Accidental exposure to blood and body fluids is a public health concern, especially among health care workers (HCW) and constitutes a risk of transmission of blood-borne viruses including Human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus(HCV)1,2. Twenty six viruses have been documented to have caused occupational infections among health care workers 3 but three viruses alone (HIV, HBV, HCV) account for most of the cases of occupational infection and of greatest public health concern due to their high prevalence among patients and the severity of the infections they cause 4.
The risk of blood borne virus transmission following occupational exposure depends on a variety of factors such as the titer of virus in the source patient’s blood or body fluid, the type of injury, quantity of blood or body fluid transferred to the health care worker during the exposure and the health care worker’s immune status 5,6. However, infections acquired through occupational exposure are largely preventable through strict infection control measures such as the use of safe devices, proper waste disposal, immunization and prompt management of exposures including the use of post exposure prophylaxis(PEP) 7. According to the World Health Organization Report 8, 2.5% of HIV cases among Health care Workers and 40% of Hepatitis B and C cases among Health care workers worldwide are as a result of occupational exposure. Over 90% of these infections are occurring in low-income countries, and most are preventable 9, 10, 11. PEP is very essential in preventing occupationally acquired infections among health care workers and it is known to reduce the infection risk by 81% 12
Definition of Terms.
Blood borne viruses: Blood borne viruses constitute a variety of infectious agents that can be transmitted through blood and sometimes other body fluids and tissues 13. For the purpose of this study we shall consider three viruses only HIV, HBV, HCV because they constitute the greatest public health concern among health care workers 1
Healthcare workers: Health workers are people whose job is to protect and improve the health of their communities 14. For the purpose of this study and considering the time factor for the study, we shall consider three categories of healthcare workers. Physicians, nurses and laboratory scientist.
Post exposure prophylaxis: The term post-exposure prophylaxis is generally understood to mean the medical response given to prevent the transmission of blood-borne pathogens following a potential exposure.15
Previous research and research gap:
The risk of occupationally acquired infection among health care workers is a serious public health concern. This is further exacerbated by documented possibility of transmission of such occupationally acquired infection from health care workers to patients 2. Post exposure prophylaxis exist as the only means of preventing such infection and has been shown to prevent about 81% of infections due to occupational exposure 12. As a result, research in this area has predominantly been centered towards assessing and quantifying the uptake of post exposure prophylaxis among health care workers around the world all of which recorded a low PEP uptake. A study by mesfin and kibret 16 among medical student in Ethiopia recorded a low HBV vaccination uptake (4.7%). Low uptake of PEP to HIV has also been recorded among healthcare workers in Lagos, Nigeria (6.3%) 10 and in Tanzania (22%) 17. In Cameroon, low uptake of PEP has also been recorded among medical students (18%) 18, among healthcare workers in a rural health district 19 and in the urban health district of Fako division 20.
Despite the fact that PEP remains the only way of preventing infections due to occupational exposure and low uptake of PEP has been recorded consistently among healthcare workers, no research has been done to understand and address the underlying cause of low PEP uptake among HCWs which is pivotal in preventing infections due to occupational exposures.