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Model-based estimates of the risk of human immunodeficiency virus and hepatitis B virus transmission through unsafe injections.
Int J Epidemiol. 1995 Apr; 24(2):446-52.IJ

Abstract

BACKGROUND

Patient-to-patient transmission through contaminated medical equipment may be the principal route 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 evaluate 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 unsterile needle and syringe reuse rates were specified. 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 unsterile needles and syringes 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.

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Publisher Full Text

Authors+Show Affiliations

Aylward B
Global Programme for Vaccines and Immunization, World Health Organization, Geneva, Switzerland.
Kane M
No affiliation info available
McNair-Scott R
No affiliation info available
Hu DJ
No affiliation info available
Hu DH
No affiliation info available

MeSH

AdultCross InfectionDeveloping CountriesEquipment ContaminationEquipment ReuseFemaleHIV InfectionsHepatitis BHumansImmunization ProgramsInfantInjectionsModels, TheoreticalPregnancyPrevalenceProbabilityRisk AssessmentRisk FactorsSyringes

Pub Type(s)

Journal Article

Language

eng

PubMed ID

7635609

Citation

Aylward, B, et al. "Model-based Estimates of the Risk of Human Immunodeficiency Virus and Hepatitis B Virus Transmission Through Unsafe Injections." International Journal of Epidemiology, vol. 24, no. 2, 1995, pp. 446-52.
Aylward B, Kane M, McNair-Scott R, et al. Model-based estimates of the risk of human immunodeficiency virus and hepatitis B virus transmission through unsafe injections. Int J Epidemiol. 1995;24(2):446-52.
Aylward, B., Kane, M., McNair-Scott, R., Hu, D. J., & Hu, D. H. (1995). Model-based estimates of the risk of human immunodeficiency virus and hepatitis B virus transmission through unsafe injections. International Journal of Epidemiology, 24(2), 446-52.
Aylward B, et al. Model-based Estimates of the Risk of Human Immunodeficiency Virus and Hepatitis B Virus Transmission Through Unsafe Injections. Int J Epidemiol. 1995;24(2):446-52. PubMed PMID: 7635609.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Model-based estimates of the risk of human immunodeficiency virus and hepatitis B virus transmission through unsafe injections. AU - Aylward,B, AU - Kane,M, AU - McNair-Scott,R, AU - Hu,D J, AU - Hu,D H, PY - 1995/4/1/pubmed PY - 1995/4/1/medline PY - 1995/4/1/entrez SP - 446 EP - 52 JF - International journal of epidemiology JO - Int J Epidemiol VL - 24 IS - 2 N2 - BACKGROUND: Patient-to-patient transmission through contaminated medical equipment may be the principal route 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 evaluate 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 unsterile needle and syringe reuse rates were specified. 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 unsterile needles and syringes 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. SN - 0300-5771 UR - https://www.unboundmedicine.com/medline/citation/7635609/Model_based_estimates_of_the_risk_of_human_immunodeficiency_virus_and_hepatitis_B_virus_transmission_through_unsafe_injections_ L2 - https://academic.oup.com/ije/article-lookup/doi/10.1093/ije/24.2.446 DB - PRIME DP - Unbound Medicine ER -