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SIGNpost 00829

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST

Post00829 Extract + HCV Egypt? + Abstracts + News      18 November 2015

CONTENTS
1. World Antibiotic Awareness Week + Extract
2. Abstract: Feasible HCV targets in Egypt
3. Abstract: Relationship between patient safety climate and standard
precaution adherence: a systematic review of the literature
4. Abstract: Intraoperative Corticosteroid Injection at the Time of Knee
Arthroscopy Is Associated With Increased Postoperative Infection Rates
in a Large Medicare Population
5. Abstract: AMSSM Scientific Statement Concerning Viscosupplementation
Injections for Knee Osteoarthritis: Importance for Individual Patient
Outcomes
6. Abstract:Hospital management training for the Eastern Mediterranean
Region: time for a change?
7. Abstract: Needle Fixation Profile: An Exploratory Assessment of
Applicability in the Australian Context
8. Abstract: Technosphere Insulin: Inhaled Prandial Insulin
9. Abstract: Face Shields For Infection Control: A Review
10. No Abstract: Curbing hepatitis C virus spread in Egypt [Free Text]
11. News
– West Virginia USA: Some Communities Seeing Growing Issue Of Dirty
Needles Littering Public Places
– UK: U.K. Nurse Who Had Ebola Relapse Now Free of Virus
– Global: Analysis Shows Hepatitis C Infection Rate is Higher for
Healthcare Workers

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1. World Antibiotic Awareness Week + Extract

The first World Antibiotic Awareness Week 16 to 22 November 2015 aims to
encourage best practices to avoid the further emergence and spread of
antibiotic resistance.
__________________________________________________________________

http://who.int/mediacentre/events/2015/world-antibiotic-awareness-week/en/
World Antibiotic Awareness Week

WHO survey reveals widespread misunderstanding about antibiotic resistance

16 November 2015 — Antibiotic resistance compromises the treatment of
infectious diseases and undermining advances in health and medicine.
Antibiotic resistance occurs naturally, but misuse of antibiotics in
humans and animals is accelerating the process. A new survey, released
today, coincides with the launch of World Antibiotics Awareness Week — a
global initiative to improve understanding of the problem and change the
way antibiotics are used.

Read the press release
http://who.int/mediacentre/news/releases/2015/antibiotic-resistance/en/

Read the fact sheet
http://who.int/mediacentre/factsheets/antibiotic-resistance/en/
__________________________________________________________________

Extract Extract Extract Extract Extract Extract

WHO News release
WHO multi-country survey reveals widespread public misunderstanding about
antibiotic resistance

16 November 2015 ¦ GENEVA – As WHO ramps up its fight against antibiotic
resistance, a new multi-country survey shows people are confused about
this major threat to public health and do not understand how to prevent it
from growing.

Antibiotic resistance happens when bacteria change and become resistant to
the antibiotics used to treat the infections they cause. Over-use and
misuse of antibiotics increase the development of resistant bacteria, and
this survey points out some of the practices, gaps in understanding and
misconceptions which contribute to this phenomenon.

Almost two thirds (64%) of some 10 000 people who were surveyed across 12
countries say they know antibiotic resistance is an issue that could
affect them and their families, but how it affects them and what they can
do to address it are not well understood. For example, 64% of respondents
believe antibiotics can be used to treat colds and flu, despite the fact
that antibiotics have no impact on viruses. Close to one third (32%) of
people surveyed believe they should stop taking antibiotics when they feel
better, rather than completing the prescribed course of treatment.

“The rise of antibiotic resistance is a global health crisis, and
governments now recognize it as one of the greatest challenges for public
health today. It is reaching dangerously high levels in all parts of the
world,” says Dr Margaret Chan, WHO Director-General, in launching the
survey findings today. “Antibiotic resistance is compromising our ability
to treat infectious diseases and undermining many advances in medicine.”

The survey findings coincide with the launch of a new WHO campaign
‘Antibiotics: Handle with care’—a global initiative to improve
understanding of the problem and change the way antibiotics are used.

