Blood-borne infections in healthcare workers in South Africa

Abstract

The risks associated with infection of healthcare workers and students with blood-borne pathogens, specifically HIV, hepatitis B virus and hepatitis C virus, are often neglected. South Africa (SA) currently has no official policies or guidelines in place for the prevention and management of these infections. This article reviews the available data and international guidelines with regard to infected healthcare practitioners and makes minimum recommendations for the SA setting.

Post-exposure prophylaxis following occupational exposure to HIV and hepatitis B: an analysis of a 12-year record in a Nigerian tertiary hospital

“…As a consequence of occupational exposure, it is estimated that 1000 human immunodeficiency virus (HIV), 66,000 hepatitis B virus (HBV) and 16,000 hepatitis C virus (HCV) infections occur each year worldwide (Prüss-Üstün et al, 2005). Because of high prevalence of blood-borne pathogens, especially HIV, HBV and HCV in developing countries, HCWs in these regions are reported to be at serious risk of infection from these pathogens (Rossouw et al, 2014; Rudolph et al, 2001). It was also pointed out that, despite the high prevalence of blood-borne pathogens in many developing countries, documentation of infection caused by occupational exposure is inadequate (Ilhan et al, 2006; Rudolph et al, 2001).…”

Exposure incidents among medical students in a high-prevalence HIV setting

“…They often work long hours, frequently in places with inadequate facilities for sharps disposal, and may not have mastered the skills required to effectively undertake appropriate venesection practices and invasive procedures. Percutaneous and mucosal incidents also expose students to infectious pathogens, especially viruses such as the human immunodeficiency virus (HIV) and hepatitis B and C viruses [6]. For instance, patients with HIV-related diseases occupied more than half of the hospital beds in sub-Saharan Africa in 2006 and in South Africa, even in the era of widely available antiretroviral treatment (ART), at least 44% of medical admissions are for HIV-infected patients [7].…”

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“…We are also reminded that the occupational risk of infection by blood-borne viruses (BBVs) in healthcare practitioners (HCPs) and students is significant, especially in the developing world. [11] Three viral pathogens are known to pose the most serious risk: HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV). The route of transmission can be percutaneous or mucosal, and is related to the work environment and practices of HCPs.…”

“…Not only are HCPs at risk of acquiring these infections, but they also pose a risk to patients once infected. Rossouw et al [11] offer these recommendations: all HCPs and all healthcare students should know their infection and immune status (as appropriate) for all three major BBVs, and all who are not infected with HBV should be vaccinated and have their immune status confirmed prior to initiation of training.…”