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Archive for December 21st, 2008

Hospitals are failing to protect their workers from HIV and tuberculosis (TB) infection

Posted by African Press International on December 21, 2008

GLOBAL: Overworked and under-protected

Photo: Kristy Siegfried/PlusNews
Many healthcare workers fear becoming infected with HIV at work

DAKAR, 4 December 2008 (PlusNews) – While healthcare workers in sub-Saharan Africa struggle to deal with unmanageable workloads resulting from HIV/AIDS, a new study has found that their needs are being neglected.

Hospitals arefailing to protect their workers from HIV and tuberculosis (TB) infection, and healthcare workers often do not have adequate access to HIV/AIDS services, according to a World Health Organisation (WHO) study conducted in Kenya, Malawi, Zimbabwe, Mozambique and Ethiopia.

The WHO survey, released on Wednesday at the International Conference on AIDS and STIs in Africa (ICASA), in Dakar, Senegal, noted that despite the extremely high risk of acquiring TB in health facilities, not enough was being done to protect staff.

Mark Wheeler, a health policy consultant who presented the study findings, told delegates that the risk of acquiring TB was up to 20 times higher for the average health worker than for the general population.

The risk was even greater for staff working inTB wards: they were 80 times more likely to be infected with TB. “Employers, however, don’t recognise [this] and don’t provide adequate protection,” Wheeler said.

Basic infection-control measures, such as providing handkerchiefs to TB patients to cover their mouths while coughing, and building separate TB wards, were not being applied, despite widespread knowledge about the effectiveness of such interventions.

The chances of becoming infected with HIV at work may be low, but Wheeler said the survey had found that the “fear of this happening is widespread and very real” among healthcare workers.

Nearly 70 percent said that they were inadequately protected from HIV at work, as they lacked gloves, soap, water and proper containers to dispose of needles.

Needle-stick injuries were “extremely frequent” in developing countries, but carried a low risk of HIV transmission. In fact, occupational transmission of HIV accounted for only between 2.5 and 4 percent of HIV infections among healthcare workers.

The study found that when staff were exposed to the virus at work, very few chose to use post-exposure prophylaxis (PEP) as a preventative measure because they often misunderstood how PEP worked, and believed that by using it they would be forced to have an HIV test.

Less than 40 percent of the 1,000 healthcare workers surveyed were aware of policies to protect them from infection and discrimination in the workplace, Wheeler noted.

Dr Yohannes Chanyalew of the International Labour Organisation (ILO) told delegates that workplace policies in the health sector could not stay “locked away in a drawer”, and called on employers to educate their personnel about their right to be protected from HIV.

Wheeler admitted that not enough was known about HIV prevalence levels among healthcare workers, but it was generally accepted that infection levels were about the same as in the general population.

WHO official Mwansa Nkowane warned that HIV and TB were among the major causes of death in healthcare workers, and said urgent steps should be taken to provide them with adequate HIV/AIDS services.

According to Nkowane, 17 percent of healthcare workers’ deaths between 1999 and 2005 in Botswana were due to HIV. “If no action is taken, this could rise to 40 percent by 2010,” she told delegates at the conference.

The fear of HIV discrimination prevented many health workers from being tested for HIV; most were also not willing to be tested by colleagues. Wheeler noted that there were often high levels of mistrust between staff and management, which meant that self-testing was the most preferred method.

Levels of access to antiretroviral (ARV) treatment were more encouraging: easy access to the life-prolonging medication was reported by 72 percent of health workers, and staff were more willing to access the drugs at their own health facility, although many raised the need for a staff clinic.


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Immunisation in Chad may give good results

Posted by African Press International on December 21, 2008

CHAD: Tackling alarming malnutrition in west

Photo: IRIN

N’DJAMENA, 19 December 2008 (IRIN) – Aid agencies have begun emergency therapeutic feeding in western Chad, where a recent study revealed that 20 percent of children under five are acutely malnourished.

As commonly happens across the Sahel, chronic deficiencies in Chads Kanem region have led to dangerous malnutrition levels that require an emergency response.

In addition to the acute malnutrition numbers, the survey – conducted by Action Against Hunger (ACF) and released in November – also found severe malnutrition in 2.8 percent of children. In a population of about half a million, for every 10,000 under-five children, three die daily.

These results are alarming, said Kingsley Amaning, UN humanitarian coordinator for Chad. While the causes for such high rates of malnutrition may be of a chronic nature, it is clear that a humanitarian response is needed, and this is therefore an urgent humanitarian problem that we need to address.

In the week of 15 December the UN Childrens Fund (UNICEF) and ACF began emergency operations in Kanem, according to Marzio Babille, head of UNICEF in Chad.

Babille said the immediate need is to screen children and provide supplementary feeding and medical attention. For the longer term, he said: We need to prevent malnutrition, which means immediately enhancing the quality of school meals and improving families access to quality foods.

Immunisation drive

UNICEF warned that without rapid intervention malnourished children will be susceptible to diseases such as measles. The agency is planning to vaccinate against measles in Kanem in January.

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This requires a concerted effort together with the government of Chad to immunise children against measles, provide vitamin A supplements, and deliver quality care for children with severe under-nutrition, Babille said.

UN and government officials told IRIN that a delegation of the Health Ministry is preparing a mission to the region.

Babille said that given effective collaboration among the government and aid agencies he is confident that emergency needs will be met. The minister of health and minister of social affairs responded immediately with a high-level meeting, he told IRIN. Im very optimistic that at least the urgent phase is going to be tackled.

Tackling the urgent phase of malnutrition must be coupled with efforts to address long-term conditions that give rise to malnutrition, experts say.

Collaboration, sustained funding needed

To address such a situation [as in Kanem], there is a need to have humanitarian and development partners and donors work together, Flicit Tchibindat, UNICEF regional health adviser for West Africa, said.

In addition to life-saving interventions to manage severe cases, steps must be taken to prevent severe malnutrition by treating moderate cases, providing blanket nutritional assistance for the lean season, and improving complementary foods, she said.

The other important issue is sustained and predictable funding in high-burden countries, to effect sustained change in the populations nutritional status, Tchibindat said. One-year funding clearly is not the solution. She said it was possible to tackle malnutrition with broad collaboration and adequate long-term funding.

The Kanem region is north of Lake Chad; ACFs representative study focused on the district south of the regional capital Mao. The region has a harsh Sahelian climate, and much of the population is nomadic.

Sylvain Trottier of ACF in Paris said Kanems high malnutrition is caused by chronic food insecurity in the area, which is exacerbated by desertification and the regions isolation.

He added that some women lack access to information on breastfeeding and weaning techniques, and have few resources as many of the men are away from the region for long periods.


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