Compliance of Healthcare Professionals with Safety Measures for Control of Hepatitis Viruses in Hemodialysis Centers: An Experience from Southeast Iran
Introduction. Noncompliance with the recommended infection control measures by the healthcare professionals (HCPs) plays a major role in transmission of hepatitis B (HBV) and hepatitis C (HCV) viruses in hemodialysis (HD) wards. This study aimed to determine the compliance rate of the HCP with safety measures in the HD wards in southeast Iran. Patients and Methods. A total of 208 patients were enrolled. Adherence of HCPs with standard infection control measures was assessed. Results. Sixty-one HCPs with a mean age of 32.4 ± 11.2 years old were responsible for healthcare services. Compliance with the following items was weak: not sharing medications trolley (29.8%), disinfecting the shared instruments (46.2%), using single use materials for many patients (52.4%), carrying used materials in disposable containers (51.9%), not returning of unused materials to the clean room (55.3%), and adherence to hand washing (58.7%). Periodic monitoring for HBV and HCV was performed on 100% and 69.7% of the patients, respectively. Less than 2/3 of HCPs participated in the retraining courses. Conclusion. Compliance of HCPs with safety measures for viral hepatitis prevention was partly inadequate in HD wards. Emphasis on retraining of HCPs and official supervision would be effective steps in the reduction of viral dissemination. 1. Introduction The dissemination of hepatitis viruses among patients in hemodialysis (HD) centers is one of the most important causes of morbidity and mortality in end stage renal disease patients. While the introduction of vaccination programs and isolation of HD machines have limited the spread of HBV infection, its prevalence rates continue to be unacceptably high in most HD centers [1]. Prevalence of positive hepatitis B surface antigen (HBsAg) ranged between 1.3% and 14.6% in Asia-Pacific countries and 13.3% in Turkey [2, 3]. Hepatitis C virus (HCV) is also a major cause of liver disease in HD patients. HCV infections are usually asymptomatic and may be transmitted to others insidiously [4]. Prevalence of HCV in HD wards has been reported from 5% to 60% in different countries [5]. High risk behaviors and blood transfusion are not the usual routes of HCV transmission in HD patients. Environment of HD and failure to follow the safety measures for infection control may be the main cause of HCV dissemination in these centers [6]. Accordingly the kidney disease improving global outcome (KDIGO) in 2008 and the center for disease control and prevention (CDC) in 2001 advised protocols for infection control in HD centers. Principally, these
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