butt ZA; Department of Public Health, Pakistan Institute of Ophthalmology, Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan., Aziz I; Department of General Surgery, Dow University of Health Sciences, Karachi, Pakistan.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2014 Jul 24; Vol. 4 (7), pp. e004767. Date of Electronic Publication: 2014 Jul 24.
DOI:	10.1136/bmjopen-2013-004767
Abstrakt:	Objectives: A high prevalence of viral hepatitis B and C was found among healthcare workers during a province-wide screening in Sindh Province, Pakistan. A follow-up study was undertaken to identify risk factors for this high prevalence in healthcare workers. Design: Population based case-control design. Setting: Public sector healthcare facilities in a rural district of Pakistan. Participants: Healthcare workers who were screened for hepatitis B surface antigen (HBsAg) and hepatitis C virus (HCV) antibodies. 178 healthcare workers employed at the public sector clinics and hospitals of the district were approached, of which 14 refused to participate. Cases had detectable serum antibodies against HCV and the presence of HBsAg. Healthcare workers non-reactive to HCV antibodies and with no HBsAg were controls. These were matched in a ratio of 1:1. Outcome Measure: Detectable serum HBsAg and HCV antibody titer were taken as outcome. OR for various exposures was calculated; those with p<0.25 were entered in a multivariate logistic regression model to find out significant predictors. Results: Needle stick injury (OR=6; CI95 1.4 to 23), recapping the needle (OR=5.7; CI95 1.1 to 28), wound care at accident and emergency of a hospital (OR=5.5; CI95 1 to 28), female gender (OR=3.4; CI95 1 to 12) and more than 10 years of formal education (OR=0.25; CI95 0.07 to 0.8) were associated with hepatitis C. Hepatitis B was found to be associated with trying to bend or break a needle after use (OR=4.9; CI95 1 to 24). Conclusions: Healthcare workers in Pakistan are at additional risk of exposure to bloodborne pathogens. Bi-dimensional risk factors present at individual and broader health systems levels are responsible. Occupational safety, health trainings and redesigning of the curriculum for allied health professionals are required. (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu