Health care workers (HCW) are at high risk of acquiring blood-borne diseases. This study compared the risk of infection among HCW in different hospital units and also between HCW and students in medical fields. This cross-sectional study involved pre-tested questionnaires that were completed by 625 HCW and undergraduate students undergoing clinical attachments from February to August 2001. The respondents were separated into two groups: i) HCW from Hospital Kuala Lumpur, HKL (n=241) and Hospital Universiti Kebangsaan Malaysia, HUKM (n=153) ii) Medical students from Universiti Kebangsaan Malaysia, UKM (n=171) and HUKM student nurses (n=60). The results obtained showed that the risk of transmission of blood-borne infections varied significantly according to professional ranks (p<0.05) and to hospital units (p<0.05). The medical intensive care (ICU), haemodialysis, and nephrology and urology units had the highest scores for the risk of infection while the diagnostic laboratory had the lowest risk of infection (p<0.05). Preventive measures taken by the subjects in this study were not satisfactory especially with reference to the use of personal protective equipment and the practice of universal precautions.
This study aimed to assess the knowledge of blood-borne diseases transmitted through needle stick injuries amongst health-care workers in a tertiary teaching hospital. We also aimed to assess the practices of universal precautions amongst these workers and its correlation with the facts. We carried out a cross-sectional study from January to July 2008 involving various levels of health-care workers in Serdang Hospital, Selangor, Malaysia. A self-administered questionnaire assessing knowledge of blood-borne diseases and universal precautions, and actual practice of universal precautions was used. Two hundred fifteen respondents participated in this study; 63.3% were staff nurses. The mean knowledge score was 31.84 (SD 4.30) and the mean universal practice score was 9.0 (SD 2.1). There was a small, positive correlation between knowledge and actual practice of universal precautions (r = 0.300, n = 206, p < 0.001) amongst the cohort studied. Factors such as age and years of experience did not contribute towards acquisition of knowledge about blood-borne illnesses or the practice of universal precautions.
Blood donors with reactive screening test results are requested to come in for counseling by letter and telephone call. It has been noticed many donors responded to neither the letters nor the telephone calls. We evaluated 589 cases with reactive screening test results (208 positive for hepatitis C, 209 for hepatitis B, 85 for VDRL and 87 for HIV). In the hepatitis C positive group 61 donors (29.3%) did not respond and 4.7% missed their follow-up appointment. Similarly low response rates were noted with the HBV (58.9%) and VDRL (67.1%) positive groups. Among HIV positive donors 46.0% failed to respond to multiple calls. We conclude that blood donors in Malaysia have a poor response to calls from the blood transfusion unit. A review of the effectiveness of the current deferral system and an increased public knowledge of transmissible infectious diseases may encourage blood donors to have a better response rate.
The crude methanol extract of Bearded Argostemma (Argostemma involucratum Hemsl., Rubiaceae) showed a good and broad spectrum of antibacterial activity against both Gram-negative and Gram-positive bacteria. The activity was increased on fractionation (hexane, dichloromethane and water), particularly in the aqueous fraction which was more active than the methanol extract and streptomycin (no activity was shown against tested moulds). Both the hexane and dichloromethane fractions were inactive. The objective of this experiment was to investigate the antibacterial activity of hexane, dichloromethane, and aqueous fractions of Argostemma involucratum Hemsl. The aqueous fraction of Bearded Argostemma may be a possible new option for the treatment of bacterial infections.
Workers in the health care industry and related occupations are at risk of occupational exposure to blood borne pathogens, including human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and other potentially infectious agents. The primary route of occupational exposure to blood borne pathogens is accidental percutaneous (through the skin) injury. Health care workers handle sharp devices and equipment such as hypodermic and suture needles, intravenous blood collection devices, phlebotomy devices, and scalpels. Health care workers with the most involvement in direct patient care e.g., nursing staff, sustain the highest proportion of reported NSIs (needle stick injuries).
Health care workers (HCW) are at higher risk of acquiring blood borne infections such as hepatitis B virus, hepatitis C virus and human immunodeficiency virus from patients. To minimise exposure, Universal Precautions Policy guidelines were introduced. This study looked into one of the aspects of hepatitis B prevention among HCW in the Malaysian context. The objective of this study was to assess hepatitis B vaccine coverage among HCW. A cross sectional study involving pre-tested questionnaires was undertaken from February 2001 to August 2001. Hospital staff in Hospital Kuala Lumpur and Hospital Universiti Kebangsaan Malaysia as well as undergraduate students undergoing clinical attachments were randomly chosen. A total of 625 subjects were enrolled. Only 58.4% had taken a complete hepatitis B vaccination. However, 82.2% have taken at least one dose of the hepatitis B vaccine and were supposed to complete the schedule in due course. Not all HCW were protected against hepatitis B. Preventing hepatitis B in HCW should be one of the priorities of the hospital management as it is definitely cheaper than managing chronic hepatitis B cases.
Hemovigilance like quality systems and audits has become an integral part of the Blood Transfusion Service (BTS) in the developed world and has contributed greatly to the development of the blood service. However developing countries are still grappling with donor recruitment and efforts towards sufficiency and safety of the blood supply. In these countries the BTS is generally fragmented and a national hemovigilance program would be difficult to implement. However a few developing countries have an effective and sustainable blood program that can deliver equitable, safe and sufficient blood supply to the nation. Different models of hemovigilance program have been introduced with variable success. There are deficiencies but the data collected provided important information that can be presented to the health authorities for effective interventions. Hemovigilance program modeled from developed countries require expertise and resources that are not available in many developing countries. Whatever resources that are available should be utilized to correct deficiencies that are already apparent and obvious. Besides there are other tools that can be used to monitor the blood program in the developing countries depending on the need and the resources available. More importantly the data collected should be accurate and are used and taken into consideration in formulating guidelines, standards and policies and to affect appropriate interventions. Any surveillance program should be introduced in a stepwise manner as the blood transfusion service develops.