title: Challenges in HIV post-exposure prophylaxis for occupational injuries in a large teaching hospital in Malawi.
abstract: We describe the evaluation of the HIV post-exposure prophylaxis (PEP) programme for occupational injuries in Queen Elizabeth Central Hospital, Blantyre, Malawi. An audit was performed 1 year after introduction, by reviewing files of all clients who sought advice regarding PEP. In addition, the incidence of occupational injuries and awareness of the programme were assessed through interviews with nurses. The logistics of the programme were adequate. Of 29 clients who reported occupational injuries,19 started PEP. Only double antiretroviral drug therapy was available; side-effects were common but generally mild. Attendance of scheduled follow-up visits was poor, and few HIV test results after completion of PEP were obtained. Interviews with nurses revealed a high incidence of occupational injuries, but many did not report for advice about PEP; mostly because of unawareness of the programme and a reluctance to be tested for HIV.
authors.affiliation: Department of Medicine, College of Medicine, University of Malawi, Blantyre, Malawi. vanoosterhout@malawi.net
authors.forename: Joep J G
authors.initials: JJ
authors.lastname: van Oosterhout
authors.forename: Mulinda
authors.initials: M
authors.lastname: Nyirenda
authors.forename: Michael B J
authors.initials: MB
authors.lastname: Beadsworth
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Kanyangalika
authors.forename: Johnstone J
authors.initials: JJ
authors.lastname: Kumwenda
authors.forename: Eduard E
authors.initials: EE
authors.lastname: Zijlstra
mesh_terms: D000062:Accidents, Occupational; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018890:Chemoprevention; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000209:etiology / Q000517:prevention & control* / Q000635:transmission*; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D008295:Malawi / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016602:Needlestick Injuries / Q000150:complications / Q000453:epidemiology*; D009786:Occupational Health Services / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010564:Personnel, Hospital / Q000706:statistics & numerical data
chemical_list: D019380:Anti-HIV Agents