E-drug: Use of injections in healthcare settings worldwide
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[Copied as fair use. HH]
Use of injections in healthcare settings worldwide, 2000: literature
review and regional estimates
Yvan J F Hutin, Anja M Hauri, and Gregory L Armstrong
BMJ 327: 1075, 2003.
http://bmj.com/cgi/content/abstract/327/7423/1075?etoc
Objective: To describe injection practices worldwide in terms of
frequency and safety.
Design literature review: The global burden of disease project of the
World Health Organization defined 14 regions on the basis of
geography and mortality patterns. Data sources included published
studies and unpublished WHO reports. Studies were reviewed by
using a standardised decision making algorithm to generate region
specific estimates.
Setting: Healthcare facilities, both formal and informal.
Data sources: General population and users of healthcare facilities.
Main outcome measure: Annual number of injections per person and
proportion of injections administered with syringes or needles, or
both, reused in the absence of sterilisation.
Results: The analysis excluded four regions (predominantly affluent,
developed nations) where reuse of injection equipment in the
absence of sterilisation was assumed to be negligible. In the 10 other
regions, the annual ratio of injections per person ranged from 1.7 to
11.3. Of these, the proportion administered with equipment reused in
the absence of sterilisation ranged from 1.2% to 75.0%. 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). No information regarding
injection safety was available for Latin America.
Conclusions: Overuse of injections and unsafe practices are still
common in developing and transitional countries. An urgent need
exists to use injections safely and appropriately, to prevent healthcare
associated infections with HIV and other blood-borne pathogens.
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