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HIV Transmission

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Principles of Infection Control

The infections acquired in health care setting can be greatly minimized by observing some simple precautions. The broad principles of infection control include the following:

  • Infection control measure: Each institution should establish an appropriate infection control (IC) policy and programme. A mechanism should be set up for planning, implementing, monitoring and evaluation of the IC programmes. Preventive measure are essential and very cost-effective, but are often overlooked and considered unnecessary by health care workers. Medical institutions are encouraged to set up an IC programme suitable for its resources
  • Hand washing is the most simple and cost-effective measure and must be encouraged. Disinfectants should be prepared and used according to the guidelines. Antimicrobials should be prescribed rationally according to guidelines to reduce bacterial resistance and side effects.
  • Patients: A patient should not be admitted into a hospital unless it is absolutely necessary and he/she should be discharged as early as possible, to reduce the risk of infection. Patients with low immunity, or those with other predisposing factors to infections should be nursed with special care. Patients with communicable disease such as cholera should be isolated as appropriate to reduce the risk of transmission to others
  • Environment: Health care facilities should be kept clean and void of virulent organisms by proper house keeping. Cleaning of premises and room floors with water and detergent is recommended. Cleaning with a disinfectant is usually not necessary unless there is a spillage with potentially infectious material. Architectural design of a health care facility should permit good ventilation. Extra-measures to decontaminate air in a health care setting is costly and has limited value in infection control. Positive or negative pressure ventilation is indicated in certain areas, but again is expensive and is not superior to practices which ensure a clean and hygienic environment. Proper waste disposal, water treatment, disinfection and sterilization of equipment can reduce the risk of infection among patients, health caretakers and community.
  • Agents: Microorganisms responsible for infections in health care setting may originate from patients, the environment or health care workers. Those sources of infections are to be identified, and specific measures must be taken appropriately to prevent their spread.

Risk of HIV Transmission to Health Care Workers (HCWs)

The transmission through blood and body fluids, organs, tissues, and contaminated material in health care settings is not much though this likely mode of transmission is responsible for apprehensive behaviour of health care workers towards HIV infected people and AIDS cases. Transmission of HIV in health care settings can occur due to following ways :

Patient to health care worker transmission

HIV transmission from patient to health care worker can occur when the health care worker is exposed to the HIV infected blood e.g.

  1. Patenteral exposure, such as needle-stick injury.
  2. Through mucous membrane contact, such as a splash of blood into the health care worker’s eye or mouth.
  3. Through mucous membrane contact, such as a splash of blood into the health care worker’s eye or mouth.
  4. Non-intact skin contact such as splash of blood on to open wounds or broken skin due to dermatitis, acne or cuts or abrasions of skin.

The risk of health care worker of acquiring HIV infection during the course of health care delivery is possible though unlikely. The risk is primarily related to percutaneous (sharp injury) exposure like needle stick injury and has been reported to be less than 0.5%. The HIV cannot enter the body through intact skin but can do so through intact mucous membrane.

The most common way in which health care workers are exposed to HIV is through accidental exposure to sharp objects.

Nearly all cases of HIV transmission to health care workers have occurred through preventable accidents. These are needle-stick injuries, cut from broken blood collection tubes.

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