KNOWLEDGE, PERCEPTION AND STANDARD PRECAUTION AMONG HEALTH WORKERS IN NIGERIA
Infection is one of the most important problems in health care services worldwide. It constitutes one of the most important causes of morbidity and mortality associated with clinical, diagnostic and therapeutic procedures.1,2
Health care workers (HCWs) are at a high risk of needle stick injuries and blood-borne pathogens as they perform their clinical activities in a hospital.3Â They are exposed to blood borne pathogens, such as human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C (HCV) viruses, from sharp injuries and contacts with blood and other body fluids.4,5Â According to a WHO estimate, in the year 2002, sharp injuries resulted in 16,000 hepatitis C Virus, 66,000 hepatitis B virus and 10,000 HIV infections in health care workers worldwide.6Â There is no immunization for HIV and hepatitis C.7Â It becomes important to prevent infection by preventing exposure.Â Recapping, disassembly, and inappropriate disposal increase the risk of needle stick injury.8,9Â The incidence rate of these causative factors is higher in developing countries for the higher rate of injection with previously used syringes.10Â Developing countries where the prevalence of HIV-infected patients is very high, record the highest needle stick injuries too.10Â Needle stick injuries were also reported as the most common occupational health hazard in a Nigerian teaching hospital.11Â The World Health Organization (WHO) estimates that about 2.5% of HIV cases among HCWs and 40% of hepatitis B and C cases among HCWs are the result of these exposures.12 Â Irrational andÂ unsafe injection practices are rife in developing countries.13Â The practice of recapping needles has been identified as a contributor to incidence of needle stick injuries among HCWs.5, 14 It is believed that only one out of three needle stick injuries are reported in the US, while these injuries virtually go undocumented in many developing countries.15Â Unsafe injections and the consequent transmission of blood borne pathogens are suspected to occur routinely in the developing world.16Â It was estimated that each person in developing countries receives an average of 1.5 infections per annum. 16, 19 About 90-95% of injections are therapeutic, while 5-10% is given for immunization.17 It has been shown that between 70% and 99% of these injections are unnecessary, while at least 50% are unsafe in 14 of 19 countries in five developing world regions with data. 17, 18, 19, 20.
Hauri et al of the Department of Essential Health Technologies, WHO estimates 3.4 injections per person per year in developing countries.16, 18Â In Nigeria, the annual mean was found to be 4.9 injections per year.21Â Injection over use and unsafe practices account for a substantial burden of death and disability worldwide.16Â Eighteen studies reported a convincing link between unsafe injections and the transmission of hepatitis B and C., HIV, Ebola and Lassa virus infections and malaria.19Â Injuries from sharp devices have been associated with the transmission of more than 40 pathogens, including HBV, HCV, HIV, haemorrhagic fevers, malaria and tetanus, thereby increasing the risk and burden of infectious diseases.22, 23, 24, 25Â Contaminated sharps such as needles, lancets, scalpels, broken glass, specimen tubes and other instruments, can transmit blood borne pathogens such as HIV, Hepatitis B (HBV) and Hepatitis C viruses (HCV).26Â The circumstances leading to needle stick injuries depend partly on the type and design of the device and certain work practices.27Â Also, the level of risk depends on the number of patients with that infection in the health care facility and the precautions the health care workers observe while dealing with these patients.