Burden and outcome of HIV infection and other morbidities in health care workers attending an Occupational Health Program at the Provincial Hospital of Tete, Mozambique

Abstract

Summaryobjectives To investigate the burden and outcome of HIV infection and other morbidities amongst a Mozambican hospital staff.methods Within an occupational health service set up in April 2008 in the provincial hospital of Tete, Mozambique, we offered to all staff members an initial clinical, laboratory and radiological screening and followed them up prospectively until April 2010.results A total of 47.5% of 423 health workers attended the program. The cohort (female-to-male ratio: 2.2; mean age: 39 years) consisted mostly of auxiliary staff (43%) and nurses (29.8%). At initial screening, 71% were asymptomatic. HIV infection (28.4%) and tuberculosis (TB) (21%) were the main reported antecedent illnesses. Laboratory screening revealed anaemia (haemoglobin level <10 mg ⁄ dl) in 9% participants, abnormal liver enzymes in 23.9% and a reactive non-treponemal syphilis test in 5%. Of 145 performed chest X-rays, 13% showed abnormalities. All 113 health workers not recently tested for HIV were screened, and 31 were newly diagnosed with HIV infection (resulting in an overall HIV prevalence of 43.8%). Nine cases of TB were diagnosed at screening ⁄ during follow-up. In April 2010, all but one of the participants were alive. All HIV-infected health workers under antiretroviral therapy were actively followed-up.conclusion Serious conditions were frequently diagnosed in health workers, in particular HIV infection. Mid-term outcome was favourable within this program. Creation of screening and care services dedicated to caregivers should be of highest priority in similar African settings.

Tuberculosis infection risk, preventive therapy care cascade and incidence of tuberculosis disease in healthcare workers at Maputo Central Hospital

“…The incidence of active TB among HCW at MCH is comparable to the median incidence of 1180/100,000 reported in a meta-analysis of active TB in HCW from high-incidence countries [17]. Similarly, in a study conducted in Tete, Mozambique in 2010, 21% of HCW reported prior TB disease with 2.1% diagnosed with active TB disease at screening or during follow up (incidence not specified) [18]. Therefore, our findings support previous work suggesting occupational risk plays a major role in this setting.…”

The Impact of Antiretroviral Therapy on Mortality in HIV Positive People during Tuberculosis Treatment: A Systematic Review and Meta-Analysis

“…We also excluded studies focusing on populations of patients not representative of the general population such as miners [17], prisoners [18], healthcare workers [19] or injecting drug users [20].…”

Feasibility of using postal and web-based surveys to estimate the prevalence of tuberculosis among health care workers in South Africa

“…The explanation could be that the web-based surveys were perceived as more timely and easy to complete. Several other studies using web-based survey also achieved high response rates, ranging from 75% to 96% [ 16 , 17 , 23 ]. However these were in high income countries where availability and use of web-based systems are widely utilised, which is not the norm in SA.…”

“…However, the higher prevalence may also be driven by a result of selection bias in the current study, where people with TB may be more motivated to complete the survey and share their experience. However, a study done in Mozambique during April 2008 –April 2010 identified a prevalence of 21% (42/201) among HCWs in an occupational health program [ 23 ]. Another study in KwaZulu-Natal from January 2006 to December 2010, using record reviews in three district hospitals, found a prevalence among HCWs of 9% (112/1,313) [ 26 ], which is the same as the current study.…”