Use of protective gear and the occurrence of occupational Marburg hemorrhagic fever in health workers from watsa health zone, democratic republic of the Congo
Use of protective gear and the occurrence of occupational Marburg hemorrhagic fever in health workers from watsa health zone, democratic republic of the Congo
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DOI：
10.1086/520540
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发表时间：
2007-11-15
影响因子：
6.4
通讯作者：
Van der Stuyft, Patrick
中科院分区：
文献类型：
--
作者：
Borchert, Matthias;Mulangu, Sabue;Van der Stuyft, Patrick
背景资料。卫生工作者的职业性传播是马尔堡出血热(MHF)暴发的典型特征。这项研究的目的是确定刚果民主共和国杜尔巴和瓦萨省卫生服务人员中职业性MHF的病例；评估暴露和保护水平；并探索不一致使用防护装备的原因。对48名护理MHF患者的妇女进行了血清调查。此外，卫生工作者还接受了关于接触类型、防护装备的使用和接触后症状的问卷调查。对健康服务工作者进行了非正式和深入的访谈。除已知的5例职业性MHF外，发现1例MHF血清阳性；4例感染控制后发生感染。HWS在有创性程序(注射、静脉穿刺术和手术)中比在非侵入性程序中保护自己更好，但医院内的整体保护水平仍然不足，特别是在隔离病房外。防护装备使用不一致的原因包括防护装备的供应不足，坚持传统的疾病起源解释模型，以及与患病同事的同伴关系。感染控制不能过于集中于建立隔离病房，而应以改善医院整体卫生为目标。健康服务的培训应该让他们能够表达和讨论他们的疑虑，并让他们为照顾生病的同事的特殊性做好准备。
Background. Occupational transmission to health workers (HWs) has been a typical feature of Marburg hemorrhagic fever (MHF) outbreaks. The goal of this study was to identify cases of occupational MHF in HWs from Durba and Watsa, Democratic Republic of the Congo; to assess levels of exposure and protection; and to explore reasons for inconsistent use of protective gear.Methods. A serosurvey of 48 HWs who cared for patients with MHF was performed. In addition, HWs were given a questionnaire on types of exposure, use of protective gear, and symptoms after contact. Informal and indepth interviews with HWs were also performed.Results. We found 1 HW who was seropositive for MHF, in addition to 5 cases of occupational MHF known beforehand; 4 infections had occurred after the introduction of infection control. HWs protected themselves better during invasive procedures (injections, venipuncture, and surgery) than during noninvasive procedures, but the overall level of protection in the hospital remained insufficient, particularly outside of isolation wards. The reasons for inconsistent use of protective gear included insufficient availability of the gear, adherence to traditional explanatory models of the origin of disease, and peer bonding with sick colleagues.Conclusions. Infection control must not focus too exclusively on the establishment of isolation wards but should aim at improving overall hospital hygiene. Training of HWs should allow them to voice and discuss their doubts and prepare them for the peculiarities of caring for ill colleagues.