ABSTRACT
BACKGROUND: Prevalence of hepatitis B and C in Pakistan is 2.5% and 4.5%, respectively. Major cause of these infections is reuse of syringes. OBJECTIVE: To determine a cost-effective, innovative solution to prevent syringe reuse and break the transmission cycle of blood-borne infections. STUDY DESIGN, SETTINGS, AND DURATION: Analytical study in a tertiary care hospital, Jinnah Postgraduate Medical Centre, Karachi, Pakistan, July 2011 to June 2012. METHODS: Healthcare workers from 30 wards included in the study were trained on injection safety, use of needle remover and needle pit, and management of needlestick injuries. Each ward was provided with 2 needle-removing devices, and a pit was constructed for disposal of needles. Usage of the device in wards and pit use were monitored regularly. RESULTS: In 28 (93.3%) wards, sharp containers were accessible by public and were slack. Syringes were recapped using both hands in 27 (90%) cases; needlestick injury was reported by 30% of paramedics, while 25 (83.3%) of the interviewed staff had not received any formal training in injection safety. Vigilant monitoring and information sharing led to healthcare workers in 28 (96.5%) wards using the device. Needle containers were emptied in 27 (93.1%) wards, and needle pits were used in 26 (96.3%) wards. Needlestick injury was nil in follow-up. CONCLUSIONS: Needle removers permanently disable syringes. The needle pit served as a cost-effective, innovative method for disposal of needles. The intervention resulted in reducing the risk of needlestick injury.
Subject(s)
Developing Countries , Guideline Adherence/organization & administration , Inservice Training , Medical Waste Disposal/methods , Needlestick Injuries/prevention & control , Occupational Exposure/prevention & control , Blood-Borne Pathogens , Hospitals, Public , Humans , Medical Waste Disposal/instrumentation , Medical Waste Disposal/standards , Needles , Pakistan , Pilot Projects , Practice Guidelines as Topic , Tertiary Care CentersABSTRACT
The World Health Organization (WHO) estimates that there are 350 million people with chronic HBV infection and 170 million people with chronic HCV infection worldwide. Hepatitis B is estimated to result in 563, 000 deaths and hepatitis C in 366, 000 deaths annually. Given its large population (180 million) and intermediate to high rates of infection, Pakistan is among the worst afflicted nations. The reuse of syringes and needles was a major factor contributing towards increased HCV prevalence. It was reported that there are several small groups involved in recycling and repacking of used unsterilized syringes, which were available in various drug stores. It was difficult for the public to differentiate between new sterilized syringes and recycled unsterilized syringes In Pakistan, the number of estimated injections per person per year ranged from 8.2 to 13.6, which was the highest among developing countries, out of which 94.2% were unnecessary. In 2000, the WHO recommended that countries should implement strategies to change the behaviour of health care workers and patients in order to decrease the over-use of injections, to ensure the practice of sterile syringes and needles, and to properly destroy sharp waste after use.
