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Transmission of hepatitis B, hepatitis C and human immunodeficiency viruses through unsafe injections in the developing world: model-based regional estimates.
Bull World Health Organ. 1999; 77(10):801-7.BW

Abstract

Thousands of millions of injections are delivered every year in developing countries, many of them unsafe, and the transmission of certain bloodborne pathogens via this route is thought to be a major public health problem. In this article we report global and regional estimates of the number of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections that may occur from unsafe injections in the developing world. The estimates were determined using quantitative data on unsafe injection practices, transmission efficiency and disease burden of HBV, HCV and HIV and the prevalence of injection use obtained from a review of the literature. A simple mass-action model was used consisting of a generalized linear equation with variables accounting for the prevalence of a pathogen in a population, susceptibility of a population, transmission efficiency of the pathogen, proportion of injections that are unsafe, and the number of injections received. The model was applied to world census data to generate conservative estimates of incidence of transmission of bloodborne pathogens that may be attributable to unsafe injections. The model suggests that approximately 8-16 million HBV, 2.3-4.7 million HCV and 80,000-160,000 HIV infections may result every year from unsafe injections. The estimated range for HBV infections is in accordance with several epidemiological studies that attributed at least 20% of all new HBV infections to unsafe injections in developing countries. Our results suggest that unsafe injections may lead to a high number of infections with bloodborne pathogens. A major initiative is therefore needed to improve injection safety and decrease injection overuse in many countries.

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Authors+Show Affiliations

Kane A
Trinity College, Duke University, Durham, NC, USA.
Lloyd J
No affiliation info available
Zaffran M
No affiliation info available
Simonsen L
No affiliation info available
Kane M
No affiliation info available

MeSH

Cross InfectionDeveloping CountriesForecastingGlobal HealthHIV InfectionsHepatitis BHepatitis CHumansIncidenceInjectionsLinear ModelsPopulation SurveillancePrevalenceReproducibility of ResultsRisk FactorsSensitivity and Specificity

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10593027

Citation

Kane, A, et al. "Transmission of Hepatitis B, Hepatitis C and Human Immunodeficiency Viruses Through Unsafe Injections in the Developing World: Model-based Regional Estimates." Bulletin of the World Health Organization, vol. 77, no. 10, 1999, pp. 801-7.
Kane A, Lloyd J, Zaffran M, et al. Transmission of hepatitis B, hepatitis C and human immunodeficiency viruses through unsafe injections in the developing world: model-based regional estimates. Bull World Health Organ. 1999;77(10):801-7.
Kane, A., Lloyd, J., Zaffran, M., Simonsen, L., & Kane, M. (1999). Transmission of hepatitis B, hepatitis C and human immunodeficiency viruses through unsafe injections in the developing world: model-based regional estimates. Bulletin of the World Health Organization, 77(10), 801-7.
Kane A, et al. Transmission of Hepatitis B, Hepatitis C and Human Immunodeficiency Viruses Through Unsafe Injections in the Developing World: Model-based Regional Estimates. Bull World Health Organ. 1999;77(10):801-7. PubMed PMID: 10593027.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transmission of hepatitis B, hepatitis C and human immunodeficiency viruses through unsafe injections in the developing world: model-based regional estimates. AU - Kane,A, AU - Lloyd,J, AU - Zaffran,M, AU - Simonsen,L, AU - Kane,M, PY - 1999/12/11/pubmed PY - 1999/12/11/medline PY - 1999/12/11/entrez KW - Behavior KW - Biology KW - Developing Countries KW - Diseases KW - Epidemiology KW - Equipment And Supplies KW - Health KW - Hepatitis--transmission KW - Hiv Infections--transmission KW - Public Health KW - Research Report KW - Risk Behavior KW - Risk Factors KW - Syringe KW - Viral Diseases SP - 801 EP - 7 JF - Bulletin of the World Health Organization JO - Bull World Health Organ VL - 77 IS - 10 N2 - Thousands of millions of injections are delivered every year in developing countries, many of them unsafe, and the transmission of certain bloodborne pathogens via this route is thought to be a major public health problem. In this article we report global and regional estimates of the number of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections that may occur from unsafe injections in the developing world. The estimates were determined using quantitative data on unsafe injection practices, transmission efficiency and disease burden of HBV, HCV and HIV and the prevalence of injection use obtained from a review of the literature. A simple mass-action model was used consisting of a generalized linear equation with variables accounting for the prevalence of a pathogen in a population, susceptibility of a population, transmission efficiency of the pathogen, proportion of injections that are unsafe, and the number of injections received. The model was applied to world census data to generate conservative estimates of incidence of transmission of bloodborne pathogens that may be attributable to unsafe injections. The model suggests that approximately 8-16 million HBV, 2.3-4.7 million HCV and 80,000-160,000 HIV infections may result every year from unsafe injections. The estimated range for HBV infections is in accordance with several epidemiological studies that attributed at least 20% of all new HBV infections to unsafe injections in developing countries. Our results suggest that unsafe injections may lead to a high number of infections with bloodborne pathogens. A major initiative is therefore needed to improve injection safety and decrease injection overuse in many countries. SN - 0042-9686 UR - https://www.unboundmedicine.com/medline/citation/10593027/Transmission_of_hepatitis_B_hepatitis_C_and_human_immunodeficiency_viruses_through_unsafe_injections_in_the_developing_world:_model_based_regional_estimates_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/10593027/ DB - PRIME DP - Unbound Medicine ER -