O029: Reporting and case management of bloodborne pathogen exposures among health care workers in Tanzania

Introduction: In sub-Saharan Africa, bloodborne pathogens exposure (BPE) is a serious risk to health care workers (HCW). Reporting BPE is necessary for effective post-exposure prophylaxis (PEP), an important element of workplace safety in health facilities. Limited data are available on factors associated with BPE reporting among HCW. Methods: We conducted a cross-sectional study assessing experiences of occupational BPE, history of BPE reporting, and use of PEP among health care workers at three public hospitals in Tanzania. From August to November 2012, HCW were interviewed using Audio-Computer Assisted Self-Interview. All HCW at risk for BPE were invited to participate. Factors associated with reporting BPE were identified using logistic regression. Results: Of the 1,102 eligible HCW, 973 (88%) completed the interview. Of these, 690 (71%) were female and 387 (40%) were nurses. Of 357 HCW who had a BPE in the past 6 months, 120 (34%) reported it. Among these 120 reported exposures, 93 (78%) HCW reported within 2 hours of exposure, 98 (82%) received pre- and post-HIV test counseling, and 70 (58%) were offered PEP; 68 (97%) of these 70 HCWs completed PEP. Independent risk factors associated with reporting BPE were being female (adjusted odds ratio (AOR)=2.0 [95% confidence interval (CI) 1.2-3.5), having ever-received BPE training (AOR=2.0, CI 1.2-3.5), knowledge that HCW receive PEP at another facility (AOR=2.6, CI 1.5-4.4) and HIV testing within the past year (AOR=2.3, CI 1.2-4.4). Conclusion: Despite the significant proportion of HCW with a recent BPE, only one in three reported it. Our results highlight the importance of appropriate and continuous training on the prevention and reporting of occupational exposures to increase acceptance of HIV testing after BPE. Disclosure of interest: None declared

Movement from the double object construction is not fully symmetrical

A movement asymmetry arises in some languages that are otherwise symmetrical for both A- and A-bar movement in the double object construction (DOC), including Norwegian, North-West British English, and a range of Bantu languages including Zulu and Lubukusu: a Theme object can be A-bar-moved out of a Recipient (Goal) passive, but not vice versa. Our explanation of this asymmetry is based on phase theory, more specifically a stricter version of the Phase Interpretability Condition proposed by Chomsky (2001). The effect is that, in a Theme passive, a Recipient object destined for the C-domain gets trapped within the lower V-related phase by movement of the Theme. The same effect is observed in Italian, a language in which only Theme passives are possible. Moreover, a similar effect is also found in some Bantu languages in connection with object marking/agreement: object agreement with the Theme in a Recipient passive is possible, but not vice versa. We show that this, too, can be understood within the theory that we articulate

First- line antiretroviral treatment failure in East African children

Objectives: To describe the incidence of antiretroviral treatment failure and associated factors in a pediatric clinical cohort within the East African International Epidemiology Databases to Evaluate AIDS (EA-IeDEA) consortium.Design: A retrospective cohort study. Clinical treatment failure was defined as advancement in clinical WHO stage, or CDC class at least 24 weeks after initiation of treatment. Immunological failure was defined as developing or returning to the following age-related immunological thresholds after at least 24 weeks on treatment; CD4 count of <200 or CD4% <10% for children aged 2-5 years and CD4 count of < 100 for a child aged > 5years.Setting: The study utilized the electronic medical records of HIV-infected pediatric patients enrolled into the EA-IeDEA consortium clinics from January 2005 to August 2012.Results: A total of 5927 children were included in the analysis. The estimated cumulative incidence of clinical ART treatment failure at one year and four years post ART initiation was 11.5% and 31% respectively, while that of immunological treatment failure was at 3%and 22.5% respectively. The main factors associated with clinical failure were advanced clinical stage at ART-initiation, year started ART and residing in a rural area. Factors associated with immunological failure were male gender and age of the child at ART-initiation. Only 6% of those identified as having clinical treatment failure were switched to second line treatment during the four years of follow-up.Conclusion: The probability of clinical and immunologic failure was relatively high and increased with time