Prevalence of needlestick injuries and factors associated with access of PEP among health workers at casualty Mulago National Referral Hospital-a cross sectional study

Abstract

Background: Needle stick injuries (NSI) are accidental skin-penetrating puncture wounds from a hollow- bore needle containing another person's blood or body fluid. They are a very prevalent challenge among health workers generally with specific groups being more vulnerable and to their consequences. These consequences include exposure to infectious diseases such as Human Immunodeficiency Virus (HIV), Hepatitis B (Hep B) and Hepatitis C (Hep C), career-limiting fear, depression, anxiety disorder, and post-traumatic stress disorder. Trauma patients in the casualty ward need special attention when handling as these is known to have higher HIV prevalence than the general population. Effective HIV prevention strategies e.g. post-exposure prophylaxis (PEP) after exposure should be availed to healthcare workers (HCW), however, challenges with its access have been noted as a big problem.Objectives: To determine the prevalence of NSI and factors associated with access to PEP. Methods: A hospital-based cross-sectional study among HCWs from the casualty unit of Mulago National Referral Hospital was done. A Semi-structured self-administered questionnaire was used for data collection and an ordinal logistic regression analysis using STATA 14 was done. Results: A total of 128 HCWs constituting of Nurses (25.8%), Doctors (11.7%) , senior house officers (28.1), interns (22.7%) and non-clinical staff (11.7%) participated in the study and had a mean age of 33.4 years with most (28.1%) being Senior house officers (SHOs), having average experience as healthcare workers handling in- and out-patients of 7.5 years and working 6 staff per shift on average. The prevalence of Needle Stick Injuries (NSI) was 54.7% and was higher than the national prevalence of 44%. The factors significantly associated with difficulty accessing PEP after a NSI were being an intern aOR =0.301, being a non-clinical staff aOR =0.199, PEP being unavailable at the unit aOR =0.218, Availability of PEP guidelines at the facility aOR=3.56. Conclusions: The of prevalence of NSI among health care workers in MNRH casualty unit is higher than the national average and accessing PEP after these NSIs is difficult when a healthcare worker is an intern or a non-clinical staff. It is similarly difficult to acquire PEP when PEP is not available at the unit or when PEP acquisition guidelines are available at the unit.