“The findings of this survey point to the urgent need to improve
understanding around antibiotic resistance,” says Dr Keiji Fukuda, Special
Representative of the Director-General for Antimicrobial Resistance. “This
campaign is just one of the ways we are working with governments, health
authorities and other partners to reduce antibiotic resistance. One of the
biggest health challenges of the 21st century will require global
behaviour change by individuals and societies.”

The multi-country survey included 14 questions on the use of antibiotics,
knowledge of antibiotics and of antibiotic resistance, and used a mix of
online and face-to-face interviews. It was conducted in 12 countries:
Barbados, China, Egypt, India, Indonesia, Mexico, Nigeria, Russian
Federation, Serbia, South Africa, Sudan and Viet Nam. While not claiming
to be exhaustive, this and other surveys will help WHO and partners to
determine the key gaps in public understanding of the problem and
misconceptions about how to use antibiotics to be addressed through the
campaign.

….. Continues at the link
http://who.int/mediacentre/news/releases/2015/antibiotic-resistance/en/
__________________________________________________________________
________________________________*_________________________________

2. Abstract: Feasible HCV targets in Egypt
__________________________________________________________________

http://dx.doi.org/10.1016/S2214-109X(14)70323-7 Open Access

Lancet Glob Health. 2014 Dec;2(12):e687.
Feasible HCV targets in Egypt.

Jansson J1, Wilson DP2.

1The Kirby Institute, University of New South Wales, Sydney, NSW 2052,
Australia.
2The Kirby Institute, University of New South Wales, Sydney, NSW 2052,
Australia. Electronic address: dwilson@unsw.edu.au.

Romulus Breban and colleagues (September issue) present modelling results
of hepatitis C virus (HCV) interventions in Egypt.1 They suggest focusing
interventions on people who regularly receive medical injections to
achieve the greatest epidemiological effect on HCV transmission.

However, we believe that universal treatment at 2·5 or even 15 years after
infection (as presented in figure 5)1 is highly ambitious, as it would
necessitate immediate identification and treatment of most of the people
living with hepatitis C in Egypt.

Comment on http://dx.doi.org/10.1016/S2214-109X(14)70188-3 Open Access

Effect of preventive and curative interventions on hepatitis C virus
transmission in Egypt (ANRS 1211): a modelling study. [Lancet Glob Health.
2014]

Free full text http://dx.doi.org/10.1016/S2214-109X(14)70323-7
__________________________________________________________________
________________________________*_________________________________

3. Abstract: Relationship between patient safety climate and standard
precaution adherence: a systematic review of the literature
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/26549480

J Hosp Infect. 2015 Sep 25. pii: S0195-6701(15)00348-5.
Relationship between patient safety climate and standard precaution
adherence: a systematic review of the literature.

Hessels AJ1, Larson EL2.

1School of Nursing, Columbia University, New York, NY, USA. Electronic
address: ah3269@cumc.columbia.edu.
2School of Nursing, Columbia University, New York, NY, USA.

Standard precaution (SP) adherence is universally suboptimal, despite
being a core component of healthcare-associated infection (HCAI)
prevention and healthcare worker (HCW) safety.

Emerging evidence suggests that patient safety climate (PSC) factors may
improve HCW behaviours. Our aim was to examine the relationship between
PSC and SP adherence by HCWs in acute care hospitals.

A systematic review was conducted as guided by the Preferred Reporting
Items for Systematic Reviews and Meta-Analysis.

Three electronic databases were comprehensively searched for literature
published or available in English between 2000 and 2014. Seven of 888
articles identified were eligible for final inclusion in the review. Two
reviewers independently assessed study quality using a validated quality
tool.

The seven articles were assigned quality scores ranging from 7 to 10 of 10
possible points.

Five measured all aspects of SP and two solely measured needlestick and
sharps handling.

Three included a secondary outcome of HCW exposure; none included HCAIs.

