Rezumat
The availability of VCT for HIV for booked antenatal patients offers a unique opportunity for best obstetrics practice but not for patients presenting with emergencies and unknown HIV status. Health workers who attend to such patients are at higher risk of acquiring HIV infections. Between 1st March 2005 and 30th September 2007, unbooked emergency obstetric patients in the labour ward of a teaching hospital who consented were tested using double rapid immunodiagnostic technique and confirmed by Western Blot. HIV positive patients were post-test counselled and offered single dose nevirapine tablet (200mg) in labour with syrup given to the baby at birth at 2mg/kg followed by syrup zidovudine for 6 weeks. The results showed that 275 (89.0%) of the 309 women pre-test counselled agreed to testing. The mean age of clients was 27.7 years (± 4.4 SD). The mean gestational age at presentation was 36.4 weeks (± 4.2 weeks). Primigravidae constituted 37.5% of the patients. Twenty-one (7.6%) of these consenting patients were HIV positive. In conclusion, the HIV prevalence of 7.6% among these unbooked obstetric patients is higher than the 4.7% among our booked antenatal patients and National prevalence of 4.4%. This poses substantial risk of transmission of HIV to attending health workers considering the readiness with which needle prick accident can occur in emergency situations.
Keywords: Emergency, obstetrics, patients, HIV
Résumé
La disponibilité du VCT aux patients VIH en soins prénatales apporte une unique opportunité pour les meilleurs soins obstétriques, mais pas pour les patients en urgence et de statut VIH inconnu. Le personnel de santé qui s’occupe de tels patients est au grand risque d’infections du VIH. Entre 1st Mars 2005 et 30th Septembre 2007, Les patients obstétriques non enregistrés en urgence á l’unité d’accouchement aprés un consentement étaient testés utilisant la double technique immunodiagnostie rapide et confirmé par le Western Blot. Les patients séropositifs étaient conseillés aprés test et obtenait une dose unique de nevirapine comprimés (200mg) en accouchement avec le syrup 2mg/kg pour l’enfant juste á sa naissance, suivit de la zidovudine syrup pour 6 semaines. Les résultats montraient que 275 (89.0%) sur 309 femmes conseillés avant le test acceptaient d’etre testées. La moyenne d’age des patients étaient de 27.7 ± 4.4 SD. Lamoyenne d’age de gestaion était de 36.4 ± 4.2 semaines. Les primigravides constituaient 37.5% des patients. Vingt et un (7.6%) étaient séropositif. En conclusion, Le taux du VIH de 7.6% parmi les patients obstétriques non enregistrées est plus élevé que 4.7% parmi celles enregistrées aux soins prénatales et un taux national de 4.4%. Ceci pose un risque substantiel de transmission du VIH au personnel de santé considérant les usages des aiguilles pendant les situations d’urgence.
Correspondence: Dr. O.A Awolude, Department of Obstetrics and Gynaecology, PMB 5116, University College Hospital, Ibadan, Nigeria. Email: tosinawolude@yahoo.com.
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