To prevent HIV: injections use must ban at clinics

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By Dr.Abdul Razak Shaikh,

A province-wide operation against fake clinics and doctors’ of Larkana, Hyderabad, and Karachi along with other major cities of Sindh was launched by the Health Care Commission Sindh and 700 Quacks practice has been closed

Thousands of used syringes were taken under custody by health care officials from the clinics in Larkana.

Infectious diseases experts investigating an HIV outbreak in Ratodero- Larkana epidemic have suggested authorities to immediately impose a ban on the use of injections at the clinic run by General Practitioners (GPs) in the province after it was learned that the majority of the persons infected with HIV were children aging between 2-5 years, who neither contracted the disease from their mothers nor through blood transfusion.

During an interview with the newly infected HIV patients and their parents, it has emerged that reuse of syringes is the major cause of spreading the viral disease and have urged the health department to immediately impose a ban on the use of injections at clinics by general practitioners, an Infectious Diseases (ID) expert who has been tasked to investigate the recent outbreak in Ratodero area of Larkana.

At the moment, an investigation is underway but infectious diseases experts and epidemiologists are suggesting that reuse of syringes could be the main source of spreading HIV. In addition to banning use of injections other than major hospitals, we need to educate masses that they should not insist on having injections in case of minor illnesses.

It is also suggested for imposing a complete ban on the production of large injection vials by the pharmaceutical companies, saying Quacks and untrained Doctors use these large vials for extracting medicine for several patients and infect the medicine, which could also be a source of spreading HIV, Hepatitis and other infectious diseases to the patients.

At the start of every injection, blood is introduced into the needle and syringe. Therefore, a needle and syringe that an HIV-positive person has used can contain blood with the virus in it. Transmission occurs when another person then uses the same syringe without cleaning it. The reuse of a blood-contaminated needle or syringe by another person can be an effective means of transmission because a large quantity of blood can be injected directly into the bloodstream.

Although HIV does not generally survive well outside the body, it can survive for long periods of time (over 28 days) if hermetically sealed in the syringe.

There is a risk of HIV infection through intravenous injecting, subcutaneous injecting (injecting into the fat under the skin) and intramuscular injection. Some injecting drug users may believe, wrongly, that they are not at risk of HIV transmission if they simply avoid intravenous injecting.

But HIV infection will not automatically occur from a single incident of shared needle/syringe use. In fact, estimates of the infection risk from an injection range from 0.63 to 2.4%.

Two factors are likely to determine the chances of HIV infection from any single incident of shared needle/syringe use.

The level of HIV present in the blood injected. Very low levels of circulating virus in the blood may make HIV infection less likely. But assuming a fairly high viral load, it is thought that amounts of blood invisible to the naked eye may be sufficient to permit HIV infection.

The quantity of blood injected. Evidence from the follow-up of needlestick injuries and other occupational injuries involving blood shows that the likelihood of HIV infection is dose-related, the more blood injected, the more likely it is that seroconversion will take place.

But HIV infection from blood can occur in other ways as a result of injecting drug use.

Moreover, studies have shown that HIV can survive in syringes for up to six weeks, while hepatitis C can remain detectable for two months. The virus is more likely to survive when there are lower temperatures, greater volumes of blood and within larger syringes.

People use needles for many reasons to inject drugs for medical purposes (like insulin to treat diabetes), get high, change their appearance, or for tattoos and piercings. No matter the reason, never share your needles or works with anyone to lower your chances of getting or transmitting HIV and hepatitis B and C.

If you inject drugs to get high, therapy, medicines, and other methods are available to help you stop or cut down on your drug use. Talk with a counselor, doctor, or other health care provider about substance abuse treatment. Some treatment programs provide medicines such as methadone or buprenorphine to people on an outpatient basis to help them quit using drugs like heroin, OxyContin, Opine, or Violin.

Use only new sterile needles. Clean your skin with a new alcohol swab before you inject. If you inject around other people, be careful not to get someone else’s blood on your hands or your needle or works.

Dispose of needles safely after one use. Use a sharps container or make sure to keep used needles away from other people. Some communities may have drop boxes where you can dispose of your used needles safely.

we suggest that the complete ban at small clinics for use of Syringes and Quacks must be arrested in area and seal their clinics immediately.


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