Prevalence and Factors Associated with Occupational HIV Exposure and Post Exposure Prophylaxis among Health Workers: A Case Study of Kiambu County, Kenya, 2017

George Njogu Karoki^{1, 2,} , Tula Galgalo^{1, 3}, Joyce Balindawa^{1, 4}, Lawrence Kirimi Gitonga^{1, 5} and Peter Kinyua Gachoki^6,

¹Field Epidemiology and Laboratory Training Program, Nairobi, Kenya

²Moi University, Eldoret, Kenya;Ministry of Health, Nairobi, Kenya

³Ministry of Health, Nairobi, Kenya

⁴Moi University, Eldoret, Kenya

⁵Department of Health, Embu County Government

⁶Department of Pure and Applied Sciences, Kirinyaga University Kenya

Cite this paper

George Njogu Karoki, Tula Galgalo, Joyce Balindawa, Lawrence Kirimi Gitonga and Peter Kinyua Gachoki. Prevalence and Factors Associated with Occupational HIV Exposure and Post Exposure Prophylaxis among Health Workers: A Case Study of Kiambu County, Kenya, 2017. American Journal of Public Health Research. 2023; 11(6):189-196. doi: 10.12691/AJPHR-11-6-3

Abstract

Occupational health risk of Human Immunodeficiency Virus (HIV) to health care workers (HCWs) is a burden in the health sector. This determines the prevalence of HIV exposure, uptake of Post Exposure Prophylaxis (PEP) among the exposed HCWs and associated factors in Kiambu County, Kenya. A hospital-based cross-sectional quantitative study was carried out in Kiambu and Thika hospitals from April to June 2017. Probability proportionate to size sampling was used to identify 108 and 184 HCWs from Kiambu and Thika. Simple random sampling was used to select participants by cadre from each site. Data was analyzed using EPI Info 7. Bivariate analysis was used to assess association between outcome variables and demographic and occupational characteristics. Odds ratio (OR) and 95% Confidence Interval (CI) was used and variables with P-value of <0.20 were entered into multiple regression. A total of 292 HCWs were interviewed. The mean age of respondents was 33.4 years (SD± 9.40), 166 (58.90%) were females, nurses 108 (37%) and 174 (59.59%) were married. Overall prevalence of exposure to HIV was 120/292 (41.1%), 67/ (55.8%) were female, needle stick exposure was 48/120 (40%). Among the exposed, 43 (35.8%) were initiated on PEP out of which 30/43 (70%) completed the treatment course. Results showed doctors (120 aOR 4.6; 95% CI: 1.6-12.6) and work experience of ≤ 5 years (aOR 2.2; 95% CI: 1.0-5.2) to be most at risk of HIV exposure. Age 35-44 years (aOR 4.7; 95% CI: 1.0-23) was associated with PEP uptake. The prevalence of occupational exposure to HIV was high among HCWs, and common route of exposure was needle stick injuries. Age 35-44 years was associated with PEP uptake whereas being a doctor and work experience of ≤ 5 years was associated with significant HIV exposure. Therefore, the study recommended mandatory infection control and prevention training for new employees and adequate counseling to reduce stigma to exposed HCWs.

Keywords

human immunodeficiency virus, post exposure prophylaxis, health care workers, prevalence, occupational exposure

