Thesis--PlanB (M.S.)--University of Wisconsin--Stout, 1999. / Includes bibliographical references.

Historically, diagnosis has relied on clinical signs of disease, microscopy and serological testing. However, these approaches have a number of drawbacks for example, differential diagnosis, low sensitivity (microscopy) and the inability to differentiate past from current infections (serology). In the past decade the use of molecular techniques, such as the polymerase chain reactions (PCR) have gained favour. Many research groups have used these techniques to study the molecular epidemiology of diseases in sub-Saharan Africa. Such methodologies rely on the detection of genetic materials and as such are reliant on the specificity of their components and the quality of the starting materials. It is the aim of this thesis is to demonstrate improvements that can be made to sample collection that will help to enhance the reliability of these tests and highlight the importance of the diagnostic parameters. The model that I will use to demonstrate these improvements are African trypanosomes, these are the causative agents of sleeping sickness in humans and nagana in animals, and are wide spread across much of sub-Saharan Africa. My work will be presented as three main sections: Firstly, a comparison of the suitability of various different approaches to cattle blood sample collection – including the genetic materials prepared directly in the field and the use of Whatman FTA®cards – in terms of the provision of appropriate materials for molecular screening will be presented. It was found that uneven distribution of genetic materials occurs across the surface of the FTA®cards due to the matrix chemistry. Therefore suggestions for improvements for the preparation of materials to be stored on these cards and their downstream application are made. Secondly, a comparison between the specificity of the pan-Trypanosoma ITS-PCR reaction and the species-specific reactions is made. The ITS-PCR has gained favour in recent years as it is reported to be capable of identifying a wide range of trypanosomes, as this is a single nested PCR reaction the reduction in time and cost has been very appealing to researchers in this field. My work suggests that this test is not reliable in terms of the accurate detection of trypanosomes species, and in fact on a direct comparison of 969 samples, 37 parasitic events where identified by this approach compared to 197 when species-specific tests were applied. Thirdly, based on my findings from the previous two chapters I present two case studies, the first of which looks to evaluate the impact on the prevalence of trypanosome species in cattle after drug treatment during the Ugandan, Stamp Out Sleeping sickness (www.sleepingsickness.com) campaign. The results of this case study highlight the importance of understanding the relationship that occurs between trypanosome species in mixed infections, my second case study therefore looks to quantifying the infection load of Trypanosoma brucei and T. congolense within the midgut of their insect vector (Glossina morsitans morsitans) using qPCR.

Thesis (M. S.)--Mechanical Engineering, Georgia Institute of Technology, 2009. / Committee Chair: Dr. Jonathan S. Colton; Committee Member: Dr. Mark R. Prausnitz; Committee Member: Dr. Rudolph L. Gleason. Part of the SMARTech Electronic Thesis and Dissertation Collection.

The problem of the study was to determine the status of bloodborne pathogen education for injection drug users in Indiana hospital emergency departments. The study was designed to answer the following research questions: (a) Do Indiana hospital emergency departments have written policies on bloodborne pathogen education for injection drug users? (b) To what extent do Indiana hospital emergency departments provide bloodborne pathogen education for injection drug users? and (c) What are the major barriers for Indiana hospital emergency departments in providing bloodborne pathogen education for injection drug users?A valid instrument was developed and sent to 110 Indiana hospital emergency department nurse managers. Forty-six instruments were returned for a response rate of 43.8%.The results indicated only three (7.1 %) responding hospital emergency departments had written bloodborne pathogen educational policies. Ten (20.8%) emergency departments provided some form of bloodborne pathogen education for injection drug users. Major barriers indicated for not providing patient education consisted of insufficient monetary resources, injection drug users denying a drug history, and emergency department nurses being unable to identify injection drug usage. / Department of Physiology and Health Science

Plastic hypodermic needles are a potential solution to the problem of disease spread through needle reuse. Plastics could be used to potentially reduce needle reuse as they are easier to destroy than steel. A key issue in their acceptance is the force required to penetrate a patient; a smaller force is associated with less pain. The effect that needle parameters have on the penetration force is studied in an effort to better understand how to reduce penetration forces and increase the success of penetrations for plastic needles. These parameters - geometry, tip radius, diameter, material, and lubricant - are studied through penetration, buckling, and coefficient of friction testing. The tests are conducted on steel needles, which serve as a control group, as well as two varieties of plastic needles. The outcome is a quantitative understanding of the effect that the various parameters have on penetration force, which is used to inform plastic needle design.

