Prevention and assistance of needle stick injury and body fluid exposure in Angola

Background: Angola’s health system is being reorganized with the reform of hospitals and implementation of biosecurity actions. Needle stick injuries are frequent, not notified and responsible for infectious diseases transmission to healthcare workers(HCW).

Objective: Provide a safer work environment and ensure a faster and more efficient care of the health care worker (HCW) after occupational exposure to blood and body fluids.

Methods: Our work team has 4 biomedical ones, 6 nurses (1 local coordinator), a doctor (Brazilians) and 5 national nurses. Since March 2008, we had introduced the use of puncture-resistant containers to disposal syringes and needles, HCW vaccination for hepatitis B and a “kit” for occupational exposure at federal hospitals. The “kits” are composed of shifts and antiretroviral drugs (enough for 5 days of treatment) to assist HCW exposed to sharp injuries and are available at the emergency rooms. Nurses and doctors were trained to give the first aid (based on a protocol) and a doctor from the aids program is responsible by the HCW follow up. The local Biosecurity Technical Committee (CTBI) is responsible for the program.

Results: From March 2008 to November 2009, 28 federal hospitals were included in the program at various provinces (Luanda, Huambo, Namibe, Malange, Huíla, Cunene, Kwanza Norte, Benguela and Kwanza Sul).
- 13600 puncture-resistant containers were placed in hospitals for the first 3 months of use.
- 1.659 HCW were immunized to hepatitis B virus (3 doses) and 3.112 had received only one or 2 doses (50% compliance).
- 64 Kits were distributed and their uses have been monitored by the work team. 770 professionals had been guided and/or trained.
- From January to October 2009, 34 needle stick injuries were notified. 22 HCW had received antiretroviral drugs and 17 cases (77%) had a known source of contamination.

Conclusions: Use of puncture-resistant containers to disposal syringes and needles, healthcare workers (HCW) vaccination for hepatitis B and a kit for occupational exposure are strategies of easy implementation and low cost that can have a high impact on the prevention of blood and body fluids contact and create a new individual and collective consciousness on the risk of occupationally acquired viral infections.