Community-based research: cost of the tests used for anti-HBc total seropositivity only and hepatitis B screening.

Our study aimed to determine anti-HBc total (IgG+IgM) seroprevalence in the adult population aged ≥ 15 and to compare the cost of testing for HBsAg and anti-HBs in only anti-HBc positive+ subpopulation to that in the whole population for HBV screening. The study involved a face-to-face survey and peripheral blood sampling from 452 adult subjects for HBV tests. HBV-DNA PCR was studied only in anti-HBc+ subjects. Of the 452 subjects anti-HBc total was positive in 192 (42.47%), of which: (a) 27 (14.06%) were HBsAg+, anti-HBs negative⁻, (b) 126 (65.62%) were HBsAg⁻, anti-HBs+, (c) 39 were HBsAg⁻, anti-HBs⁻. This last group (c) were tested for HBV-DNA PCR and six (15.38%) were positive. When we perform HBsAg and anti-HBs tests in all 452 subjects as in routine practice in blood banks, the cost is 3320 Euros. However, when all subjects are tested for anti-HBc total at first and then only anti-HBc total+ ones are tested for HBsAg and anti-HBs, the cost is 2929 Euros. The cost difference between the two methods is 391 Euros for 452 subjects. Accordingly, our HBV screening algorithm brings a financial saving of 11.78% and helps to identify the isolated anti-HBc total+ subjects who carry potential risk for spreading HBV.

Long working hours increase the risk of sharp and needlestick injury in nurses: the need for new policy implication.

AIM: This paper reports a study to determine the sharp and needlestick injury incidence in nurses working at a university hospital and the contributing factors. BACKGROUND: Although it is generally felt that working in the healthcare sector is clean and without risk, healthcare staff and especially physicians and nurses who generally work very long hours are actually exposed to various occupational risks. Sharps and needlestick injuries are important problems for healthcare workers as they increase the risk of spread of infection. METHOD: A self-administered questionnaire was completed in October 2005 by 449 of the 516 nurses working at a Turkish hospital (response rate 87.0%). RESULTS: The percentage of nurses experiencing a sharp or needlestick injury during their professional life was 79.7%. The incidence of exposure to sharp or needlestick injury in the last year was 68.4%. The factors increasing the rate of sharp and needlestick injury were: age 24 years and less,