title: Occupational exposure to bloodborne pathogens among health care workers in Botswana: Reporting and utilization of postexposure prophylaxis.
abstract: This study assessed reporting behavior and satisfaction with postexposure prophylaxis (PEP) systems among health care workers (HCWs) at risk for occupational bloodborne pathogen exposure (BPE) in 3 public hospitals in Botswana.
  
  
  
  A cross-sectional survey among HCWs provided information on perceptions, attitudes, and experiences with occupational exposures, reporting, and postexposure care. HCWs potentially in contact with blood or body fluids were surveyed using audio computer-assisted self-interview.
  
  
  
  Between August 2012 and April 2013, 1,624 HCWs completed the survey; most were women (72%), and almost half (48%) were nurses. Sixty-seven percent of them had ever received training related to BPE management; 62% perceived themselves to be at high risk for BPE. Among the 426 HCWs who were exposed to sharps injuries or splashes in the last 6 months, 160 (37%) reported the exposure. Of these, 111 of the 160 (69%) received PEP, and 79 of the 111 (71%) completed their medication. Whereas >92% of the total HCWs had ever been tested for HIV, only 557 (37%) were tested in their own health facility. Most HCWs (87%, n = 1,406) reported they would be interested in testing themselves. Of HCWs who reported an exposure, less than half (49%, n = 78) were satisfied with existing reporting systems.
  
  
  
  Underreporting of occupational exposures and dissatisfaction with PEP management is common among HCWs. Improved PEP management strategies and regular monitoring are needed.
authors.affiliation: Mailman School of Public Health, ICAP-Columbia University, New York, NY. Electronic address: gechbel@gmail.com.
authors.forename: Getachew
authors.initials: G
authors.lastname: Kassa
authors.affiliation: Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Dejana
authors.initials: D
authors.lastname: Selenic
authors.affiliation: Mailman School of Public Health, ICAP-Columbia University, New York, NY; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
authors.forename: Maria
authors.initials: M
authors.lastname: Lahuerta
authors.affiliation: Botswana Harvard AIDS Institute Partnerships, Gaborone, Botswana.
authors.forename: Tendani
authors.initials: T
authors.lastname: Gaolathe
authors.affiliation: Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Botswana Harvard AIDS Institute Partnerships, Gaborone, Botswana.
authors.forename: Garegole
authors.initials: G
authors.lastname: Letang
authors.affiliation: Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Cari
authors.initials: C
authors.lastname: Courtenay-Quirk
authors.affiliation: Ministry of Health Botswana, Gaborone, Botswana.
authors.forename: Nelson Kiama
authors.initials: NK
authors.lastname: Mwaniki
authors.affiliation: Centers for Disease Control and Prevention Botswana, Gaborone, Botswana.
authors.forename: Sarah
authors.initials: S
authors.lastname: Gaolekwe
authors.affiliation: Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Naomi
authors.initials: N
authors.lastname: Bock
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D017848:Blood-Borne Pathogens; D001902:Botswana / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D017060:Patient Satisfaction; D056990:Post-Exposure Prophylaxis / Q000706:statistics & numerical data*; D012308:Risk Management; D055815:Young Adult
keywords: Bloodborne pathogens; health care worker; occupational exposure; postexposure prophylaxis