Document 2448
 DOCN  M94A2448
 TI    The risk of transmission of HIV and other blood-born diseases via jet
       injectors during immunization mass campaigns in Brazil.
 DT    9412
 AU    Brito GS; Chen RT; Stefano IC; Campos AM; Oselka G; State Department
       Health/SP-BR.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):301 (abstract no. PC0132). Unique
       Identifier : AIDSLINE ICA10/94370127
 AB    OBJECTIVES: In Brazil, jet injectors are routinely used among military
       recruits and mass immunization campaigns which include residents of
       rural Amazon. Conditions for optimal use of injectors are present in
       several settings and military recruits, but not in the Amazon. We
       conducted a study to compare the potential risk of transmission of HIV
       and other blood-born diseases by jet injectors in these diverse
       vaccination conditions. METHODS: Ped-O-Jet injectors were used as per
       routine among military recruits and Amazon residents. The injection site
       was visually examined immediately after the injection for evidence of
       obvious bleeding. In addition, instead of administering the next dose of
       vaccine to a person, we collect it in a test tube this dose was tested
       qualitatively for the presence of blood using a dipstick which can
       detect from 0.002 to 0.01 microliters of blood per 0.5 ml of vaccine.
       RESULTS: A total of 2815 persons were studied after jet gun injection
       among 12 different immunization sessions among military recruits and 30
       persons in one session among Amazon residents. The rate of immediate
       bleeding was also higher among Amazon residents 23% compared to 3.4%
       among military recruits. The rate of occult blood was also higher among
       Amazon residents, 6.6% vs. 1% in military recruits. CONCLUSION: Given a
       rate of occult blood of 1%, this translates into a theoretical risk of
       HIV transmission under conditions of optimal use. the HIV prevalence in
       Brazilian children (from 2 to 14 years old) estimated to be 7-14/100.000
       pop and taking to account the rate of HIV transmission by needlesticks
       in health care workers estimated to be 0.3%, we estimated the
       theoretical risk of HIV transmission through the use of Ped-O-Jet
       injectors to be in the range between one per 238 to 476 million
       injections. This results suggest that the use of jet injectors in this
       vaccination strategy and military recruits are safe. The HBV prevalence
       in the Amazon region is as high as 15%, based in findings, we estimate
       the risk of HBV transmission at one per 388 to 3367 Ped-O-Jet
       injections. Jet injectors are no longer recommended for use in the
       Amazon area.
 DE    Adolescence  Brazil  Child  Child, Preschool  Human  HIV
       Infections/*TRANSMISSION  Immunization/*ADVERSE EFFECTS  Immunization
       Programs  Injections, Jet/*ADVERSE EFFECTS  Military Personnel  MEETING
       ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).