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J R Soc Health. 1996 Jun;116(3):157-60.

Doctors at risk of hepatitis B and HIV infection from patients in Nigeria.

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Department of Medicine, University College Hospital, Ibadan, Nigeria.


The aim of this study was to assess the degree of residents' concern about acquiring hepatitis B virus (HBV) and human immunodeficiency virus (HIV) infection from their patients at the University College Hospital, Ibadan, Nigeria. We surveyed 149 resident doctors. The response was 89%. Nine per cent of the resident doctors reported percutaneous exposures to needles contaminated with blood of patients infected with HBV or HIV. Eighty per cent of the residents experienced moderate to major concern about contracting these viral infections from their patients. The majority of the doctors (54-64%) indicated that they should be allowed to decide for themselves whether to treat the infected patients. A substantial proportion of them (46-49%) believed that refusing to take care of the patient was not unethical. About 86-96% of the doctors believed that the hospital as well as the Residency Training Programme administrators were not concerned about the risk of acquiring the viruses from their patients. In general, the results demonstrate a major degree of concern about acquiring HBV and HIV infections among resident doctors. Moreover, there is a need for the hospital and Residency Training Programme administrators to formally address these concerns so as to motivate well and reassure these doctors. No such study exists that exclusively address this important and topical subject in doctors in tropical Africa.


In Ibadan, Nigeria, 149 resident physicians completed a questionnaire revolving around their degree of exposure to hepatitis B virus (HBV) or HIV-infected patients, their concern about acquiring these infections, and the effect of this concern on their caring for patients and on the health policies of the University College Hospital. 9% had been stuck by a needle contaminated with the blood of an HBV- or HIV-infected patient. The 12 residents reporting a needle stick had 21 needle-stick exposures altogether. 54% of the residents used universal precautions while performing procedures no more than 50% of the time. 61-67% estimated their risk of acquiring these infections as no greater than 1/10,000, which compares to the estimate found in the literature. Yet 80% had moderate to high concern about acquiring HBV or HIV infection from their patients. 32-34% of residents reported that their concerns about acquiring these infections would not adversely affect patient care. 60-77% of residents would continue to care for patients with HBV or HIV infection if given a choice. 54-64% believed that they should be allowed to decide themselves whether to provide care to infected patients. About 50% did not consider it unethical to refuse to care for infected patients. 86-96% thought that the hospital and the residency training program administrators did not worry about the risk of acquiring HBV or HIV infection from their patients. These findings show that resident physicians are greatly concerned about acquiring HBV and HIV infections. They also indicate a need for the hospital and training program administrators to formally handle these concerns in order to motivate and reassure the residents.

[Indexed for MEDLINE]

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