South African health service must strengthen infection control measures
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《英国医生杂志》
South Africa抯 public healthcare facilities, groaning under the weight of the AIDS epidemic, have inadequate infection control measures, a report commissioned by its Department of Health says.
The report followed research into the impact of HIV and AIDS on the health sector and was conducted by the Human Sciences Research Council—a state owned research facility.
The overall conclusions of the report include the fact that some 20% of younger health workers (aged 18 to 35) are estimated to be infected with the virus, suggesting that 16% will die from AIDS related diseases if they do not receive adequate treatment.
These health workers, however, have to treat large numbers of AIDS cases. About 46% of hospital admissions in the public sector are people with AIDS related disorders who stay in hospital for a mean of 13.7 days, close to double the stay of patients without AIDS.
The report states that, as well as the heavy workload that this places on staff, attention should be focused on strengthening the infection control measures. It reports that close to a third of primary healthcare facilities do not stock sterilising equipment, and substantial numbers of private as well as public facilities do not stock protective clothing and drugs. Only 36% of health workers have had training in universal precautions against infection.
"The extent to which the lack of infection control contributes to HIV infections from health worker to patient, or more likely from patient to patient, in South Africa is unknown and needs to be investigated," the report states. "We recommend that the South African Ministry of Health establishes a committee to advise it on the development of policy guidelines for health facilities on the management of health workers who are HIV positive, and also to ensure training in universal precautions against infection," it concludes.
In the survey, more than 71% of health staff reported that goggles were never available for them to use. Less than 60% of health workers reported that gowns were always available, and although gloves were largely available, complaints were made about the quality.
About two thirds of health workers had received some information on precautions against infection. However, the non-professional category with low skills levels, without any training "might not be able to protect themselves properly or prevent infection spreading from one patient to another," the report states.
This report, although commissioned by the health department, was kept under wraps by the department until it was leaked in the past month. Although the government has announced that it is to provide antiretroviral treatment to those who need and want it, controversy continues to dog the effectiveness of the government抯 AIDS policy.
The Impact of HIV/AIDS on the Health Sector can be found at www.hsrc.ac.za(Johannesburg Pat Sidley)
The report followed research into the impact of HIV and AIDS on the health sector and was conducted by the Human Sciences Research Council—a state owned research facility.
The overall conclusions of the report include the fact that some 20% of younger health workers (aged 18 to 35) are estimated to be infected with the virus, suggesting that 16% will die from AIDS related diseases if they do not receive adequate treatment.
These health workers, however, have to treat large numbers of AIDS cases. About 46% of hospital admissions in the public sector are people with AIDS related disorders who stay in hospital for a mean of 13.7 days, close to double the stay of patients without AIDS.
The report states that, as well as the heavy workload that this places on staff, attention should be focused on strengthening the infection control measures. It reports that close to a third of primary healthcare facilities do not stock sterilising equipment, and substantial numbers of private as well as public facilities do not stock protective clothing and drugs. Only 36% of health workers have had training in universal precautions against infection.
"The extent to which the lack of infection control contributes to HIV infections from health worker to patient, or more likely from patient to patient, in South Africa is unknown and needs to be investigated," the report states. "We recommend that the South African Ministry of Health establishes a committee to advise it on the development of policy guidelines for health facilities on the management of health workers who are HIV positive, and also to ensure training in universal precautions against infection," it concludes.
In the survey, more than 71% of health staff reported that goggles were never available for them to use. Less than 60% of health workers reported that gowns were always available, and although gloves were largely available, complaints were made about the quality.
About two thirds of health workers had received some information on precautions against infection. However, the non-professional category with low skills levels, without any training "might not be able to protect themselves properly or prevent infection spreading from one patient to another," the report states.
This report, although commissioned by the health department, was kept under wraps by the department until it was leaked in the past month. Although the government has announced that it is to provide antiretroviral treatment to those who need and want it, controversy continues to dog the effectiveness of the government抯 AIDS policy.
The Impact of HIV/AIDS on the Health Sector can be found at www.hsrc.ac.za(Johannesburg Pat Sidley)