Skip Navigation

This Article
Right arrow Full Text (PDF)
Right arrow An erratum has been published
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (26)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by AYLWARD, B.
Right arrow Articles by HU, D. H
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by AYLWARD, B.
Right arrow Articles by HU, D. H
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 1995 Oxford University Press

research-article

Model-Based Estimates of the Risk of Human Immunodeficiency Virus and Hepatitis B Virus Transmission through Unsafe Injections

BRUCE AYLWARD*, MARK KANE*,, ROBERT McNAIR-SCOTT* and DALE H HU*,{dagger}

* Global Programme for Vaccines and Immunization, World Health Organization Geneva, Switzerland.
{dagger} current address. Division of HIV/AIDS, Centers for Disease Control and Prevention Atlanta, USA.

Reprint requests to. Dr Mark Kane, Global Programme for Vaccines and Immunization, World Health Organization 20 Avenue Appia, 1211-Geneva-27, switzerland.

Background. Patient-to-patient transmission through contaminated medical equipment may be the principal roule of nosocomial blood-borne infections globally. Quantifying cross infection risks could facilitate efforts to ensure safe injections in developing countries.

Method. A mathematical model was developed to evaluale the risk of cross infection due to unsafe injections. The model was applied to immunization programmes with a fixed number of injections and in which unsterlle needle and synnge reuse rales were speclfied. Risk estimates were generated using a range of human immunodeficiency virus (HIV) and hepatitis B (HBV) prevalences.

Results. The risk of cross Infection is zero when properly sterilized equipment is used. With unsafe Injections, the risk of cross infection with HBV is consistently higher than HIV for comparable levels of endemicity. A single reuse of each needle and syringe in areas with an HBeAg prevalence of 4% results in 980 cases of HBV/100 000 Infants; reuse four times results in 3740 cases. When the HIV prevalence is 1% and the reuse rate is 4, 14 to 35 cases of HIV/100 000 women could occur. Contamination of multidose vaccine vials could considerably increase these estimates.

Conclusions. Neither HIV nor HBV transmission has been reported with injections administered through the Expanded Programme on Immunization. However, ample evidence exists that reuse of unsterlle needles and synnges is common in developing countries. Ongoing efforts to ensure safe practices and improve injection technologies are required to protect these populations from both medical and traditional skin-piercing procedures.

Received 1 May 1994


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 GutHome page
G Dusheiko and N Antonakopoulos
Current treatment of hepatitis B
Gut, January 1, 2008; 57(1): 105 - 124.
[Full Text] [PDF]

Home page
 BMJHome page
Y. J F Hutin, A. M Hauri, and G. L Armstrong
Use of injections in healthcare settings worldwide, 2000: literature review and regional estimates
BMJ, November 8, 2003; 327(7423): 1075.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
Committee on Infectious Diseases, 1998MIHNEAndash1, Ex-Officio, and L. Representatives
Combination Vaccines for Childhood Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP)
Pediatrics, May 1, 1999; 103(5): 1064 - 1077.
[Full Text]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.