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Kuhar, D. T., Henderson, D. K., Struble, K. A., et al. (2013). Updated US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis. Infection Control & Hospital Epidemiology, 34 (9), 875–892.
[2]	Otten, M. W. (2000). Efficacy of postexposure prophylaxis after intravaginal exposure of pig-tailed macaques to a human-derived retrovirus (human immunodeficiency virus type 2). The Journal of Infectious Diseases, 181 (3), 740–743.
[3]	Orisakwe, O. E., Igwe, W., Afonne, O. J., & Vwioko, D. E. (2012). Post-exposure prophylaxis for HIV prevention in Nigeria. African Journal of Reproductive Health, 16 (4), 17-25.
[4]	NASCOP. (2014). Guidelines for antiretroviral drug therapy in Kenya (4th ed.). Nairobi: NASCOP.
[5]	WHO. (2007). Guidance on prevention of transmission of HIV and hepatitis viruses through health care settings. Geneva: WHO.
[6]	Hamers, R. L. (2012). Antiretroviral post-exposure prophylaxis after sexual, injection-drug use, or other nonoccupational exposure to HIV. Current HIV/AIDS Reports, 9 (4), 273–280.
[7]	WHO. (2012). Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: Recommendations for a public health approach. Geneva: WHO.
[8]	Karen, O. (2004). Postexposure prophylaxis for HIV infection after sexual, injection-drug use, or other nonoccupational exposure. Chicago Medical Journal, 66 (9), 595-604.
[9]	Pinto, J., & Vaz, P. (1999). Prevention of mother-to-child transmission of HIV-1 in resource-poor countries. AIDS, 13 Suppl A, S1-S4.
[10]	Mbasi, E. N. (2011). Efficacy of zidovudine chemoprophylaxis and its effect on viral load after occupational exposure to HIV. African Health Sciences, 11 (2), 268-273.
[11]	Bourry, O. (2010). HIV postexposure prophylaxis, prevention of occupational transmission. Medecine et maladies infectieuses, 40 (4), 165–172.
[12]	NASCOP. (2015). Kenya HIV estimates report 2015. Nairobi: NASCOP.
[13]	Cochran, W. G. (1977). Sampling techniques (3rd ed.). New York: John Wiley & Sons.
[14]	Odongkara, B. (2012). Occupational exposure to HIV infection among health workers in Gulu and Kole Districts, Uganda. African Health Sciences, 12 (1), 48-54.
[15]	Muralidhar, S., Singh, P. K., Jain, R. K., Malhotra, B., & Bala, M. (2010). Needle stick injuries among health care workers in a tertiary care hospital of India. Indian Journal of Medical Research, 131 (3), 405-410.
[16]	Filmawit, A. (2014). Occupational exposure to HIV and post exposure prophylaxis among health professionals in Amhara Region, Ethiopia. Occupational Medicine & Health Affairs, 2 (3), 1-6.
[17]	Mponela, M., Njau, B., Mmbaga, E. J., Neke, N., & Mshana, S. E. (2015). Occupational exposure to HIV and use of post exposure prophylaxis among health care workers in Mbeya Referral Hospital, South Western Tanzania. BMC Research Notes, 8 (1), 1-6.
[18]	Odongkara, B. M., Ndejjo, R., Musinguzi, G., & Muhamadi, L. (2012). Occupational exposure to HIV infection among health workers in Gulu and Kole Districts, Uganda. African Health Sciences, 12 (1), 48-54.
[19]	Chalya, P. L., Mabula, J. B., Dass, R. M., Mbelenge, N., Ngayomela, I. H., Chandika, A. B., & Joseph, N. M. (2015). Incidence and causes of needle stick and sharps injuries among health care workers in a Tanzanian tertiary hospital. Tanzania Journal of Health Research, 17 (1), 1-1.
[20]	Mbaisi, E. M., Ng'ang'a, Z., Wanzala, P., & Omolo, J. (2011). Prevalence and factors associated with percutaneous injuries and splash exposures among health-care workers in a provincial hospital, Kenya, 2010. Pan African Medical Journal, 10 (1), 1-9.
[21]	Butsashvili, M., Kamkamidze, G., Gvetadze, R., & Goguadze, K. (2012). Occupational exposures to blood and body fluids among health care workers in Georgia. International Journal of Occupational Medicine and Environmental Health, 25 (1), 3-10.
[22]	Afridi, N. I., Khan, S. N., & Ali, S. (2013). Frequency of needle stick injuries among health care workers and evaluation of post exposure prophylaxis protocol in a tertiary care hospital of Karachi. Journal of the Pakistan Medical Association, 63 (2), 169-172.
[23]	Rampal, L., Zain, R. M., & Husain, R. (2010). A study on needle stick injuries among health care workers in a Malaysian hospital. Singapore medical journal, 51 (7), 616-620.
[24]	Lee, L. M., Andriesen, J., Gaseitsiwe, S., Mosepele, M., Letlhogile, R., & Seipone, K. (2014). Occupational exposure to blood and body fluids and post-exposure prophylaxis completion among health care workers in Botswana. International journal of occupational and environmental health, 20 (4), 307-314.
[25]	Babanawo, R. (2016). Occupational exposure to body fluids and needle stick injuries among health care workers in a tertiary hospital in Nigeria. Nigerian journal of clinical practice, 19 (5), 637-642.
[26]	Ntombizodwa, B. M. (2011). Post-exposure prophylaxis practices following occupational exposures to HIV among health care workers in KwaZulu-Natal, South Africa. South African Family Practice, 53 (5), 468-473.
[27]	Connor, E. M., Sperling, R. S., & Gelber, R. (1994). Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. New England Journal of Medicine, 331 (18), 1173–1180.