AEGiS-14IAC: Poor injection practices in health care setting two decades into the HIV pandemic: Are we missing opportunities to prevent nosocomial HIV infections?

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Poor injection practices in health care setting two decades into the HIV pandemic: Are we missing opportunities to prevent nosocomial HIV infections?

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. MoOrD1064)

Hutin YJ, Hauri A
WHO, Geneva, Switzerland

BACKGROUND: In a number of countries, reports of nosocomial HIV transmission lead to improvement of injection practices in health care setting. However, unsafe injection practices persist. We reviewed the literature to assess injection safety and injection frequency in developing and transitional countries and evaluate the risks of injection-associated nosocomial HIV infection.

METHODS: Fourteen regions were defined by the Global Burden of Disease project based on mortality patterns and geography. The analysis excluded four regions (predominantly affluent, developed nations) where reuse of injection equipment in the absence of sterilization was negligible. Data sources included published studies and unpublished WHO reports. Studies were reviewed using a standardized decision-making algorithm based upon the quality of the data to generate region-specific estimates of the annual number of injections per person and of the proportion of injections reused in the absence of sterilization

RESULTS: The annual ratio of injections per person was 3.7 (Range: 1.1 to 5.2). The proportion of injections administered with equipment reused in the absence of sterilization was 40.6% (Range: 1.5% - 74.2%). Reuse was highest in the South East Asia region "D" (seven countries, mostly located in South Asia), the Eastern Mediterranean region "D" (nine countries, mostly located in the Middle East crescent) and the Western Pacific region "B" (22 countries) which together accounted for 92% of the 7.5 thousand million injections given annually with equipment reused in the absence of sterilization in the 10 regions studied.

CONCLUSIONS: Two decades into the HIV pandemic, injection overuse and unsafe practices are still common in developing and transitional countries. There is an urgent need to use injections safely and appropriately to prevent nosocomial HIV infections worldwide and more particularly in South Asia, the Middle East crescent and the Western Pacific.

Keywords: AEGIS, Injections, HIV Infections, Cross Infection, Sterilization, HIV Seropositivity, Geography, Middle East, Asia, Asia, Southeastern, Mediterranean Region

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