A research project submitted in partial fulfilment of the requirements for the degree of Master’s (Industrial/Organisational Psychology) in the Faculty of Humanities, University of the Witwatersrand, Johannesburg, March 2017 / A South African study, based on a sample of 208 medical personnel working in public and private institutions, was conducted in order to determine whether job demands and job resources led to differences in the propensity to comply with Needlestick Injury (NSI) intervention scores. Three self-report questionnaires were completed by the participants, namely the self-developed demographic questionnaire, the Job Demands-Resources Scale (JDRS) which measured job demands and resources, and thirdly the self-developed Propensity to Comply with Interventions for Needlestick Injuries Scale (PCINS) which measured the propensity to comply with interventions for NSIs. Accidental needle stick, as well as sharp, injuries occur frequently within the medical context and are associated with high risks for blood-borne infections (Adefolalu, 2014). Specifically within South Africa blood-borne infections such as HIV carry heavy significance. Needlestick injuries often go unreported by healthcare professionals, and these injuries are widely prevalent. The researcher aimed to explore the job demands and resources that contribute to and mitigate against these injuries. Therefore support for the analysis of job demands and resources and the propensity to comply with NSI interventions exists. The results of the study suggested that there were mostly no significant differences between Job Demands and Resources and the propensity to comply with NSI Interventions scores. However significant relationships were found between length of shift and the propensity to comply with NSI interventions and growth opportunities and the propensity to comply with NSI interventions. The findings did not follow the proposed hypotheses that job demands would lead to a decrease in the propensity to comply with NSI interventions and job resources would lead to an increase in the propensity to comply with NSI interventions as longer length of shift (job demand) led to an increase in propensity to comply with NSI interventions and an association between high levels of growth opportunity (job resource), and low levels of propensity to comply with NSI interventions, was found. / GR2018

Thesis (MPhil)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: The research focused on the knowledge of occupational safety by hospital managers towards HIV and other blood borne pathogens transmission in Abakaliki region in eastern Nigeria. These pathogens are easily transmissible by needle sticks and other occupational accidents. It is important to identify factors that pre-expose hospital cleaners to occupational risk exposure that can lead to the transmission of HIV, HBV and HCV. The research was conducted in 10 different hospitals. A total of 90 questionnaires were administered to the hospital cleaners that volunteered to participate in the research and 68 questionnaires were returned representing 75.6% of the total questionnaires. The mean age and standard deviation of the respondents in this study was 38.6 + or – 5.4 years. The researcher conducted a semi-structured interview with all the 10 hospital managers involved with the study and the interviews showed there was a need for an organised training on hospital work and occupational hazards, risk exposures and precautions. The questionnaires showed the knowledge of hospital cleaners on occupational safety and it was observed the majority of the hospital cleaners were not aware of post exposure prophylaxis for HIV. The workers relatively had good practices put in place to prevent HIV, HBV and HCV transmission but majority of them had not received HBV vaccine due to lack of awareness and availability. There was a significant positive correlation between the knowledge of the health workers and HIV transmission and the practice put in place by health workers to prevent HIV transmission (P<0.05). This implies as the knowledge of the health workers about HIV transmission increases, the practice put in place by health workers to prevent HIV transmission and Hepatitis B&C increases. Therefore there is need for continuous training on blood borne pathogens transmission such as HIV transmission in the hospitals and its routes of transmission. There is need for awareness creation for HBV vaccine and Post exposure prophylaxis for HIV exposure. / AFRIKAANSE OPSOMMING: Nie beskikbaar / jfl201601

