針刺し事故：ケニアの医療従事者にとっての増大する懸念

タイトル: HIV post-exposure prophylaxis adherence due to needle stick and sharp injuries

概要: BackgroundHealthcare workers frequently experience needle sticks and other sharp injuries, which are among the most prevalent types of occupational accident in hospital settings. Studies indicate that approximately 50% of these devices are contaminated with blood, exposing users to potential infections from blood-borne pathogens such as HIV. Despite the efficacy of post-exposure prophylaxis in lowering the risk of HIV transmission, ensuring consistent adherence to this treatment regimen remains a widely acknowledged challenge. ObjectiveThis study aimed to assess healthcare workers adherence to HIV post-exposure prophylaxis following needlestick and sharp injuries at Kijabe Hospital, Kenya, between February 2017 and June 2022. MethodA retrospective chart review was conducted on healthcare workers who were started on HIV PEP following a reported occupational exposure due to needle sticks and sharp injuries between February 2017 and June 2022. ResultIn total, 136 healthcare workers were exposed to needle sticks and sharp injuries. The majority of exposures (82.3%) were at a high risk of HIV transmission. The overall adherence rate to the 28-day HIV-PEP course was 26%. Healthcare workers were more likely to complete HIV-PEP when the sources HIV status was positive than when it was negative [ 42.4% vs. 11.8%; p = 0.001]. The drug regimen (TDF/3TC/DTG) was significantly associated with default treatment (aOR, 5.0 (95% CI 2.0 - 11.0) (p= 0.001) compared with patients using the TDF/3TC/ATVr regimen. ConclusionOur study found that 74% of healthcare workers did not complete the full 28-day course of HIV post-exposure prophylaxis (PEP) as recommended, indicating a significant issue with adherence. This highlights the need for strategies to improve compliance and ensure occupational health. Additionally, as there is limited research on HIV PEP completion rates among healthcare workers in Kenya, these findings will contribute valuable knowledge in this area.