Study sites: Port Harcourt metropolis in Rivers State has designated PMTCT health facilities of public and private ownership. The private and public health facilities offer comprehensive healthcare services to clients. All study sites are reputed for good volume of client turn out and had at least a representative of the healthcare worker of interest whose day to day activity require their contact with HIV patient or their body fluid.
Interviewer administered questioner was used to assess occupational exposure to HIV by asking about accidental splashes with patient’s body fluids or prick by sharps while caring out their duty, also their risk perception to occupational exposure, the practice of standard precaution procedure as well as the use of personal protective equipment. The availability of safety protocol/regulation and method of waste disposal were also assessed.
Study design: We conducted a cross-sectional health facility based study.
Study population: The study population was made up of healthcare workers whose daily activities require caring for HIV infected patients such as doctors, nurses and midwives, laboratory scientist or technicians and environmental workers.
Inclusion criteria: Healthcare workers in the selected health facility who were included in this study are doctors, nurses and midwives, laboratory scientist or technicians and environmental workers who were on duty and present at the time of visit; and gave their consent.
Exclusion criteria: Trainee healthcare workers, healthcare workers that had assumed administrative responsibility and those who are less than 6 months into posting at present workplace were excluded from the study.
Sample size Calculation
The sample size of 341 was calculated using the formula,
Where,
n = the minimum sample size
Zα = the standard normal deviate corresponding to level of significance of 5%=1.96
d = the desired level of precision, 0.05
p = proportion of HCW exposed to needle stick injury in Northern Uganda = 0.28 [11]
q =1- p = 0.72
10% non-response rate brings n=341
Sampling Technique
Multiple stage sampling technique was used to select the study subjects.
Stage 1: Health Facility Selection: All 22 public facilities within the study area designated PMTCT sites were sampled and an additional 22 of identified 34 private health facilities were selected by simple random sampling.
Stage2: Selection of health care workers from Health Facility: The study sample size of 341 was divided equally among the 44 selected health facilities giving 6 participants per facility.
Stage 3: Selection of cadre participants:
At the facility, one health care worker was selected by balloting to represent each cadre of health workers among doctors, nurses/midwifes, laboratory scientist or technicians and environmental workers. The remaining two health workers were selected randomly from the four cadres of healthcare workers in the facility. Where a facility had six health care workers, all were studied and where less the remaining is made up from another facility.
Pre-testing of data collection tool
Pre-testing of the questionnaire was conducted on 30 healthcare workers working in five health institutions that were not selected for the study before the actual data collection. Modification of logical sequence, simplicity, and clarity of questionnaire was done using the findings at the pre-test.
Data collection
Data was collected using semi-structured interviewer-administered questionnaire. The questionnaire had three sections. Section A: socio-demographic characteristics of health care workers such as age, sex and occupation. Section B: Occupational risk exposure to HIV, and Section C: Determinant factors to occupational risk exposure to HIV infection. The questionnaire was adopted from previous similar published works [1].
Statistical analysis
We used Epi info 7 and SPSS statistical software to analyse descriptive variables and logistic regression to identify the independent risk factors associated with occupational exposure to HIV among healthcare workers using p-value of <0.05 as the level of significance.