title: Burden and outcome of HIV infection and other morbidities in health care workers attending an Occupational Health Program at the Provincial Hospital of Tete, Mozambique.
abstract: OBJECTIVE
  To investigate the burden and outcome of HIV infection and other morbidities amongst a Mozambican hospital staff.
  
  
  METHODS
  Within an occupational health service set up in April 2008 in the provincial hospital of Tete, Mozambique, we offered to all staff members an initial clinical, laboratory and radiological screening and followed them up prospectively until April 2010.
  
  
  RESULTS
  A total of 47.5% of 423 health workers attended the program. The cohort (female-to-male ratio: 2.2; mean age: 39 years) consisted mostly of auxiliary staff (43%) and nurses (29.8%). At initial screening, 71% were asymptomatic. HIV infection (28.4%) and tuberculosis (TB) (21%) were the main reported antecedent illnesses. Laboratory screening revealed anaemia (haemoglobin level <10 mg/dl) in 9% participants, abnormal liver enzymes in 23.9% and a reactive non-treponemal syphilis test in 5%. Of 145 performed chest X-rays, 13% showed abnormalities. All 113 health workers not recently tested for HIV were screened, and 31 were newly diagnosed with HIV infection (resulting in an overall HIV prevalence of 43.8%). Nine cases of TB were diagnosed at screening/during follow-up. In April 2010, all but one of the participants were alive. All HIV-infected health workers under antiretroviral therapy were actively followed-up.
  
  
  CONCLUSIONS
  Serious conditions were frequently diagnosed in health workers, in particular HIV infection. Mid-term outcome was favourable within this program. Creation of screening and care services dedicated to caregivers should be of highest priority in similar African settings.
authors.affiliation: Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium. esther.casas@msf.org
authors.forename: Esther Carrillo
authors.initials: EC
authors.lastname: Casas
authors.forename: Tom
authors.initials: T
authors.lastname: Decroo
authors.forename: Jules Aimé Bonou
authors.initials: JA
authors.lastname: Mahoudo
authors.forename: Jesus Maria
authors.initials: JM
authors.lastname: Baltazar
authors.forename: Carla Das
authors.initials: CD
authors.lastname: Dores
authors.forename: Luisa
authors.initials: L
authors.lastname: Cumba
authors.forename: Anja
authors.initials: A
authors.lastname: De Weggheleire
authors.forename: Veerle
authors.initials: V
authors.lastname: Huyst
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Bottieau
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology*; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000706:statistics & numerical data; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009017:Morbidity; D009073:Mozambique / Q000453:epidemiology; D016272:Occupational Health; D015995:Prevalence; D011446:Prospective Studies