HIV/AIDS Pandemic and Surgical Practice in a Nigerian Teaching Hospital

Abstract

The objective of the study was to determine the effects of the HIV/AIDS pandemic on surgical practice in a Nigerian teaching hospital. It involved a questionnaire survey of all the doctors practising in the surgical specialties at Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria, in order to obtain their attitudes and practices toward HIV-positive surgical patients. Sixty-five doctors were interviewed, their ages ranged from 26 years to 62 years with a mean age of 35.1 years. The majority (35.4%) were in general surgery or obstetrics and gynaecology (24.6%). Almost half (47.7%) had operated on known HIV-positive patients and the majority were in support of preoperative HIV screening. Almost all (95.4%) were worried about occupational HIV infection--a significant number of consultants would refuse to be screened if their patient were allowed to know the results (P = 0.014). The cross infection control commonly employed included adequate instrument sterilization, presurgical hand washing and the use of gloves and facemasks. The wearing of eye goggles, double gloving, indirect instrument passing and wearing of water impervious gowns were used less frequently. As HIV/AIDS infected individuals are presenting for surgical procedures in the hospital, there is a need to improve the use of universal infection control measures and to educate all categories of healthcare personnel in order to allay the fears and to prevent discrimination that could militate against effective management of HIV/AIDS patients.

Barriers to HIV Care and Treatment by Doctors: A review of the literature

“…This barrier was most frequently reported in the early 1990 in most countries, but in some developing countries such as Nigeria this fear remained high even during the 21 st century. 16 Fears were expressed not only in respect of surgical procedures, but some doctors even feared droplets from sneezing and shaking hands. [9,17,18,21] Some doctors even feared working in HIV areas or for caring for HIV and AIDS patients.…”

Predictors of postoperative complications in HIV-infected children undergoing surgery

“…complication of the disease, or for routine surgery [1][2][3]. The risk of developing complications postsurgery may be influenced by patient or surgical factors or both.…”

journal

“…Yapılan çalışmalarda, HIV pozitif olması nedeniyle ameliyat edilmeyen hastaların yaklaşık %20-25'inde cerrahi girişim gerektirecek hastalıkla-rın bulunduğu belirtilmekte birlikte, gelecekte HIV/ AIDS'li hastaların genel populasyona göre daha fazla oranda cerrahi girişimlere maruz kalacağı tahmin edilmektedir 45,46 . Nijerya' da yapılan bir çalışmada, çene cerrahisi uzmanlarının, HIV pozitif olduğunu bildikleri hastaların %41,5'ini opere ettiklerini, buna karşın test edilmeyen veya HIV pozitif olduğu bilinmeyen çok sayıda kişi bulunduğu ve uzmanların bu durumun farkında olmadıkları ve endişe duydukları belirlenmiştir 47 .…”