Unsafe injection practice, a huge contributor to Hep B & C Spread

KARACHI- "Unsafe injections accounted for most of the infections rampant in our society. Unsafe injection practices put patients and healthcare providers at risk of infectious and non-infectious adverse events”, said Dr Nida Hussain, Pro-Chancellor of Ziauddin University. She also stressed upon the need to educate masses regarding the hazards of unsafe injections.

She was speaking on the seminar “Injection Safety” organized by Ziauddin University in collaboration with Pakistan Society for the Study of Liver Disease (PSSLD).

President, PSSLD, Prof Dr Masood Siddiq underscored the magnitude of this problem in Pakistan. He said that in Pakistan, an average person receives 8-13 injections per year, of which more than 90% are avoidable and remain non-essential. Unnecessary injections and IV drips prepared in unhygienic condition are becoming the major cause of spread of Hepatitis B, Hepatitis C and HIV.

“It was reported that 59% of syringes were dumped into the general waste and not properly disposed in the healthcare waste. Scavengers seeking valuable things from the waste are at high risk of receiving needle stick injuries from contaminated needles”, Dr Masood exclaimed.

Vice President PSSLD, Prof Zaigham Abbas, Head of Gastroenterology Department, Ziauddin University discussed injection safety and safe practices for giving injections, drawing blood and doing lancet procedures. He stressed on the need for procedures that should not harm the recipients, nor should result in exposure to any avoidable risk. Avoiding waste production that could be of peril to other people should become a priority.

“The same syringes should not be used on more than one patient even if the needle is changed. Multi-dose vials should be avoided when possible”, he further added.

“In Pakistan, more than 90% injections are given with syringes used on more than one patient. Pakistanis receive the highest number of injections per person, per year in the world i.e. between 8.2 - 8.5 injections, because of which in Eastern Mediterranean Region, within Pakistan almost 12 million people are suffering from Hepatitis B or C. Each year brings about 150,000 new cases”, said Dr Minhaj Qidwai, CEO Sindh Health Care Commission.

Dr Qidwai disclosed that during the inspections by Sindh Health Care Commission of different hospitals, clinics, laboratories & diagnostic centres, a lot of shocking irregularities were found, including expired medicines and supplies in pharmacies, poor infection control and waste management, lack of awareness about quality and standards as well as lack of trained professionals.

Founding-President PSSLD and Associate Dean, Aga Khan University Hospital, Prof. Wasim Jafri, whilst sharing WHO’s guidelines about injection safety said that safe injection practices were part of standard precautions aimed at basic level for patient safety and provider protection as defined by the World Health Organization. A safe injection does not harm the recipient and does not expose the provider to any avoidable risk.

According to speakers at the seminar, in public sector settings, 93% injections have been found to be used unnecessarily whereas, 75-94% injection equipment was reused.

There is a huge burden of reuse and sharing of syringes across the country. We need to create awareness among healthcare workers and the community. It will lead to significant reduction in the burden of needle transmitted viral diseases.

The seminar was chaired by Prof Shahab Abid, Chief Gastroenterology, Aga Khan University; Prof Dr Rukhsana Sattar, Fazaia Ruth Pfau Medical College; and Prof Uzma Ghori, Associate Dean Ziauddin University.