title: Scarcity of protective items against HIV and other bloodborne infections in 13 low- and middle-income countries.
abstract: OBJECTIVE
  To assess protection of surgical healthcare workers against HIV and other bloodborne infections in low- and middle-income countries (LMICs).
  
  
  METHODS
  Literature review based on recent studies assessing baseline surgical capacity in LMICs using the WHO Situational Analysis of Access to Emergency and Essential Surgical Care, the Surgeons OverSeas (SOS) Personnel, Infrastructure, Procedures, Equipment and Supplies (PIPES) survey and the Harvard Humanitarian Initiative survey tools. The availability of protective eyewear, sterile gloves and sterilisers was assessed.
  
  
  RESULTS
  Thirteen individual country studies with relevant data were identified documenting items from 399 hospitals. The countries included Afghanistan, Bolivia, Gambia, Ghana, Liberia, Mongolia, Nigeria, Sierra Leone, Solomon Islands, Somalia, Sri Lanka, Tanzania and Zambia. Overall, only 29% (79/270) of hospitals always had eye protection. Sterilisers were only available at 64% (244/383) of facilities. Sterile gloves were the most available item, available at 75% of facilities (256/340).
  
  
  CONCLUSIONS
  Surgical healthcare worker protection for bloodborne infections continues to be deficient in LMICs. Improved documentation of these items should be incorporated into future surgical capacity studies. Policy makers and clinicians should work together to secure resources and interventions that will protect this vital workforce.
authors.affiliation: Department of Surgery, University of California San Francisco, East Bay, Oakland, CA, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Surgeons OverSeas, New York, NY, USA.
authors.forename: Shailvi
authors.initials: S
authors.lastname: Gupta
authors.forename: Evan G
authors.initials: EG
authors.lastname: Wong
authors.forename: Adam L
authors.initials: AL
authors.lastname: Kushner
mesh_terms: D017848:Blood-Borne Pathogens; D003906:Developing Countries / Q000706:statistics & numerical data; D013502:General Surgery / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006282:Health Personnel; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control* / Q000706:statistics & numerical data; D009784:Occupational Diseases / Q000453:epidemiology / Q000517:prevention & control*; D011203:Poverty / Q000706:statistics & numerical data; D011482:Protective Devices / Q000600:supply & distribution*; D018805:Sepsis / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D012923:Social Class
keywords: developing countries; interventions chirurgicales; operativa/utilización; operative/utilisation; opération/utilisation; pays en développement; países en vías de desarrollo; procedimientos quirúrgicos; surgical procedures