Utilization of post exposure prophylaxis among health workers following percutaneous injuries in public health facilities in Kampala Capital City

Abstract

Background: Of the 3 million percutaneous exposures that occur annually among health workers, 90% are in low income countries. The estimated prevalence of percutaneous exposures among health workers in Uganda is 57-82%. However, utilization of post exposure prophylaxis following percutaneous exposure remains largely undetermined. Methods: This cross-sectional study aimed to determine the level of utilization of post exposure prophylaxis for HIV and Hepatitis B following percutaneous injuries among clinical health workers in public health facilities in Kampala Capital City and the associated determinants. A total of 709 Health workers of various cadres across various levels of health facilities in Kampala were included. Results: 28% (n=709) of HWs had sustained percutaneous injuries in the preceding 12 months. 14% (n=197) of the exposed HWs had been immunised against Hep B. Prevalence of injuries was higher among HWs in lower level facilities (Adjusted prevalence ratio-APR 1.1, 95% CI 1.02-1.26) and International Hospital Kampala (APR 1.3, 95% CI 1.04-1.52). 15% (n=197) of the exposed HWs initiated HIV PEP and 0.5% Hep B PEP. 69% (n=29) completed HIV PEP treatment and 100% (n=1) completed Hep B PEP treatment. Being a consultant and having moderately deep injury were significantly associated with PEP uptake. 6 of 7 health facilities lacked a reporting procedure following percutaneous injury. Conclusion: Health workers are vulnerable to blood borne pathogens across all levels of Health care institutions. Much as PEP for HIV is widely available across all Health facilities, PEP utilization is low. Comprehensive measures to ensure Health worker safety including mandatory Hep B immunisation and occupational exposure surveillance are called for.