Assessment of Safety of Injection and Related Medical Practices in Health Institutions at Sidama Zone, SNNPRS
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Date
2004-04
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Addis Ababa University
Abstract
Background: There is substantial discrepancy between much of the epidemiological
evidence and the belief that nearly all of the HIV burden in sub-Sahara Africa can be
accounted by heterosexual transmission and the sexual behavior of Africans. For this a
number of observations raise the question of an alternative route of transmission, for
which medical care and the use of injections are prime candidates.
Objective: To assess the potential risk of transmission of blood born pathogens (HIV,
HBV, and HCV) through needles and sharps in health care settings found at Sidama zone
of SNNPRS.
Methods: Health institutions based cross sectional survey was conducted from November
2003 to March 2004. From 22 government, 9 NGO and 9 private health institutions, 213
health care workers and 352 clients/patients were interviewed; 178 injection practices
were observed; and dressing and delivery practices were observed in 37 and 27 health
institutions respectively.
Result: Accordingly, 74% of the observed injections were found out to be unsafe to the
health workers, recipients or to the community. Contaminated and unsterile medical
equipment that contact open skin or used for percutanous procedure were observed put
ready for reuse in most health institutions. Most (97%) of the health institutes lack at
least one equipment that was used for wound care or to assist delivery. Although, most
the health care workers were aware of the transmission of diseases through contaminated
vi
needles, only 7% of them cited HBV, HCV, and HIV simultaneously. Thirty two percent
of the health care workers reported a 12-month prevalence of accidental needle or sharp
injury. 64% of these were deep or penetrating injuries.
Most clients/patients (89.5%) were knowledgeable on the transmission of diseases
through dirty needles. One hundred fifty seven (44.6%) of clients responded that they
prefer oral drugs to injection preparations, which was preferred by 136(38.6%), when
their children have fever. As opposed to the clients/patients, the majority (64.9%) of the
HCWs claim that clients prefer injections when they appear to the out patient
departments.
Conclusion and recommendations: The study revealed that many injection and related
medical practices were poor exposing clients/patients, health care workers and the
community at risk for blood born pathogens. On job training for health care workers, and
assessing reasons for the poor safety using assessment tool “A” was recommended.
Key words
Unsafe, Injection, medical, practice, health institution, blood born pathogens, health
worker, clients, patients, clients
Description
Keywords
Unsafe Injection, Health institution, Blood born pathogens, Health worker