Epidemiology of needlesticks and other sharps injuries and injection safety practices in the Dominican Republic
Fecha
2007Autor
Moro, Pedro L.
Moore, Arelis
Balcacer, Patricia
Montero, Alex
Díaz, Delissa
Gómez, Virgen
Gabic, Zacarias
Weniger, Bruce G.
Metadatos
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Contaminated sharps, such as needles, lancets, scalpels, broken glass, specimen tubes, and other instruments,
can transmit bloodborne pathogens such as HIV, hepatitis B (HBV), and hepatitis C viruses (HCV). Methods: Observation of
facilities and injections and questionnaire-guided interviews were conducted in 2005 among health care workers (HCWs) in 2
public hospitals in Santo Domingo and 136 public immunization clinics (IC) in the Dominican Republic. Injection practices and
sharps injuries (SIs) in health care facilities in the Dominican Republic were assessed in cross-sectional surveys to identify
areas in which preventive efforts might be directed to make injection practices safer. Results: Of the 304 hospital HCWs and
136 ICs HCWs interviewed, 98 (22.3%) reported ≥1 SIs during the previous 12 months. ICs had a lower incidence (13 per 100
per person-years [p-y]) of SIs than hospitals (65 per 100 p-y) (P < .0001). Unsafe needle recapping was observed in 98% of all
injections observed at hospitals but in only 12% of injections at ICs (P < .0001). Sharps were observed improperly disposed in
regular waste containers in 24 (92%) of 26 areas at which injections are prepared at the hospitals but in only 11 (8%) of 136 ICs
(P < .0001). Training in injection safety was received by 4% of HCWs in hospitals but by 77% in ICs (P < .001). Of 425 HCWs,
247 (58%) were fully immunized against hepatitis B. There was a higher risk of SIs among staff dentists (adjusted relative risks
[aRR], 5.9; 95% confidence interval [CI]: 2.8-12.6), resident physicians (aRR, 3.5; 95% CI: 1.8-6.9), and those who gave ≥11
therapeutic injections per day (aRR, 1.6; 95% CI: 1.1-2.4). Conclusion: Injection practices at ICs were safer than those found at
public hospitals. Preventive strategies to lower SIs in public hospitals should include regular training of hospital staff to minimize
needle recapping and improper disposal, among other interventions to reduce the dangers of needles.
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