Kane, A., Lloyd, J., Zaffran, M., Simonsen, L. & Kane, M. 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. 77, 801-807

Trinity College, Duke University, Durham, NC, USA.
Bulletin of the World Health Organisation (Impact Factor: 5.09). 02/1999; 77(10):801-7.
Source: PubMed


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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Available from: Lone Simonsen, Jul 16, 2014
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    • "As the injection is a process that requires supervision by skilled health care providers, its number is regarded very important. The excessive and unnecessary use of injection medications is not only a waste of medical costs, medical staff, time and medical equipment but also increases the risk of infection by viruses, like hepatitis C and AIDS (Beaney & Black, 2011; Kane, Lloyd, Zaffran, Simonsen, & Kane, 1999). "

    Full-text · Dataset · Sep 2015
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    • "HBV is more infectious through blood-borne exposure than both HCV and HIV. Contaminated needles alone are thought to be responsible for 8-16 million HBV infections per year [6]. "
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    ABSTRACT: WHO estimates reveal that the global prevalence of viral hepatitis may be as high as 500 million, with an annual mortality rate of up to 1.3 million individuals. The majority of this global burden of disease is borne by nations of the developing world with high rates of vertical and iatrogenic transmission of HBV and HCV, as well as poor access to healthcare. In 2013, 3.2% of the global population (231 million individuals) migrated into a new host nation. Migrants predominantly originate from the developing countries of the south, into the developed economies of North America and Western Europe. This mass migration of individuals from areas of high prevalence of viral hepatitis poses a unique challenge to the healthcare systems of the host nations. Due to a lack of universal standards for screening, vaccination and treatment of viral hepatitis, the burden of chronic liver disease and hepatocellular carcinoma continues to increase among migrant populations globally. Efforts to increase case identification and treatment among migrants have largely been limited to small outreach programs in urban centers, such that the majority of migrants with viral hepatitis continue to remain unaware of their infection. This review summarizes the data on prevalence of viral hepatitis and burden of chronic liver disease among migrants, current standards for screening and treatment of immigrants and refugees, and efforts to improve the identification and treatment of viral hepatitis among migrants. Copyright © 2015. Published by Elsevier B.V.
    Preview · Article · May 2015 · Journal of Hepatology
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    • "Unfortunately, these particulates generally display low oral absorption efficiencies[3]. Millions of unsafe injections are delivered in developing countries, and the transmission of certain blood borne pathogens via this route is thought to be a major public health problem[4]. Several technological advances developed to overcome this challenge. "

    Full-text · Article · Jan 2015
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