Impact of a recapping device on venepuncture-related needlestick injury.

In a 33-month prospective analysis of needlestick injuries, venepuncturists working under Centers for Disease Control (CDC) guidelines for handling used needles were shown to incur a needlestick injury for every 3,175 to 4,006 needle-handling procedures. On the other hand, users of a simple device designed to reduce the risk of injury when recapping used needles were shown to incur a needlestick only once in every 16,100 venepunctures performed (P less than 0.001). This represents a fourfold reduction in the rate of needlestick injuries. We thus question the effectiveness of the CDC nonrecapping policy.

Iron deficiency and anemia among Indian women in Fiji.

In June 1979, 245 Hindu and 240 Moslem women of childbearing age (14-45 yr) living in a semi-rural area north of Lautoka were tested for anemia and for iron-deficiency. Ninety-six (39%) of the 245 Hindu women and 77 (32%) of the 240 Moslem women were anemic according to World Health Organization criteria. Most of the cases of anemia were due to iron-deficiency. The prevalence of anemia did not change significantly with advancing age or increasing parity. Hookworm ova were found on examination of a single specimen of feces in 27 (14%) of 195 Hindu and 50 (24%) of 209 Moslem women. The presence of hookworm did not correlate with anemia. The red cell folate level was less than 160 micrograms/l in 117 (24%) of 478 women and the serum vitamin B12 level was less than 100 ng/l in 47 (10%) of 476 women. Subnormal levels of these vitamins did not correlate with anemia. The serum ferritin was determined to assess tissue iron stores. Two-hundred-and-twenty-four (46%) of 484 Indian women tested had serum ferritin values of less than 10 microgram/l; 400 (83%) had ferritin values of less than 26 microgram/l. The high prevalence of iron deficiency appears to be due predominantly to dietary factors.

The prevalence and nature of anemia among apparently normal subjects in Fiji.

A total of 4939 apparently healthy Fijian and Indian subjects living in Fiji were tested for anaemia by determination of the microhaematocrit of a sample of capillary blood. The prevalence of anaemia during childhood varied with age but was similar for Fijians and Indians of either sex. The overall prevalences were: 0-4 years, 20.3%; 5-9 years, 3.7%; 10-14 years, 23.5%. The prevalence of anaemia among Indian women (33.3%) was substantially higher than that for Indian men (6.9%), Fijian women (8.1%) or Fijian men (6.8%). Iron deficiency was the most common cause of anaemia and was established by laboratory studies in 203 (68%) of 298 anaemic subjects who were followed up. Iron deficiency was an important aetiological factor in 91 (93%) of 98 subjects with moderate or severe anaemia. Folate deficiency was found, usually in combination with iron deficiency, in 44 or 141 anaemic indian adults were followed up. Folate deficiency was uncommon in Fijian adults and among children of either race. Two cases of nutritional vitamin B12 deficiency, one case of pernicious anaemia, 6 cases of heterozygous thalassaemia and one case of heterozygous haemoglobin E were found among the anaemic Indian subjects. No cases of vitamin B12 deficiency anaemia, thalassaemia or haemoglobinopathy were detected among the Fijians. In 5 Indians and 7 Fijians the anaemia was associated with an underlying chronic disorder. This study emphasizes that in Fiji, as in other developing countries, nutritional anaemia is prevalent among asymptomatic subjects. Iron deficiency is by far the most common cause.