Health-care workers' occupational exposures to body fluids in 21 countries in Africa: systematic review and meta-analysis

• Published in: Bulletin of the World Health Organization Vol. 95; no. 12; pp. 831 - 841F
• Main Authors: Auta, Asa, Adewuyi, Emmanuel O, Tor-Anyiin, Amom, Aziz, David, Ogbole, Esther, Ogbonna, Brian O, Adeloye, Davies
• Format: Journal Article
• Language: English
• Published: Switzerland World Health Organization 01.12.2017
• Subjects: Blood; Body Fluids; Central government; Confidence intervals; Exposure; Health care; Health care policy; Health Personnel; Health services; Hepatitis C; HIV; Hospitals; Human immunodeficiency virus; Humans; Infections; Infectious Disease Transmission, Patient-to-Professional - prevention & control; Injuries; Institutions; Laboratories; Medical personnel; Medical wastes; Meta-analysis; Midwifery; Midwives; Needlestick injuries; Nurses; Nursing; Occupational Exposure; Occupational health; Pathogens; Physicians; Prevalence; Prevention; Public health; Random effects; Risk; Surgeons; Systematic review; Systematic Reviews; Technicians; Training; Trust; Workers; Africa
• ISSN: 0042-9686; 1564-0604
• DOI: 10.2471/blt.17.195735

To estimate the lifetime and 12-month prevalence of occupational exposure to body fluids among health-care workers in Africa. Embase®, PubMed® and CINAHL databases were systematically searched for studies published between January 2000 and August 2017 that reported the prevalence of occupational exposure to blood or other body fluids among health-care workers in Africa. The continent-wide prevalence of exposure was estimated using random-effects meta-analysis. Of the 904 articles identified, 65 studies from 21 African countries were included. The estimated pooled lifetime and 12-month prevalence of occupational exposure to body fluids were 65.7% (95% confidence interval, CI: 59.7-71.6) and 48.0% (95% CI: 40.7-55.3), respectively. Exposure was largely due to percutaneous injury, which had an estimated 12-month prevalence of 36.0% (95% CI: 31.2-40.8). The pooled 12-month prevalence of occupational exposure among medical doctors (excluding surgeons), nurses (including midwives and nursing assistants) and laboratory staff (including laboratory technicians) was 46.6% (95% CI: 33.5-59.7), 44.6% (95% CI: 34.1-55.0) and 34.3% (95% CI: 21.8-46.7), respectively. The risk of exposure was higher among health-care workers with no training on infection prevention and those who worked more than 40 hours per week. The evidence available suggests that almost one half of health-care workers in Africa were occupationally exposed to body fluids annually. However, a lack of data from some countries was a major limitation. National governments and health-care institutions across Africa should prioritize efforts to minimize occupational exposure among health-care workers.