Occupational exposure to HIV amongst health care workers in the maternity unit at King Edward VIII hospital; Durban; South Africa

ABSTRACT

The increasing HIV sero-prevalence amongst pregnant women places health care workers in busy labour wards at high risk of occupational exposure to HIV. Aim: The aim of this study was to determine whether there has been a change in the prevalence of needle-stick and sharps injuries at King Edward VIII Hospital; Durban; South Africa; since the first study done on the issue in 1999; and if so - the reasons. Design: A cross-sectional retrospective survey assessing the prevalence of needle-stick and sharps injuries which occurred from January 2003 to December 2003. Setting: The study was conducted at the Department of Obstetrics and Gynaecology; King Edward VIII Hospital; Durban; South Africa. Method: Staff members in the labour ward; including doctors; nurses; student nurses; and supportive staff; i.e. cleaners; porters; and messengers were interviewed and asked to fill in a structured questionnaire. Results: Healthcare workers (114) were interviewed over a period of 1 year; from January to December 2003. 49 of the 90 (54) who agreed to participate reported an incident of exposure to patients' body fluids; 19 of who were through sharp injuries (21); forty percent of exposures occurred with known HIV infected patients; whereas at least 28 of patients sero-status was unknown at the time of the exposure. Only 61 of the sharps injuries were reported; and of these; only a third of the health workers completed the prescribed 4 week course of prophylactic antiretroviral treatment. Conclusion: This study showed an increase in the number of HIV exposures amongst health workers; and most of these are as a result of lack of adherence with preventative measures. Improved reporting mechanisms which ensure confidentiality may assist health workers to deal with this