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Infect Control Wkly. 1994 Feb 14:5-6.

Cost-effective infection control for developing world described. Nigeria.

[No authors listed]



The high incidence of needlestick injuries in a Nigerian hospital could be reduced by simple interventions, researchers from Nigeria and Washington related. Adegboye, the colleagues from Obafemi Awolowo University, Ile-Ife, Nigeria, and the University of Washington, Seattle, performed a cross-sectional survey of a random sample (n=514) of health care workers (HCWs) at the university and clinics, with special attention to needlestick and sharp instrument injuries in the year preceding the study. In all, 474 HCWs were available. Out of 470 participants who responded to the question, 468, or 99.6% had heard of AIDS, and 97% of these knew that HIV can be transmitted by needlestick of skin by HIV-infected blood. One hundred sixty-one (34%) of 474 HCWs sustained at least one percutaneous injury owing to a needlestick during the previous year. The overall rate of percutaneous injuries was 0.8 per person-year. One or more needlestick injuries were reported by 126 (27%) of 47 HCWs; of these, 54 reported one, 33 reported two and 39 reported three or more. Needlestick injuries were most common in dentists and surgeons. Among HCWs with needlesticks, the most recent injury occurred during suturing in 24%, while giving an intramuscular injection in 23%, during disposal of used needles in 23%, and during dental injections in 10%. 29% of these needlesticks were attributed to unexpected patient movement, 18% to needle recapping, 18% to an accidental stick by a colleague, and 10% to needle disassembly. Sixty-nine (15%) of the HCWs experienced sharp instrument injuries. Forty-one reported one injury, 16 reported two, and 12 reported three or more. The rate of sharp instrument injuries was highest among dental assistants, surgeons, and lab workers. The use of latex gloves was recommended during exposure to patients' blood, as was the use of disposable syringes and scalpels, when financially feasible. Inexpensive methods to reduce needlestick injuries included: educational seminars to teach HCWs improved techniques for handling and disposal of needles and scalpels, preparation of patients before procedures to reduce unexpected movements, puncture-resistant sharps disposal containers, single-handed "scoop" technique to recap needles, instrument passage in a bowl, avoidance of blind suturing, scalpel blade disassembly using a mechanical device, and safety design for laboratory specimen transport boxes to reduce glass breakage.

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