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  1. 1
    347416
    Peer Reviewed

    Uncovering high rates of unsafe injection equipment reuse in rural Cameroon: Validation of a survey instrument that probes for specific misconceptions.

    Okwen MP; Ngem BY; Alomba FA; Capo MV; Reid SR; Ewang EC

    Harm Reduction Journal. 2011 Feb 7; 8(4):1-9.

    Background: Unsafe reuse of injection equipment in hospitals is an on-going threat to patient safety in many parts of Africa. The extent of this problem is difficult to measure. Standard WHO injection safety assessment protocols used in the 2003 national injection safety assessment in Cameroon are problematic because health workers often behave differently under the observation of visitors. The main objective of this study is to assess the extent of unsafe injection equipment reuse and potential for blood-borne virus transmission in Cameroon. This can be done by probing for misconceptions about injection safety that explain reuse without sterilization. These misconceptions concern useless precautions against cross-contamination, i.e. "indirect reuse" of injection equipment. To investigate whether a shortage of supply explains unsafe reuse, we compared our survey data against records of purchases. Methods: All health workers at public hospitals in two health districts in the Northwest Province of Cameroon were interviewed about their own injection practices. Injection equipment supply purchase records documented for January to December 2009 were compared with self-reported rates of syringe reuse. The number of HIV, HBV and HCV infections that result from unsafe medical injections in these health districts is estimated from the frequency of unsafe reuse, the number of injections performed, the probability that reused injection equipment had just been used on an infected patient, the size of the susceptible population, and the transmission efficiency of each virus in an injection. Results: Injection equipment reuse occurs commonly in the Northwest Province of Cameroon, practiced by 44% of health workers at public hospitals. Self-reported rates of syringe reuse only partly explained by records on injection equipment supplied to these hospitals, showing a shortage of syringes where syringes are reused. Injection safety interventions could prevent an estimated 14-336 HIV infections, 248-661 HBV infections and 7-114 HCV infections each year in these health districts. Conclusions: Injection safety assessments that probe for indirect reuse may be more effective than observational assessments. The auto-disable syringe may be an appropriate solution to injection safety problems in some hospitals in Cameroon. Advocacy for injection safety interventions should be a public health priority.
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  2. 2
    287447

    Condemned to death: thanks to the US-led drug war, AIDS is exploding among injection drug users. (Thailand).

    Wolfe D

    Nation. 2004 Apr 26; 278(16):[13] p..

    In addition to the obligatory red ribbons, the logo for the XV international AIDS Conference features three Asian elephants raising their trunks as if in welcome. The world's most important gathering of AIDS specialists will be held this July in Bangkok, a location chosen not only because Asia is thought to be the site of the next big wave of HIV infections but because Thailand is one of only a few developing countries that have thus far seemed able to control them. International experts have hailed Thailand's 100 percent condom program, which in the 1990s distributed some 60 million condoms for free sex establishments, engaged brothel owners and government officials alike to make sure they were used and helped bring down rates of HIV and sexually transmitted infections as much as fourfold. Thailand is also the first developing country to create a functional program to stop mother-to-child HIV transmission, providing free prenatal care and preventive medication to more than three-quarters of pregnant women testing positive for HIV. Last June Kofi Annan's praise of Thailand was one of the few bright spots in an otherwise grim report to the UN General Assembly on lack of global progress against AIDS. (excerpt)
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  3. 3
    192662

    Best infection control practices for skin-piercing, intradermal, subcutaneous, and intramuscular needle injections.

    Safe Injection Global Network [SIGN]; World Health Organization [WHO]; International Council of Nurses

    Geneva, Switzerland, WHO, Department of Blood Safety and Clinical Technology, SIGN, 2001 Nov. [2] p. (WHO/BCT/DCT/01.02)

    Best Infection Control Practices for Skin-Piercing Intradermal, Subcutaneous, and Intramuscular Needle Injections. Use sterile injection equipment; Use sterile injection equipment; Prevent needlestick injuries to the provider; Prevent access to used needles; Prevent access to used needles. (excerpt)
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