Document 0766
 DOCN  M9550766
 TI    Estimating the number of HIV transmissions through reused syringes and
       needles in the Mbeya Region, Tanzania.
 DT    9505
 AU    Hoelscher M; Riedner G; Hemed Y; Wagner HU; Korte R; von Sonnenburg F;
       Department of Infectious Diseases and Tropical Medicine,; University of
       Munich, Germany.
 SO    AIDS. 1994 Nov;8(11):1609-15. Unique Identifier : AIDSLINE MED/95151240
 AB    OBJECTIVE: HIV infection attributable to medical injections is suspected
       to be low, although case-control studies have not provided definite
       results. This study aims to determine the number of HIV infections
       caused by the reuse of syringes and needles in the Mbeya Region,
       Tanzania. METHODS: The direct identification or detection of HIV in
       syringes and needles under field conditions was not appropriate,
       therefore a surrogate marker consisting of two components for possible
       HIV transmission was used: insufficient sterilization, and blood
       remaining from a previous patient. The assumption was that HIV infection
       can only occur if both markers are positive. Samples were collected in
       nine health-care facilities. All syringes and needles prepared for use
       in these facilities were collected without prior notification. The
       samples were rinsed and the resulting fluid was cultured for bacteria.
       Traces of blood were detected by urine stick test for haemoglobin
       volumes > 0.0015 microliters. RESULTS: Bacterial contamination was found
       in 32.8% of the total 1219 syringes and needles; 67% was caused by
       improper handling of the equipment after sterilization. Blood was
       detected in 12.5% of the samples. In the following three sampling
       strata, both contamination criteria were positive either on the syringe
       or the needle: wards/outpatient departments (OPD), 1.39%; laboratories,
       7.45%; expanded programme on immunization (EPI), < 0.1%. We calculated
       that from 1.1 million patients injected in wards/OPD in any 1 year,
       fewer than 13 become infected, in laboratories fewer than 12 (160,000
       blood-taking procedures), and less than one child in the EPI (850,000
       vaccinations). CONCLUSION: With an established AIDS intervention
       programme supporting the health system, less than 0.4% of the total
       annual incidence of 4500-8500 is attributable to medical injections in
       the Mbeya Region.
 DE    Case-Control Studies  Community Health Services  *Equipment Reuse
       Hospital Units  Human  HIV Infections/*EPIDEMIOLOGY/*TRANSMISSION  HIV
       Seroprevalence  Laboratories/STANDARDS  *Needles  Prevalence  Sexually
       Transmitted Diseases  Sterilization/STANDARDS  Substance Abuse,
       Intravenous/EPIDEMIOLOGY  Support, Non-U.S. Gov't  *Syringes
       Tanzania/EPIDEMIOLOGY  JOURNAL ARTICLE

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