India to use AD syringes to stem infection from reused needles

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India to use AD syringes to stem infection from reused needles

Dinesh C Sharma

The Lancet. Volume 4, Number 10 01 October 2004

The Indian health ministry has decided to introduce auto-disposable

(AD) syringes to all immunisation programmes, in a bid to improve

injection safety and prevent spread of infection through reused

syringes. AD syringes will replace the glass syringes being used in

immunisation programmes. The use of these syringes has been tested out

in a pilot scheme of hepatitis B vaccination at over 45 locations

across India. No date has been fixed for the switchover, but officials

said it might take place in a phased manner.

The decision follows reports of high infection threat from improper

sterilisation of glass syringes as well as reuse of plastic syringes.

A recent study commissioned by the health ministry found that an

estimated 8% of all plastic syringes used are gathered by rag pickers

and find their way back into the system. Almost one third of

injections given in government health centres carry a potential risk

of transmitting blood borne viruses like HIV and hepatitis B. Overall,

the study showed that about 68•8% of injections given through the

government health system and 59•9% of those given in the private

sector are unsafe. As high as 74% of injections in immunisation

clinics are unsafe. Safety was judged by criteria such as questionable

sterility, wrong administration, and reuse.

One of the factors contributing to the low rate of routine

immunisation is the use of glass syringes because it is usually

cumbersome for paramedical staff to sterilise these. " AD syringes will

reduce this work burden and translate into better immunisation

coverage. Another advantage would be interruption of reuse of syringes

and needles, and thus the transmission of avoidable infective diseases

like HIV and hepatitis B, " pointed out HPS Sachdev (Indian Academy of

Paediatrics, New Delhi, India).

But the introduction of AD syringes may not be easy. For immunisation

purposes alone, India needs over 210 million injections every year.

" Right now there is no plan for the disposal of these syringes. Going

by the current disposal practices, this huge amount of plastic will be

either incinerated or burnt in the open. In either case, it will be

dangerous for the environment and violate waste handling rules " ,

pointed out Ravi Agarwal (Toxics Link, New Delhi, India).

" Some cost effective, practical, and local solutions which can be

easily rooted in the system, need to be worked out " , said Prasanna

Hota (Family Welfare Secretary, Health Ministry, New Delhi, India), at

a meeting held to discuss the problem.

http://infection.thelancet.com/journal/vol4/iss10/full/laid.4.10.newsdesk.30767.\

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