Assessing Five Years of Management of Accidental Exposure to Blood at Gao Hospital, Mali

Abstract

Accidental exposure to blood (AEB) constitutes a risk of transmission of blood-borne viruses including HIV, hepatitis B and hepatitis C virus especially amongst health workers. This study aims to describe accidental exposure to blood and post exposure management five years after it begin at the Hospital of Gao, since 2012 there is insurrection in this area making difficult to maintain health care system. This study will help to identify gaps to fill in order to improve the prevention of blood borne pathogen infection in this hospital. All cases of AEB declared at the Hospital from January 1st 2007 to December 31, 2011 have been enrolled. The sociodemographic profile of victims, the circumstances of the accident, the post exposure management and the follow up of subject have been registered. Data were entered and analyzed with the SPSS software. Chi square test was used with the level of significance p<0.05. During the 60 months of the study, an average of 124 workers were employed at the Hospital of Gao and 15 cases of accidental blood exposure were declared equal to an incidence density of 4.2 cases per 100 persons per year. Males were the most affected (60%). Nurses and lab technicians represent the majority of victims (53.3%). The most frequent type of accident was the injury by cannula needle sticks during intravenous injections (73.3%). Most of the cases received High Activity Antiretroviral Therapy (HAART) within a mean delay of 25 Hours from the accident, and the regiment (AZT/3TC/LPV/r) is predominantly used. HIV serology was done in 53.3% of subjects and revealed 1 positive case. Initial blood tests in all victims were normal. The HAART observance was worst among medical doctors (p < 0.001). No contaminations by HIV were detected after 6 months of follow up. The frequency of declared accidental exposures to blood at the Hospital of Gao is low. The post exposure management is facing a problem of observance of the treatment whenever it shows efficacy in all cases.