HIV/AIDS and the surgeon
Department of Surgery, College of Medicine, University of Ibadan, Nigeria.African journal of medicine and medical sciences 01/2007; 35 Suppl:77-83.
Human Immunodeficiency Virus and Acquired Immunodeficiency Disease (HIV/AIDS) are one of the most difficult challenges facing practicing surgeons worldwide. The challenge is more acute in sub-Saharan Africa as it currently has the highest prevalence of HIV infection in the world. Surgeons are at risk of occupationally acquired infection as a result of intimate contact with the blood and other body fluids of HIV patients requiring surgery. Patients also risk being infected by surgeons and other health care workers during surgical or dental procedures. The seropositive status of the majority of HIV positive patients may be unsuspected by the attending medical personnel who may not practice universal precautions against infection. The non-availability of relevant devices is however the most important factor militating against the use of universal precautions, especially in developing countries. There is therefore a need to increase the awareness about universal precautions and to provide the necessary devices to promote constant adherence to these procedures in order to reduce the risk of nosocomial HIV infection.
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- "Infection with HIV and acquired immunodeficiency disease (AIDS) are among the most difficult challenges facing surgeons worldwide. Surgeons are at risk of occupationally acquired infection as a result of intimate contact with the blood and other body fluids of HIV patients requiring surgery.3 A literature review revealed 33 reports of health care workers who had contracted HIV infection due to their occupation.4 "
ABSTRACT: To determine the prevalence of human immunodeficiency infection among patients who underwent surgery at a rural eye care facility in southeastern Nigeria. A retrospective chart review was performed for all patients who had undergone surgery and a pre-operative Human Immunodeficiency Virus (HIV) test, between August 2008 and July 2009 at the Eye unit of the Presbyterian Joint Hospital, Ohaozara, Ebonyi State, Nigeria. Data were analyzed for age, sex, type of surgery and HIV status. Frequency, percentage and 95% confidence intervals (CI) were calculated with univariate analysis and the parametric method. A total of 380 cases were reviewed comprised of 228 males and 152 females (M:F= 1.5:1).The mean age of the cohort is 56 years (range, 4 years to 91 years). Fourteen patients (3.7%; 95% confidence interval 1.8 - 5.6) were HIV positive. A high HIV sero-prevalence was reported in our study. Infection-control precautionary measures are indicated to minimize risk of HIV transmission to ophthalmic surgeons and allied health-workers.
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- "Particularly important is the use of protective items such as gloves, aprons and eye protection (CDC 1988). Current evidence suggests that using such items significantly reduces the risk of infection and safeguards occupational health, with several studies showing splash rates of more than 40% onto protective masks and glasses during operations (Mast et al. 1993; Marasco & Woods 1998; Sharbaugh 1999; Calfee 2006; Olapade-Olaopa et al. 2006; Davies et al. 2007). The aim of this study was to review recently published data from various LMIC hospitals and document the availability of equipment and supplies for the protection of healthcare workers. "
ABSTRACT: Objective In view of the substantial incidence of bloodborne diseases and risk to surgical healthcare workers in low- and middle-income countries (LMICs), we evaluated the availability of eye protection, aprons, sterile gloves, sterilizers and suction pumps. Methods Review of studies using the WHO Tool for the Situational Analysis of Access to Emergency and Essential Surgical Care. Results Eight papers documented data from 164 hospitals: Afghanistan (17), Gambia (18), Ghana (17), Liberia (16), Mongolia (44), Sierra Leone (12), Solomon Islands (9) and Sri Lanka (31). No country had a 100% supply of any item. Eye protection was available in only one hospital in Sri Lanka (4%) and most abundant in Liberia (56%). The availability of sterile gloves ranged from 24% in Afghanistan to 94% in Ghana. Conclusion Substantial deficiencies of basic protective supplies exist in low- and middle-income countries.
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ABSTRACT: Surgical patients and healthcare workers in sub-Saharan Africa are at an increased risk of contracting HIV. Sierra Leone is one of the poorest countries in the world and has a documented HIV prevalence rate of 2%. Because surgeons and other healthcare staff in sub-Saharan Africa are at risk for HIV exposure from their patients, an assessment of protective supplies and equipment was considered essential. A Society of International Humanitarian Surgeons team in cooperation with the Sierra Leonean Ministry of Health and Sanitation undertook a survey of HIV-protective supplies and equipment at government hospitals in Sierra Leone. The presence of eye protection, sterile gloves, aprons, functioning suction machines, and sharps containers was recorded and compared with a local mission hospital and a local private hospital. Only 20% of government hospitals in Sierra Leone have adequate stores of sterile gloves or eye protection. Suction pumps and aprons are available in only 30-40% of facilities, respectively, and only half have functioning sterilizers and sharps containers. The mission and private hospitals were fully stocked. Although surgical healthcare workers are at risk for exposure to HIV, resources for their protection at government hospitals in Sierra Leone are severely lacking. The Society of International Humanitarian Surgeons is developing a program to provide protective supplies and equipment to hospitals in Sierra Leone, but additional efforts by other organizations working to decrease the spread of HIV are essential.
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