All reported a statistically significant relationship between better PSC
and greater SP adherence and used data from self-report surveys including
validated PSC measures or measures of management support and leadership.

Although limited in number, studies were of high quality and confirmed
that PSC and SP adherence were correlated, suggesting that efforts to
improve PSC may enhance adherence to a core component of HCAI prevention
and HCW safety.

More clearly evident is the need for additional high-quality research.

Copyright © 2015 The Healthcare Infection Society. Published by Elsevier
Ltd. All rights reserved.

KEYWORDS: Healthcare-associated infection; Infection prevention; Safety
climate; Standard precautions
__________________________________________________________________
________________________________*_________________________________

4. Abstract: Intraoperative Corticosteroid Injection at the Time of Knee
Arthroscopy Is Associated With Increased Postoperative Infection Rates
in a Large Medicare Population
__________________________________________________________________
Arthroscopy. 2015 Nov 6. pii: S0749-8063(15)00777-X.

Intraoperative Corticosteroid Injection at the Time of Knee Arthroscopy Is
Associated With Increased Postoperative Infection Rates in a Large
Medicare Population.

Cancienne JM1, Gwathmey FW1, Werner BC2.

1Department of Orthopaedic Surgery, University of Virginia Health System,
Charlottesville, Virginia, U.S.A.
2Department of Orthopaedic Surgery, University of Virginia Health System,
Charlottesville, Virginia, U.S.A.. Electronic address: bcw4x@virginia.edu.

PURPOSE: To employ a national database of Medicare patients to evaluate
the association of ipsilateral intra-articular knee corticosteroid
injections at the time of knee arthroscopy with the incidence of
postoperative infection.

METHODS: A national Medicare insurance database was queried for patients
who underwent ipsilateral intra-articular corticosteroid injection of the
knee at the time of knee arthroscopy from 2005 to 2012. Patients who
underwent arthroscopically assisted open procedures, those who underwent
more complex arthroscopic procedures, and those for whom laterality were
not coded were excluded. This study group was compared to a control cohort
of patients without intraoperative steroid injections that was matched to
the study group for age, gender, obesity, diabetes mellitus, and smoking
status. Infection rates within 3 and 6 months postoperatively were
assessed using International Classification of Diseases, 9th Revision, and
Current Procedural Terminology codes.

RESULTS: The incidence of postoperative infection rates after knee
arthroscopy was significantly higher at 3 months (0.66%; odds ratio [OR],
2.6; P < .0001) and 6 months (1.92%; OR, 3.6; P < .0001) in patients who
underwent ipsilateral intra-articular knee steroid injection at the time
of knee arthroscopy (n = 2,866) compared with matched controls without
intraoperative injections (n = 170,350) at 3 months (0.25%) and 6 months
(0.54%).

CONCLUSIONS: The present study demonstrates a significant increase in
postoperative infection in Medicare patients who underwent ipsilateral
intra-articular knee corticosteroid injections at the time of knee
arthroscopy compared with a matched control group without intraoperative
injection.

LEVEL OF EVIDENCE: Therapeutic Level III, retrospective comparative study.

Copyright © 2015 Arthroscopy Association of North America. Published by
Elsevier Inc. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

5. Abstract: AMSSM Scientific Statement Concerning Viscosupplementation
Injections for Knee Osteoarthritis: Importance for Individual Patient
Outcomes
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/26562453

Clin J Sport Med. 2015 Nov 9.
AMSSM Scientific Statement Concerning Viscosupplementation Injections for
Knee Osteoarthritis: Importance for Individual Patient Outcomes.

Trojian TH1, Concoff AL, Joy SM, Hatzenbuehler JR, Saulsberry WJ, Coleman
CI.

1*Division of Sports Medicine, Department of Family, Community and
Preventive Medicine, Drexel University College of Medicine, Philadelphia,
Pennsylvania; †Outpatient Musculoskeletal Rehabilitation, St Jude Medical
Center, Fullerton, California; ‡Department of Orthopaedic Surgery,
Cleveland Clinic, Cleveland, Ohio; §Maine Medical Center Sports Medicine,
Portland, Maine; ¶Hartford Hospital Evidence-Based Practice Center, UCONN
School of Pharmacy; and ?Hartford Hospital Evidence-Based Practice Center,
Hartford, Connecticut.

