Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #113449

Richard S. Hughes, MA¹, Christopher Mazimba, Mmed(ob/gyn)², Martha Ndhlovu², Answell Chipukuma, Higher Diploma³, and Matildah Matipa Zyambo, mcips⁴. (1) Zambia Country Office, JHPIEGO Corporation, 8 Ngumbo Road, Long Acres, PO Box 36873, Lusaka, Zambia, (2) Prevention of medical transmission of HIV program, JHPIEGO Corporation, PO Box 32481, Lusaka, Zambia, PO Box 32481, Lusaka, Zambia, (3) Manoff Group inc., Prevention of medical transmission of HIV program, P.O Box 36873, Ngumbo Road, LongAcres, Lusaka, Zambia, 260-1-256255, achipukuma.misp@jhpiego.net, (4) Zambia Injection Safety, Chemonics International, P.O. Box 36873, Lusaka, Zambia

Issues: Zambia's HIV prevalence rate is 16%; some urban areas have rates of 30-40%. The prevalence of other blood-born diseases, such as Hepatitis B, is also high. Exacerbating this crisis, the situation in terms of human resources for health, to care for those affected, is dire. Not only is the health system over-stretched, but health worker attrition is high, and half of this attrition is due to illness and death. Poor ‘conditions of service,' including inadequate measures to protect health workers from occupational exposure to serious diseases such as HIV and hepatitis, also contribute significantly to the high attrition levels. Poor practices put health workers, patients, and communities at risk.

Description: While medical transmission of HIV accounts for a relatively small percentage of total HIV transmission, it is preventable through simple, practical measures. This program in Zambia has been working for one year in two pilot districts to improve infection prevention and injection safety practices, with noticeable results.

Lessons Learned: Simple steps can generate improvements across range of practices: for example, unnecessary prescription of injectables (45% to 23%), recapping of needles (26% to 4%), interpersonal communication (37% to 75%), washing hands (10% to 66%), and overfilling sharps disposal boxes (25% to 9%). This paper presents the evidence of improvements seen in Zambia over the course of one year, together with an overview of the key measures taken to achieve these results.

Recommendations: Simple, practical measures must be put in place to protect health workers, clients, and communities from preventable infections.

Learning Objectives: Participants attending this session will be able to

• Identify the major issues in preventing medical transmission of HIV through improved medical practice;
• Describe specific approaches applied in Zambia to reduce the risk of medical transmission of HIV;
• Discuss the specific results in terms of improvements in behavior observed in the pilot districts in Zambia

Keywords: HIV Interventions, Disease Prevention

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.