The injection century: massive unsterile injections and the emergence of human pathogens

Drucker, Ernest; Alcabes, Phillip G.; Marx, Preston A.

doi:10.1016/s0140-6736(01)06967-7

Cited by 202 publications

(133 citation statements)

References 12 publications

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“…In the same time period, there was rapid growth in the use of hypodermic needles and syringes initially for subcutaneous, and subsequently intravenous, administration of medications. There was a dramatic fall in prices for these devices between 1920 and 1950 [42]. In addition, there had been a preceding rise in the routine administration of opium and morphine by physicians, which is cited as the leading cause of opiate dependency at that time [43].…”

Section: Discussionmentioning

confidence: 99%

Historical Trends in the Hepatitis C Virus Epidemics in North America and Australia

Rodrigo¹,

Eltahla²,

Bull³

et al. 2016

J Infect Dis.

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Background. Bayesian evolutionary analysis (coalescent analysis) based on genetic sequences has been used to describe the origins and spread of rapidly mutating RNA viruses, such as influenza, Ebola, human immunodeficiency virus (HIV), and hepatitis C virus (HCV).Methods. Full-length subtype 1a and 3a sequences from early HCV infections from the International Collaborative of Incident HIV and Hepatitis C in Injecting Cohorts (InC3), as well as from public databases from a time window of 1977-2012, were used in a coalescent analysis with BEAST software to estimate the origin and progression of the HCV epidemics in Australia and North America. Convergent temporal trends were sought via independent epidemiological modeling.Results. The epidemic of subtype 3a had more recent origins (around 1950) than subtype 1a (around 1920) in both continents. In both modeling approaches and in both continents, the epidemics underwent exponential growth between 1955 and 1975, which then stabilized in the late 20th century.Conclusions. Historical events that fuelled the emergence and spread of injecting drug use, such as the advent of intravenous medical therapies and devices, and growth in the heroin trade, as well as population mixing during armed conflicts, were likely drivers for the cross-continental spread of the HCV epidemics.

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Section: Discussionmentioning

confidence: 99%

Historical Trends in the Hepatitis C Virus Epidemics in North America and Australia

Rodrigo¹,

Eltahla²,

Bull³

et al. 2016

J Infect Dis.

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“…Starting in the 1950s Africans experienced a massive increase in medical injections associated with mass injection campaigns targeted at yaws, with introduction and spread of parenteral therapies to treat other diseases, and with plummeting prices for antibodies and injection equipment 99 . For example, UNICEF administered 12 million injections 99 .…”

Section: Epidemic Of Unsafe Injections In Much Of Africa and South Asiamentioning

confidence: 99%

“…For example, UNICEF administered 12 million injections 99 . From the 1950s into the 1980s, unsafe injections may have contributed to the silent spread of HIV in Africa in much the same way that unsafe injections for schistosomiasis and other treatments in Egypt established hepatitis C as a major blood-borne pathogen, infecting about 15% to 20% of the general population at the end of the 1990s 100 .…”

Section: Epidemic Of Unsafe Injections In Much Of Africa and South Asiamentioning

confidence: 99%

HIV infections in sub-Saharan Africa not explained by sexual or vertical transmission

et al. 2002

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An expanding body of evidence challenges the conventional hypothesis that sexual transmission is responsible for more than 90% of adult HIV infections in Africa. Differences in epidemic trajectories across Africa do not correspond to differences in sexual behaviour. Studies among African couples find low rates of heterosexual transmission, as in developed countries. Many studies report HIV infections in African adults with no sexual exposure to HIV and in children with HIV-negative mothers. Unexplained high rates of HIV incidence have been observed in African women during antenatal and postpartum periods. Many studies show 20%–40% of HIV infections in African adults associated with injections (though direction of causation is unknown). These and other findings that challenge the conventional hypothesis point to the possibility that HIV transmission through unsafe medical care may be an important factor in Africa's HIV epidemic. More research is warranted to clarify risks for HIV transmission through health care.

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“…8,9 Furthermore, it has been proposed that the introduction of plastic disposable syringes played a major role in altering the ecological balance of routes for blood-borne pathogens in low-and middle-income countries. 10 Plastic disposable syringes meant for one use are reused without proper sterilization only in high-deprivation settings such as Africa and Latin America. Use of glass syringes, which may be adequate for proper resterilization, has been proposed as a way for preventing nosocomial HIV transmission and other blood-borne pathogens 11 in middle-and low-income countries.…”

Section: Discussionmentioning

confidence: 99%

Contact with hospital syringes containing body fluids: implications for medical waste management regulation

Volkow¹,

Jacquemin²,

Vilar‐Compte³

et al. 2003

Salud pública Méx

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Se hizo una encuesta del uso de jeringas en un hospital de tercer nivel de atención durante toda una semana. Se clasificaron, de acuerdo con el uso que se les dio, en cuatro categorías: a) aspiración de sangre, b) otros fluidos corporales (orina, secreción gástrica, líquido cefalorraquídeo, drenaje de herida, etcétera), c) uso exclusivo para diluir medicamentos y administrarlos a través de tubos de terapia intravenosa, d) para aplicación de inyecciones intramusculares (IM), subcutáneas (SC) o intradérmicas (ID).Resultados. Se utilizó un total de 7 157 jeringas plásticas desechables, 1 227 (17%) de las cuales contuvieron sangre durante su uso, 346 (4.8%) otros líquidos corporales, 5 257 (73%) se usaron exclusivamente para diluir medicamentos y administrarlos mediante tubos de terapia intravenosa, y 327 (4.5%) se usaron para inyecciones IM, SC o ID. El consumo anual de jeringas estimado fue de 369 140, o sea ocho jeringas por paciente por día de hospitalización. Todas las jeringas fueron desechadas como residuo peligroso bioló-gico infeccioso (RPBI) de acuerdo con la Norma -087 Ecol 1995. Conclusiones. Existe una necesidad urgente de revisar las recomendaciones para el manejo de la basura mé-dica regulada, tanto por agencias internacionales como por los gobiernos locales, que deberán basarse en información científica y en un análisis de costo beneficio para evitar el dispendio de recursos y un mayor daño al medio ambiente. El texto completo en inglés de este artículo también está disponible en:

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The injection century: massive unsterile injections and the emergence of human pathogens

Cited by 202 publications

References 12 publications

Historical Trends in the Hepatitis C Virus Epidemics in North America and Australia

Historical Trends in the Hepatitis C Virus Epidemics in North America and Australia

HIV infections in sub-Saharan Africa not explained by sexual or vertical transmission

Contact with hospital syringes containing body fluids: implications for medical waste management regulation

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