Low Knowledge Levels on PEP among Cameroonian Nurses

A study recently published on PLOSONE has established that the knowledge and practice of nurses on PEP for HIV in Cameroon is critically low. The study also found that there is urgent need for training programs and workshops to increase awareness, improve practice, and reduce the risk of HIV acquisition from work-related activities among health care providers in Cameroon.

Poor PEP Training among the Nurses

The study was conducted between April and July 2013, and involved 80 nurses at Tubah Health District in the North West Region of Cameroon. Tubah Health District is a rural area with a population of 53,988 inhabitants. 73.7% of the participants in the study had poor knowledge about PEP for HIV. A good proportion (83.8%) of the participants had heard about PEP for HIV mostly from ward rounds. Only 12.5% of the nurses had had a formal training on PEP for HIV and just 11 participants were aware of their hospital PEP policies. In addition, only eight nurses knew the proportion of needle pricks that result in HIV transmission.

Less than a fifth of the nurses could correctly identify potentially high-risk fluids. In all, 63, 41, and another 41, of the participants knew that needle prick, rape and infants born to HIV-positive mothers, respectively, were indications for initiation of PEP. Almost all (98.8%) of the participants correctly identified the appropriate first aid measure to institute in the case of needle stick injury. 66% of the nurses knew how soon PEP was to be initiated after needle prick. With respect to the ideal PEP drug regimen, only 24 participants correctly stated the expanded 3 drug regimen, while 36 and 13 incorrectly stated two-drug and one-drug regimens respectively and 7 did not know at all. 68 nurses in the study considered themselves at risk of acquiring HIV and 54 admitted to have had occupational exposure to HIV. Majority (63.0%) of the exposures were needle pricks while 24.0% had both needle prick and splashing of blood/bodily fluid on mucosal surfaces.

HIV/AIDS Prevalence and Risk in Sub-Saharan Africa

Health care providers are at risk of acquiring human immunodeficiency virus (HIV) infection from occupational exposure, with nurses being the most exposed. HIV and AIDS are an epidemic especially in sub-Saharan Africa where they affect even health workers. The introduction of Antiretroviral Therapy (ART) has significantly improved the management and prevention of HIV infection including those at risk through programs such as the Prevention of Mother to Child Transmission (PMTCT), Post-exposure prophylaxis (PEP) and more recently Pre-exposure prophylaxis (PrEP). PEP consists of administering a short course of ART to reduce the likelihood of seroconversion following events with high risk of exposure to HIV.

Informal Sources Responsible for Low Knowledge Levels

The poor knowledge observed in the study can be blamed on the informal sources of information among the participants. There is therefore, an urgent need for professional training programs to improve awareness and uptake of PEP among health care workers. Hospital and STD Clinic PEP policies for HIV should be provided to all health care workers thus reducing the risk of occupational HIV transmission.

The original research paper can be found here: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0124416