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HCWs in poorest countries lack gear to protect against HIV, Ebola
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New research from the Johns Hopkins Bloomberg School of Public Health suggests that health care workers in lower-income countries lack adequate personal protective equipment to guard against HIV and other bloodborne infections during surgical procedures.
The findings underscore the risks health care workers (HCWs) face in the world’s poorest countries, especially in light of the Ebola outbreak currently spreading in West Africa, according to researchers.
“Sadly, one of the only benefits of the Ebola crisis in West Africa may be to highlight the baseline lack of personal protective equipment such as eye protection, gloves and aprons for [HCWs],” study researcher Adam L. Kushner, MD, MPH, an associate at the department of international health at Johns Hopkins, said in a press release. “These items are crucial to protect [HCWs] today, but were lacking long before the current crisis. We’ve seen this for many years with HIV.”
Adam L. Kushner
Kushner and colleagues performed a literature review to assess the level of protection of surgical HCWs against HIV and other bloodborne infections in low- and middle-income countries. They included in their analysis 13 studies documenting the availability of personal protective equipment in 399 hospitals throughout Afghanistan, Bolivia, Gambia, Ghana, Liberia, Mongolia, Nigeria, Sierra Leone, Solomon Islands, Somalia, Sri Lanka, Tanzania and Zambia.
The researchers found that only 29% of hospitals always had eye protection available. Sterilizers were always available at 64% of hospitals. Sterile gloves were the best supplied item, available at 75% of medical facilities.
The availability of these and other items varied significantly between countries. For example, 24% of hospitals in Afghanistan were supplied with sterile gloves vs. 100% of hospitals in Bolivia.
In no country was a hospital fully supplied with every piece of personal protective equipment.
In Liberia and Sierra Leone — two countries heavily affected by the Ebola outbreak — resources to protect HCWs were found to be deficient. Only 56% of Liberian hospitals had protective eyewear for its medical staff, and 63%% had sterile gloves. Just 30% of hospitals in Sierra Leone always had eye protection, whereas 70% had sterile gloves.
According to Kushner and colleagues, their research may have focused on protection against HIV, but the findings are no less relevant as the largest Ebola outbreak ever documented continues to spread in West Africa, affecting a record number of HCWs.
“We can all learn from this new epidemic and be better prepared for the next one by remembering that inexpensive protective equipment can keep doctors and nurses safe from infection — and better able to care for patients who need them,” Kushner said in the release. “It is imperative that we make this a priority.”
Although WHO’s Millennium Development Goal 6 was adopted by governments worldwide to halt and reverse the spread of HIV, malaria and other diseases, few resources have been devoted to the protection of surgical HCWs, the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
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