Page 232 - SAHCS HIVMed Journal Vol 20 No 1 2019

Southern African Journal of HIV Medicine
ISSN: (Online) 2078-6751, (Print) 1608-9693
Page 1 of 6 Original Research

Occupational blood and body fluid exposures and

human immunodeficiency virus post-exposure

prophylaxis amongst intern doctors

Authors: Background: Healthcare workers (HCWs) are constantly vulnerable to occupational blood
Sunday J. Aigbodion 1 and body fluid exposures (OBBFEs). Exposed HCWs experience emotional, physical and
Feroza Motara 2
2
Abdullah E. Laher psychological trauma. Less experienced HCWs, such as intern doctors, are more prone to
OBBFEs.
Affiliations:
1 Department of Emergency Objectives: The aim of this study was to investigate the prevalence and practices pertaining to
Medicine, Far East Rand OBBFEs amongst a select group of intern doctors in the Gauteng province of South Africa.
Hospital, Johannesburg,
South Africa Methods: A quantitative cross-sectional descriptive study using a questionnaire based on a
practical model was used. Intern doctors were recruited from four major hospitals in Gauteng.
2 Department of Emergency
Medicine, Faculty of Health Results: A total of 175 intern doctors participated in the study. There was a total of 182
Sciences, University of the (mean = 1.04, standard deviation [s.d] 0.88) reported OBBFEs amongst 136 (77.7%) subjects.
Witwatersrand,
Johannesburg, South Africa The exposures occurred predominantly whilst subjects were working in surgery (n = 50,
27.5%), obstetrics and gynaecology (n = 49, 26.9%) and internal medicine (n = 48, 26.4%)
Corresponding author: departments; were superficial wounds (n = 69, 37.9%); were acquired during vascular puncture
Abdullah Laher, or intravenous line insertion (n = 69, 37.9%); and occurred when subjects were working >12 h
[email protected]
shifts (n = 101, 55.5%). Human immunodeficiency virus (HIV) post-exposure prophylaxis
Dates: (PEP) was initiated in 141 (77.5%) out of the 182 exposures. Only 90 (63.8%) subjects completed
Received: 22 Feb. 2019 the recommended 28-day course of PEP. Two (1.1%) subjects reported that they had acquired
Accepted: 22 Mar. 2019
Published: 22 May 2019 HIV infection as a consequence of the OBBFE.
Conclusion: Occupational blood and body fluid exposures are common amongst intern
How to cite this article:
Aigbodion SJ, Motara F, doctors. It is recommended that regular training, health education and monitoring compliance
Laher AE. Occupational should be incorporated during the induction of medical intern doctors in hospitals. The
blood and body fluid availability of PEP regimens with better tolerability will encourage compliance.
exposures and human
immunodeficiency virus Keywords: Occupational blood and body fluid exposure; Needle stick injury; Intern doctors;
post-exposure prophylaxis
amongst intern doctors. S Afr Post-exposure prophylaxis; Healthcare workers.
J HIV Med. 2019;20(1), a958.
https://doi.org/10.4102/
sajhivmed.v20i1.958 Introduction
Copyright: Medical doctors, especially intern doctors who are the most junior doctors employed at hospitals,
© 2019. The Authors. face the threat of occupational blood and body fluid exposure (OBBFE) with the consequent risk
Licensee: AOSIS. This work
is licensed under the of acquiring blood-borne infections (BBIs) by pathogens such as the human immunodeficiency
Creative Commons virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV). 1
Attribution License.
Significant occupational exposure to blood and other infectious body fluids is defined as (1)
percutaneous exposures resulting in a breach to the skin by a human bite or a contaminated
needle, blade, lancet or other sharp objects; (2) mucocutaneous exposure which includes splashes
to mucosal surfaces such as the nose, mouth or eyes; and (3) non-intact skin exposure which
includes dermatitis, chapped skin, abrasions and open wounds. Potentially infectious body fluids
include blood, tissue, semen, vaginal secretions, visibly bloody fluids as well as cerebrospinal,
pleural, pericardial, synovial and amniotic fluids. 2

Read online: Previous studies predominantly reported on OBBFEs or needle stick injuries (NSIs) amongst
Read online:
Scan this QR healthcare workers (HCW) in general. 3,4,5 However, more recent studies have recognised the
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code with your
code with your necessity of the frequent education of intern doctors concerning blood and body fluid exposures.
6
smart phone or
smart phone or
mobile device
mobile device Therefore, the rationale for this study was prompted by the lack of studies directed specifically at
to read online.
to read online.
intern doctors. We hypothesised that intern doctors, because of their lack of experience, high
http://www.sajhivmed.org.za 225 Open Access