Medical injection and access to sterile injection equipment in low- and middle-income countries: a meta-analysis of Demographic and Health Surveys (2010-2017).
Adolescent
Adult
Developing Countries
/ statistics & numerical data
Female
Humans
Injections
/ statistics & numerical data
Male
Middle Aged
Needles
/ standards
Poverty
/ statistics & numerical data
Safety Management
/ statistics & numerical data
Sterilization
/ statistics & numerical data
Young Adult
blood-borne infections
low- and middle-income countries
medical injection
sterile injection equipment
Journal
International health
ISSN: 1876-3405
Titre abrégé: Int Health
Pays: England
ID NLM: 101517095
Informations de publication
Date de publication:
01 09 2020
01 09 2020
Historique:
received:
23
04
2019
revised:
22
07
2019
accepted:
05
10
2019
pubmed:
19
12
2019
medline:
9
3
2021
entrez:
19
12
2019
Statut:
ppublish
Résumé
Unsafe injection practices contribute to increased risks of blood-borne infections, including human immunodeficiency virus, hepatitis B and hepatitis C viruses. The aim of this study was to estimate the prevalence of medical injections as well as assess the level of access to sterile injection equipment by demographic factors in low- and middle-income countries (LMICs). We carried out a meta-analysis of nationally representative Demographic and Health Surveys (DHSs) conducted between 2010 and 2017 in 39 LMICs. Random effects meta-analysis was used in estimating pooled and disaggregated prevalence. All analyses were conducted using Stata version 14 and Microsoft Excel 2016. The pooled 12-month prevalence estimate of medical injection was 32.4% (95% confidence interval 29.3-35.6). Pakistan, Rwanda and Myanmar had the highest prevalence of medical injection: 59.1%, 56.4% and 53.0%, respectively. Regionally, the prevalence of medical injection ranged from 13.5% in west Asia to 42.7% in south and southeast Asia. The pooled prevalence of access to sterile injection equipment was 96.5%, with Pakistan, Comoros and Afghanistan having comparatively less prevalence: 86.0%, 90.3% and 90.9%, respectively. Overuse of medical injection and potentially unsafe injection practices remain a considerable challenge in LMICs. To stem the tides of these challenges, national governments of LMICs need to initiate appropriate interventions, including education of stakeholders, and equity in access to quality healthcare services.
Sections du résumé
BACKGROUND
Unsafe injection practices contribute to increased risks of blood-borne infections, including human immunodeficiency virus, hepatitis B and hepatitis C viruses. The aim of this study was to estimate the prevalence of medical injections as well as assess the level of access to sterile injection equipment by demographic factors in low- and middle-income countries (LMICs).
METHODS
We carried out a meta-analysis of nationally representative Demographic and Health Surveys (DHSs) conducted between 2010 and 2017 in 39 LMICs. Random effects meta-analysis was used in estimating pooled and disaggregated prevalence. All analyses were conducted using Stata version 14 and Microsoft Excel 2016.
RESULTS
The pooled 12-month prevalence estimate of medical injection was 32.4% (95% confidence interval 29.3-35.6). Pakistan, Rwanda and Myanmar had the highest prevalence of medical injection: 59.1%, 56.4% and 53.0%, respectively. Regionally, the prevalence of medical injection ranged from 13.5% in west Asia to 42.7% in south and southeast Asia. The pooled prevalence of access to sterile injection equipment was 96.5%, with Pakistan, Comoros and Afghanistan having comparatively less prevalence: 86.0%, 90.3% and 90.9%, respectively.
CONCLUSIONS
Overuse of medical injection and potentially unsafe injection practices remain a considerable challenge in LMICs. To stem the tides of these challenges, national governments of LMICs need to initiate appropriate interventions, including education of stakeholders, and equity in access to quality healthcare services.
Identifiants
pubmed: 31851322
pii: 5680313
doi: 10.1093/inthealth/ihz113
pmc: PMC7443715
doi:
Types de publication
Journal Article
Meta-Analysis
Langues
eng
Sous-ensembles de citation
IM
Pagination
388-394Informations de copyright
© The Author(s) 2019. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.
Références
Ann Med Health Sci Res. 2013 Apr;3(2):177-81
pubmed: 23919185
J Epidemiol Community Health. 2016 Dec;70(12):1151-1154
pubmed: 27343304
Int J Equity Health. 2016 Jul 22;15(1):116
pubmed: 27449349
J Public Health (Oxf). 2017 Dec 1;39(4):653-660
pubmed: 28069990
J Public Health (Oxf). 2011 Dec;33(4):565-70
pubmed: 21345884
Bull World Health Organ. 2017 Dec 1;95(12):831-841F
pubmed: 29200524
Int J Epidemiol. 2018 Dec 1;47(6):1972-1980
pubmed: 30272173
J Coll Physicians Surg Pak. 2006 Sep;16(9):622-4
pubmed: 16945242
Health Promot Int. 2004 Mar;19(1):95-103
pubmed: 14976177
Int J STD AIDS. 2004 Jan;15(1):7-16
pubmed: 14769164
PLoS Med. 2009 Jul 21;6(7):e1000100
pubmed: 19621070
Lancet. 2015 Dec 12;386(10011):2442-4
pubmed: 26364261
Lancet. 2008 Nov 15;372(9651):1733-45
pubmed: 18817968
Lancet Infect Dis. 2016 Dec;16(12):1385-1398
pubmed: 27665254
PLoS One. 2014 Jun 09;9(6):e99677
pubmed: 24911341
World J Gastroenterol. 2016 Jul 7;22(25):5837-52
pubmed: 27433097
PLoS One. 2014 Dec 11;9(12):e115109
pubmed: 25501652
PLoS One. 2015 Jul 08;10(7):e0127199
pubmed: 26154083
Int J Qual Health Care. 2005 Oct;17(5):401-8
pubmed: 15883127
Trop Med Int Health. 2013 Sep;18(9):1157-1159
pubmed: 23876226