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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Working with risk: Occupational safety issues among healthcare workers in Kenya
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, Volume 20, No. 3, Year 2008
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Description
The objective of this study was to explore knowledge of, attitudes towards and practice of post-exposure prophylaxis (PEP) among healthcare workers (HCWs) in the Thika district, Kenya. We used site and population-based surveys, qualitative interviews and operational research with 650 staff at risk of needlestick injuries (NSIs). Research was conducted over a 5-year period in five phases: (1) a bio-safety assessment; (2) a staff survey: serum drawn for anonymous HIV testing; (3) interventions: biosafety measures, antiretrovirals for PEP and hepatitis B vaccine; (4) a repeat survey to assess uptake and acceptability of interventions; in-depth group and individual interviews were conducted; and (5) health system monitoring outside a research setting. The main outcome measures were bio-safety standards in clinical areas, knowledge, attitudes and practice as regards to PEP, HIV-sero-prevalence in healthcare workers, uptake of interventions, reasons for poor uptake elucidated and sustainability indicators. Results showed that HCWs had the same HIV sero-prevalence as the general population but were at risk from poor bio-safety. The incidence of NSIs was 0.97 per healthcare worker per year. Twenty-one percent had had an HIV test in the last year. After one year there was a significant drop in the number of NSIs (OR: 0.4; CI: 0.3-0.6; p<0.001) and a significant increase in the number of HCWs accessing HIV testing (OR: 1.55; CI: 1.2-2.1; p=0.003). In comparison to uptake of hepatitis B vaccination (88% of those requiring vaccine) the uptake of PEP was low (4% of those who had NSIs). In-depth interviews revealed this was due to HCWs fear of HIV testing and their perception of NSIs as low risk. We concluded that Bio-safety remains the most significant intervention through reducing the number of NSIs. Post-exposure prophylaxis can be made readily available in a Kenyan district. However, where HIV testing remains stigmatised uptake will be limited - particularly in the initial phases of a programme. © 2008 Taylor & Francis.
Authors & Co-Authors
Taegtmeyer, Miriam M.
Kenya, Nairobi
Liverpool Vct
United Kingdom, Liverpool
Liverpool School of Tropical Medicine
Suckling, R. M.
United Kingdom, Liverpool
Liverpool School of Tropical Medicine
Nguku, Patrick Mboya
Kenya, Nairobi
Ministry of Health Nairobi
Meredith, C.
Kenya, Nairobi
Liverpool Vct
Kibaru, Josephine
Kenya, Nairobi
Ministry of Health Nairobi
Chakaya, Jeremiah Muhwa
Kenya, Nairobi
Kenya Medical Research Institute
Muchela, H.
Kenya, Nairobi
Liverpool Vct
Gilks, Charles F.
United Kingdom, Liverpool
Liverpool School of Tropical Medicine
Switzerland, Geneva
Organisation Mondiale de la Santé
Statistics
Citations: 52
Authors: 8
Affiliations: 5
Identifiers
Doi:
10.1080/09540120701583787
ISSN:
09540121
e-ISSN:
13600451
Research Areas
Health System And Policy
Infectious Diseases
Violence And Injury
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study
Study Approach
Qualitative
Quantitative
Study Locations
Kenya