Standard precautions are a set of guidelines that aim to protect health care workers from infections from blood, body fluids, secretions, excretions except sweat, non-intact skin, and mucous membranes while providing care to patients. However, compliance to the standard precautions is often low in low-income countries in spite of the greater risk of infection. This study examined the knowledge and practice of standard precautions among health care workers in public secondary health facilities in Abuja, the Federal Capital Territory of Nigeria. A quantitative descriptive survey was conducted with 83 doctors and 194 nurses using a structured questionnaire. Findings show suboptimal knowledge and practice of the standard precautions among the health care workers. Knowledge of post-exposure prophylaxis for HIV was low as well as hepatitis B immunization among the respondents. A lack or irregular supply of essential materials, such as personal protective equipment, was the main reason the respondents did not comply to the precautions. This report recommends the development and implementation of a comprehensive infection prevention and control program in health facilities in order to ensure compliance to the standard precautions by health care workers. / Public Health / M.A. (Public Health)

Thesis (MMed (Occupational Medicine))--Stellenbosch University, 2013. / Introduction Exposure incidents involving blood and body fluids represent a major hazard for medical undergraduates. Every medical teaching university experiences the problem of undergraduate medical students sustaining such incidents. Although Post Exposure Prophylaxis (PEP) is readily available and accessible to medical undergraduates following an incident, continuity and quality of care extends beyond the provision of PEP. This includes follow up consultations after receiving PEP according to protocol. Study Design This study was performed at the Tygerberg Campus of Stellenbosch University in Cape Town, South Africa to assess compliance with follow up consultations following an exposure incident. The study base consisted of all the medical undergraduates who reported an exposure incident at the Campus Health clinic. Cases were defined as medical undergraduate students of Stellenbosch University who had reported an exposure incident between January 2007 and December 2011. They were identified using the clinic database and records. Influential factors associated with the exposure incident, including compliance regarding follow up consultations were obtained from standardised reporting forms and medical records. The data was analysed in 2 sections, a cross sectional component (descriptive and analytical) and a retrospective cohort component. Two student cohorts were retrospectively followed from the beginning of their 3rd year to the end of their medical curriculum (6th year). Results There were 280 exposure incidents reported in the study period, of which 174 were low risk and were 106 high risk incidents for which PEP was prescribed (37.86% used PEP). For those who had high risk exposures, 90.57% (n=96) attended the 6-week follow up consultation, 48.11% (n=51) attended the 3 month visit and 34.91% (n=37) attended the 6 month follow up visit. There was an increase in the number of exposure incidents from 2010 (n=43) to 2011 (n=76). Internal medicine accounted for the most number of incidents (n=68), followed by Surgery (n=51), Obstetrics and Gynaecology (n=44), and Paediatrics (n=42). Drawing blood was the most common reported activity associated with exposures. Of notable importance was recapping, disposing of needles and insertion of blood into sample tubes. These activities accounted for 63 of the 280 exposure incidents. The 4th year students were the least at risk for exposure incidents compared to 3rd, 5th, 6th years. The annual average cumulative risk of having an exposure incident was found to be 5.7% (95%CI=4%-8%) and 6.8% (95%CI=5%-9%) amongst the 2 student cohorts over the duration of 4 years (clinical exposure time). Recommendations There is an urgent need for the number of exposure incidents to be reduced, e.g. needle recapping and disposal, and insertion of blood in sample tubes cause numerous preventable incidents. Various other strategies can be implemented in order to reduce the number of incidents across all undergraduate years of study. It is envisaged that by reducing the number of exposure incidents, there will be a subsequent decrease in the number of individuals requiring PEP. The importance of ensuring compliance with regard to follow up consultations needs to be emphasized. Factors that lead to noncompliance need to be investigated in a separate study.

Standard precautions are a set of guidelines that aim to protect health care workers from infections from blood, body fluids, secretions, excretions except sweat, non-intact skin, and mucous membranes while providing care to patients. However, compliance to the standard precautions is often low in low-income countries in spite of the greater risk of infection. This study examined the knowledge and practice of standard precautions among health care workers in public secondary health facilities in Abuja, the Federal Capital Territory of Nigeria. A quantitative descriptive survey was conducted with 83 doctors and 194 nurses using a structured questionnaire. Findings show suboptimal knowledge and practice of the standard precautions among the health care workers. Knowledge of post-exposure prophylaxis for HIV was low as well as hepatitis B immunization among the respondents. A lack or irregular supply of essential materials, such as personal protective equipment, was the main reason the respondents did not comply to the precautions. This report recommends the development and implementation of a comprehensive infection prevention and control program in health facilities in order to ensure compliance to the standard precautions by health care workers. / Public Health / M.A. (Public Health)