OBJECTIVE: Osteoarthritis (OA) is a disabling disease that produces severe
morbidity reducing physical activity. Our position statement on treatment
of knee OA with viscosupplementation injection [hyaluronic acid (HA)]
versus steroid [intra-articular corticosteroid (IAS)] and placebo [intra-
articular placebo (IAP)] is based on the evaluation of treatment effect by
examining the number of subjects within a treatment arm that met the
Outcome Measures in Rheumatoid Arthritis Clinical Trials-Osteoarthritis
Research Society International (OMERACT-OARSI) criteria, which is
different and more relevant than methods used in other reviews which
examined if the average change across the treatment groups was clinically
different.

DATA SOURCES: We performed a systematic literature search for all relevant
articles from 1960 to August 2014 in the MEDLINE, EMBASE, and Cochrane
CENTRAL. We performed a network meta-analysis (NMA) of the relevant
literature to determine if there is a benefit from HA as compared with IAS
and IAP.

MAIN RESULTS: Eleven articles met the inclusion criteria from the search
strategy. On NMA, those subjects receiving HA were 15% and 11% more likely
to respond to treatment by the OMERACT-OARSI criteria than those receiving
IAS or IAP, respectively (P < 0.05 for both).

CONCLUSIONS: In light of the aforementioned results of our NMA, the
American Medical Society for Sport Medicine recommends the use of HA for
the appropriate patients with knee OA.
__________________________________________________________________
________________________________*_________________________________

6. Abstract:Hospital management training for the Eastern Mediterranean
Region: time for a change?
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/26556162
J Health Organ Manag. 2015 Nov 16;29(7):965-72.

Hospital management training for the Eastern Mediterranean Region: time
for a change?

Rabbani F1, Hashmani FN, Mukhi AA, Gul X, Pradhan N, Hatcher P, Farag M,
Abbas F.

1Department of Community Health Sciences, Aga Khan University, Karachi,
Pakistan.

Purpose – The WHO Eastern Mediterranean Regional Office has emphasized
health system strengthening among the top five strategic priorities. One
of the integral elements of health systems are the hospitals. The purpose
of this paper is to review the need for formalized training in hospital
management to improve the quality of care.

Design/methodology/approach – Literature review and hands on experience of
conducting a regional training in hospital management for Eastern
Mediterranean Region (EMR) countries.

Findings – Majority of patients in EMR bypass Primary Health Care
facilities due to inadequate quality of services and prefer seeking
specialized care at a tertiary level.

There is mounting evidence of mediocre to poor patient satisfaction due to
inefficient health care practices in hospitals of EMR. Strengthening the
management capacity of the hospitals through a formal training programme
is therefore necessary for improving the performance of health care
delivery and the overall health system.

Hospital management encompasses hospital planning and operational
activities including development and implementation of organizational
strategies to ensure adequate numbers and quality of trained human
resources and effective financial management, disaster management, health
management information system utilization, support services, biomedical
engineering, transport and waste management.

Such training will prepare health care professionals with leadership
skills to deliver quality hospital services.

Originality/value – This is one of the first papers emphasizing the need
for a formal structured regional training in hospital management for the
countries of EMR. A modular incremental training approach developing an
EMR Credit Transfer and Accumulation system is proposed.

KEYWORDS: EMR countries; Formalized training; Health systems; Hospital
management; Hospital managers; WHO
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Needle Fixation Profile: An Exploratory Assessment of
Applicability in the Australian Context
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/26549690

Subst Use Misuse. 2015 Nov 7:1-4.
Needle Fixation Profile: An Exploratory Assessment of Applicability in the
Australian Context.

Hinton S1, Signal T2, Ghea V3.

