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EPIDEMIOLOGY OF OCCUPATIONAL HIV INFECTION BY DR. OKWESILI OBINNA.

EPIDEMIOLOGY OF OCCUPATIONAL HIV INFECTION BY DR. OKWESILI OBINNA. More than 40million infected worldwide. 37million adults and 2.5 million children. 95% of global total live in developing world. Prevalence has risen slightly in developed world due to anti-retroviral therapy.

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EPIDEMIOLOGY OF OCCUPATIONAL HIV INFECTION BY DR. OKWESILI OBINNA.

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  1. EPIDEMIOLOGY OF OCCUPATIONAL HIV INFECTION BY DR. OKWESILI OBINNA.

  2. More than 40million infected worldwide. • 37million adults and 2.5 million children. • 95% of global total live in developing world. • Prevalence has risen slightly in developed world due to anti-retroviral therapy.

  3. AGE AND SEX PREVALENCE • About 50% of those that acquire HIV before 25yrs die of AIDS before 35yrs • In 2003 an estimated 700,000 children aged 15 and below became infected. • Over 90% of these babies were from sub-Saharan Africa. • In all parts of the world except in Sub-Saharan Africa, more men become infected with HIV and die of AIDS than women

  4. RISK AFTER OCCUPATIONAL EXPOSURE • The risk of transmission after injury with a hollow needle contaminated with HIV infected blood is 0.3% • The risk is 16-fold if the hollow needle injury was a deep soft tissue penetration. • 5-fold if there is either visible blood on the needle or involved placement of a needle in an artery or vein.

  5. 6-fold if the patient has advanced AIDS (and a high viral titre) • Prophylactic administration of zidovudine to the health personnel effects 80% reduction in risk.

  6. OCCUPATIONAL RISK OF HIV TRANSMISSION • In a study on occupational exposure to risk HIV infection among surgeons at UNTH(T.A Okeke) • 53% of surgeons reported needle-stick injury in preceding 3months. Majority were during IV catheterization- recapping of needles. • <50% used double gloving. • 17% did nothing. • In a study on the Epidemiology of needle stick

  7. and sharp instrument accidents in a Nigerian Hospital (Adeboye A.A. et al): needle stick accidents during the previous year: 27% of 474 HCW, including- • 100% of dentists, 81% of surgeons, 32% of non surgical physicians and 31% of nursing staff. • Study on Occupational on HIV/AIDS : Occupational risk , attitude and Behaviour

  8. of surgeons in S-E, Nigeria (Obi S.N., Waboso P, Ozumba B.C ): • 40.2% reported needle-stick injuries during surgeries. • 89% were operating on patients with open wounds in their hands and 5% had their wounds contaminated with blood. • Survey of KAP of Nigerian surgery trainees to HIV infected persons and AIDS (C.A. Adebamowo, E.R Ezeome): Parenteral exposure to

  9. Patients blood was reported as occurring in 92.5% • 85.6% do not routinely use all the protective means advocated for reducing transmission, mainly due to non availability. • Study in OAUTH: • 47.7% had operated on HIV positive patients. • 95.4% were worried about HIV infection.

  10. OCCUPATIONAL RISK OF HIV VERSUS HEPATITIS INFECTION • Percutaneous exposure to HIV infected blood- o.3% . Mucous membrane exposure- 0.9% • Risk of developing clinical hepatitis if the blood was both HBsAg and HBeAg was 22%- 31% in those with injuries from needles contaminated with HBV. • Risk of developing serological evidence of HBV infection was 37% - 62% • Risk for HCV is 1.8% (mainly hollow needles.

  11. In a study on occupational risk of HIV and HBV among HCW in South East Nigeria: • Results- materials and equipments needed for protective and hygienic practices (adequate water supply, protective clothing and availability of disinfectants) were inadequate in all the hospitals. • Were available ,they ere found to be inconsistently used.

  12. HIV SEROPREVALENCE OF SURGICAL PATIENTS. • Penetrating trauma victims in Baltimore had sero-prevalence rate of 13%(1987) • Sero-prevalence rate among drug addicts in Brooklyn hemodialysis unit was 89%. • 29% of patients going to the theatre had risk factors associated with HIV infection.

  13. HIV TRANSMISSION FROM PROVIDER TO PATIENT. • Since 1990, at least 22,759 patients have received medical care from 53 health care providers with HIV infection in USA (including 29 dental care workers and 15 surgeons and obstetricians) • Retrospective study found 113 to be infected. 3 of these were proven to come from the health care workers.

  14. CONCLUSION • HIV prevalence is high and the risk in managing surgical patients with it can not be ignored. • We have to take precaution not only to avoid being infected by patients but to also prevent doctor to patient transmission.

  15. THANKS FOR YOUR PATIENCE

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