E-drug: Unsafe injections: a great threat to China's health
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[Cross-posted from the SIGN Network. Thanks, HH]
Unsafe injections: a great threat to China's health
Dramatic increases in hepatitis B and C in China, may be related to
these practices. The risk of spreading AIDS (an increasing problem
throughout the south due to blood donation practices) is also
highlighted at the embassy web link provided below.
The file of PRC journal and press articles on HIV/AIDS, updated
recently is at
http://www.usembassy-china.org.cn/english/sandt/hivartic.html
Summary of the December 1999 article in the Chinese Journal of
Epidemiology
Unsafe Injections: A Great Threat to China's Health
Unsafe injection practices are widespread in China. A 1998-1999
survey of 3066 village immunization stations that participated in the
1996 planned immunization program found that only one-third of
the stations achieved the one person - one needle ideal.
This led to the PRC Ministry of Health goal of safe injections by
2000. A 1999 study of injection practices at by 585 village, district
and epidemic prevention station medical workers at 149 village
immunization stations in Yingcheng City and Yinmeng counties in
Hubei Province found 88 percent unsafe injections from a
combination of improper sterilization of equipment (17 percent) and
unsafe injection practices (40 percent) or both (43 percent). The
160 medical workers with just middle school or elementary school
training had an unsafe injection rate of over 50 percent. The most
highly trained 40 who had post high school vocational medical
training had an unsafe injection rate of 30 percent.
Fifty-five percent of the Yingcheng City medical workers didn't
know how to sterilize properly. Fifty percent of the Yumeng County
medical workers didn't know either. Only 27 percent of the village
medical workers did injection procedures properly. So 73 percent
did them the wrong way. Fifty- six percent said they only change
needles when they notice blood on the syringe. One smaller survey
of 16 village medical workers found that one third thought that the
effectiveness of heat sterilization and pressure sterilization was the
same.
The most common unsafe practices were reusing a needle and
syringe; just changing the needle but not the syringe; and merely
wiping the needle with a disinfectant and then giving the next child
an injection. Ignorance among medical workers and even county
and district epidemiological station managers is a major problem.
Many medical workers believe changing the needle but not the
syringe is safe. Some know safe practices but don't believe in them
since they never saw one of their patients get sick from an
injection. One third of the epidemiological station managers
questioned believed changing needles but not changing the syringe
is safe. (Chinese Journal of Epidemiology, December 1999)
One major consequence of unsafe injections and other dangerous
medical practices is China's hepatitis epidemic that costs the
Chinese nation 300,000 deaths annually to liver cancer. Liver
cancer ranks no. 1 among cancer killers in China compared with no.
14 in the United States because of China's hepatitis B epidemic.
Syphilis and other blood-borne diseases can spread through unsafe
injections just as hepatitis does. Unsafe injections and unsterile
medical practices, particularly in the poorer provinces of central and
western China, also increase China's vulnerability to the HIV
epidemic although HIV does not spread through injections as easily
as does hepatitis. Embarassment of both government officials and
medical professionals that medical workers play a major role in the
spread of disease makes it especially difficult to address this issue.
Visit the SIGN website at: www.injectionsafety.org
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