Use of hub cutters and the volume of sharp waste and occurrence of needle-stick injuries during 2011 mass immunization campaigns against yellow fever in Ghana: a cohort study.

BACKGROUND: Current WHO best infection control practices for injections do not address the use of hub cutters due to insufficient evidence on safety and efficacy. OBJECTIVE: To assess the impact of the use of hub cutters on 1) the frequency of needle-stick injuries (NSIs) and other blood exposures among workers and 2) the volume of sharps waste in a mass vaccination campaign setting. METHODS: During yellow fever vaccination in Ghana, we conducted a cohort study on the use of hub cutters. We compared two groups---one group using hub cutters and a control group---for the occurrences of NSIs and the volume of sharp waste produced. RESULTS: In the control arm, vaccinators used 284 482 syringes in 825 vaccination sessions. In the group using hub cutter, vaccinators used 397 079 syringes in 1599 sessions. Among vaccinators, the rate of NSI was not significantly (p=0.14) different between the hub cutter users (0.15/10 000 syringes) and the control group (0.04/10 000). Factors such as workload, lack of organization and pressure seemed to have influence the occurrence of NSIs. With all the limitations of the work, the volume of sharp waste per 10 000 syringes was 0.24 m(3) in the hub cutter users and 0.41 m(3) in the control group---a reduction of 41.2%. Vaccinators found hub cutters easy to use and safe. Use of hub cutter was not associated with increased duration of work. CONCLUSION: The use of hub cutters did not increase the risk of NSIs. More training is needed to facilitate its implementation in mass campaign setting.

Guinea worm disease--a chance for successful eradication in the Volta Region, Ghana.

A guinea worm eradication program in two farming communities in the Akatsi District in the Volta region of Ghana was initially threatened by failure to apply simple preventive practices. Persistent monitoring and education on the use of locally supplied, inexpensive materials for water filtration has turned the program around. In March 1996, the Volta rural water supply and sanitation (VRWSS) project commissioned a guinea worm prevalence and knowledge, attitude and practice (KAP) study to collect baseline prevalence data. This study revealed some of the factors that contributed to the persistent high prevalence of guinea worm in the two communities. The community's only source of potable drinking water was irrigation dams which also served as the source of guinea worm infection. The Last quarterly report stated that guinea worm cases had been reduced from 62 to 5 in the two communities. Lessons learnt from Avega and Avevi will be extended to other guinea worm endemic communities that have registered with the project in the region. The prospect of total eradication of guinea worm in the region now exists.

Water and dirt--matters of life and death.

Poor hygiene and sanitation are responsible for much of the disease burden in two rural communities in the Volta Region of Ghana. A study produced recommendations for educational activities on personal and public hygiene and the creation of improved water supply and sanitation facilities through community participation and the use of local resources. These steps are now being taken.