1a Central Queensland Mental Health , Alcohol and Other Drugs Division,
Queensland Government , Rockhampton , Queensland , Australia.
2b School of Human Health and Social Sciences , CQUniversity , North
Rockhampton , Queensland , Australia.
3c Rockhampton Psychology Services , Rockhampton , Queensland , Australia.

BACKGROUND: Needle fixation has the potential to undermine harm-reduction
efforts and may affect up to one-quarter of all injecting drug users
(IDUs). Being largely ignored in the extant literature, the majority of
research on this phenomenon has been carried out exclusively in Cardiff,
Wales.

OBJECTIVES: The current exploratory study examined the applicability of
needle fixation in a population of Australian IDUs to determine whether
Australian IDUs were familiar with the behaviors and secondary gains that
have been found to be associated with needle fixation and are assessed by
the needle fixation profile (NEFPRO).

METHODS: A mixed-method design utilizing semi-structured interviews and
questionnaire data was employed.

RESULTS: Australian IDUs were aware of or had experience with the
behaviors and secondary gains that have been found to be associated with
needle fixation. A number of other behaviors and secondary gains
associated with injecting were discussed by participants during the semi-
structured interviews.

Conclusions/Importance: This study offers preliminary support for the use
of NEFPRO as a clinical and research tool within Australia. To ensure that
all avenues toward harm reduction are being explored, it would be fruitful
to engage in further research concerning the cross-cultural
representations of needle fixation specifically as well as the general
influence of needle fixation in perpetuating injecting drug use.

KEYWORDS: addiction; behavioral addiction; blood-borne virus; clinical
screening tool; harm reduction; inject; injecting drug use; injection drug
use; needle fixation; substance use
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Technosphere Insulin: Inhaled Prandial Insulin
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/26567896

Expert Opin Biol Ther. 2015 Nov 15.
Technosphere Insulin: Inhaled Prandial Insulin.

Setji TL1, Hong BD1, Feinglos MN1.

1a Department of Medicine, Division of Endocrinology , Duke University
Medical Center , Durham , NC USA.

INTRODUCTION: Insulin therapy is a mainstay for treatment of diabetes
mellitus, however many barriers to insulin exist. Insulin human inhalation
powder (technosphere insulin) is a new FDA approved alternative to
subcutaneous bolus insulin.

Areas covered: This is an overview of technosphere insulin (TI).
Pharmacokinetics, clinical efficacy, safety and tolerability are
discussed. Expert Opinion: TI is more quickly absorbed than subcutaneous
insulin therapies and has a shorter duration of action. It appears to be
noninferior compared with subcutaneous insulin regimens, and is associated
with less hypoglycemia.

Thus, it may serve as an alternative insulin agent in patients reluctant
to administer multiple subcutaneous injections of insulin daily or in
patients who experience late postprandial hypoglycemia with subcutaneous
insulin.

Cough is the most common side effect, but tends to be mild and transient.
A small decrease in the forced expiratory volume has been demonstrated,
but does not appear to progress and is reversible. Patients should have
periodic pulmonary function tests.

TI is contraindicated in patients with chronic lung disease.

The long-term risk of lung cancer is being monitored but at this point
does not appear to be higher than the expected incidence of lung cancer in
this population.
__________________________________________________________________
________________________________*_________________________________

9. Abstract: Face Shields For Infection Control: A Review
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/26558413

J Occup Environ Hyg. 2015 Nov 11:1-28.
Face Shields For Infection Control: A Review.

Roberge RJ1.

1a National Personal Protective Technology Laboratory , National Institute
for Occupational Safety and Health, Centers for Disease Control and
Prevention , Pittsburgh , PA.

Face shields are personal protective equipment devices that are used by
many workers (e.g., medical, dental, veterinary) for protection of the
facial area and associated mucous membranes (eyes, nose, mouth) from
splashes, sprays and spatter of body fluids. Face shields are generally
not used alone, but in conjunction with other protective equipment and are
therefore classified as adjunctive personal protective equipment.

