ARTICLE IN PRESS
Journal of Hospital Infection xxx (2010) 1–5

Available online at www.sciencedirect.com

Journal of Hospital Infection
journal homepage: www.elsevierhealth.com/journals/jhin

Educational intervention for preventing bloodborne infection among medicalstudents in China
Z. Zhang a, b, *, T. Yamamoto a, X.N. Wu c, K. Moji d, G.X. Cai d, e, C. Kuroiwa fa

Department of International Health, Institute of Tropical Medicine (NEKKEN), Global Center of Excellence, Nagasaki University, Nagasaki, JapanJapan Foundation for AIDS Prevention (JFAP), Tokyo, JapancFujian Medical University, Fujian, ChinadResearch Institute for Humanity and Nature, Kyoto, Japane
Chinese Center for Disease Control and Prevention, Beijing, Chinaf
Yotsukaido Tokushukai Medical Center, Chiba, Japanba r t i c l e i n f os u m m a r y

Article history:
Received 20 October 2009
Accepted 18 December 2009
Available online xxx

Although medical students are known to be at risk for bloodborne infections, there have beenno systematic studies, effective intervention programmes, or guidelines for them in China. We
developed prevention guidelines, implemented an intervention, and evaluated the effectiveness of knowledge among medical students. This study was designed as a cluster randomised
controlled trial. All those who completed a consent form were randomly assigned either to anintervention or to a control group. The intervention group underwent an educational intervention programme consisting of a series of lectures and videos following a baseline survey.
The control group completed the same intervention programme after the study wascompleted. A questionnaire of 25 items was sent to participants three months and nine months
after the initial intervention programme. Outcomes measured before and after intervention
included knowledge of transmission route, ﬁrst-aid care, and post-exposure prophylaxis.
Pearson’s c2-test was used, and the efﬁcacy of students was analysed to control for bias.
Intervention in the form of a one-time bloodborne pathogen educational prevention programme for Chinese medical students had little effect on knowledge.
Ó 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

Keywords:
Bloodborne infection
Chinese medical students
Educational intervention
Intervention programme

Introduction
Bloodborne infections such as human immunodeﬁciency virus(HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections
are a great burden to healthcare workers around the world becauseof the high probability of exposure to blood in the workplace.1–3 The
risk of seroconversion after a single percutaneous exposure to
infected blood ranges from 39.0% for hepatitis C to 37% for hepatitis
B and to 4.4% for HIV.1 An estimated three million healthcareworkers are exposed to at least one percutaneous injury froma sharp object contaminated with HCV (0.33 million), HBV (2.1million), or HIV (0.93 million) each year. Not only healthcare
workers but also medical students need to pay attention to these* Corresponding author. Address: Department of International Health, Institute ofTropical Medicine (NEKKEN), Global Center of Excellence, Nagasaki University,
1-12-4 Sakamoto, Nagasaki 852-8523, Japan. Tel.: þ81 95 819 7869; fax: þ81 95 819
7869.
E-mail address: zzhuozhang@gmail.com (Z. Zhang).

risks.4–7 Lack of practical experience and/or technical expertiseleaves medical students at high risk of acquiring bloodborne
infections during their training.8–10 The introduction of safetymeasures to prevent accidental bloodborne infections in school
curricula is therefore required.11 However, the magnitude of thehealth burden, caused by bloodborne infections in China, has beenpoorly understood. Although educational programmes haveproduced positive changes in knowledge on safety protocols insome countries,11,12 little is known concerning protection of medical
students in China.13 Only one cross-sectional study, conducted innortheast China, revealed that most medical students are eager tolearn about preventive measures for bloodborne pathogens.14
There are no consistent national guidelines on bloodborne
pathogens in China, except for HIV.15,16 This situation motivated us
to conduct the current study to meet at least two needs: (i) morecomprehensive prevention guidelines for bloodborne pathogens;(ii) an effective intervention programme for bloodborne pathogens.
To accomplish these objectives, an educational intervention
programme was designed and implemented.

0195-6701/$ – see front matter Ó 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.
doi:10.1016/j.jhin.2009.12.021

Please cite this article in press as: Zhang Z, et al., Educational intervention for preventing bloodborne infection among medical students inChina, J Hosp Infect (2010), doi:10.1016/j.jhin.2009.12.021