Although there are millions of potential users of face shields, guidelines
for their use vary between governmental agencies and professional
societies and little research is available regarding their efficacy.

KEYWORDS: face shields; guidance; infection control; proper use;
regulations
__________________________________________________________________
________________________________*_________________________________

10. No Abstract: Curbing hepatitis C virus spread in Egypt [Free Text]
__________________________________________________________________

Open access http://dx.doi.org/10.1016/S2214-109X(14)70292-X

Lancet Glob Health. 2014 Sep;2(9):e495-6.

Curbing hepatitis C virus spread in Egypt.

Negro F1.

1Divisions of Gastroenterology and Hepatology and of Clinical Pathology,
University Hospital of Geneva, 1211 Geneva 14, Switzerland. Electronic
address: francesco.negro@hcuge.ch.

Comment on

Effect of preventive and curative interventions on hepatitis C virus
transmission in Egypt (ANRS 1211): a modelling study. [Lancet Glob Health.
2014]

Free full text http://dx.doi.org/10.1016/S2214-109X(14)70292-X
__________________________________________________________________
________________________________*_________________________________

11. News

– West Virginia USA: Some Communities Seeing Growing Issue Of Dirty
Needles Littering Public Places
– UK: U.K. Nurse Who Had Ebola Relapse Now Free of Virus
– Global: Analysis Shows Hepatitis C Infection Rate is Higher for
Healthcare Workers

Selected news items reprinted under the fair use doctrine of international
copyright law: http://www4.law.cornell.edu/uscode/17/107.html
__________________________________________________________________

https://tinyurl.com/pgt96lf
West Virginia USA: Some Communities Seeing Growing Issue Of Dirty Needles
Littering Public Places

Taisha L. Walker, Jarrod Clay, WCHS-TV8 W. VA USA (13.11.15)

CROSS LANES, W.Va. – The state’s drug problem continues to trickle down
and indirectly affect everyone. Old, used heroin needles are now finding
their way onto the streets and could pose as a health hazard.

People are spotting needles in plain sight in Kanawha County– in public
restrooms and feet away from a school bus stop– but it’s important that
people do not touch them because they can transfer hepatitis and even HIV.

Kerstein’s Heating and Air Conditioning sits off of Cross Lanes Drive.
General Manager Tim Simmons said along that busy street is where his
employees found old needles.

“When I went out, one of them had put on rubber gloves and picked up five
needles that had been used,” said Tim Simmons. “One of them even had
product in it. We just instructed them to put them in the dumpster.”

Another one of his employees spotted more needles a block away from the
shop. Simmons said it’s eye-opening. Children — including his– get
dropped off by the bus just feet away from where the needles were found.

“The kids get off the bus right in front of the shop every day. They stand
here for 20 to 30 minutes to get on the bus every day and to find those
needles laying where they’re at,” Simmons said.

Charleston’s Public Works director Gary Taylor is awaiting the arrival of
Sharps disposal boxes. The $300 boxes will go in each of the restrooms at
the Transit Mall. That’s where Taylor said used needles have been popping
up.

“We’re hoping that they’ll (heroin users) at least put the needle in there
and they’ll dispose of them.” he said. “And less chance of our people who
clean the restrooms get stuck with one.”

Taylor said refuse workers aren’t finding many on the streets of
Charleston. He also said workers aren’t checking checking underneath
bridges and behind vacant buildings.

Improperly disposed needles are also catching the attention of the
Kanawha-Charleston Health Department. Health officials are looking to
launch a needle exchange program similar to the one Cabell County is
using, in which people can swap their dirty needles for clean ones.

“People think that’s counter intuitive but what that does is keep people
from getting Hepatitis B, Hepatitis C and even HIV,” said John Law, the
public information officer for the Kanawha Charleston Health Department.

Law said if someone finds a needle on the street, the person should avoid
touching it, especially the needle stick. Instead, alert police and the
health department, which will find a trained professional to dispose of
the needles.

Kanawha County plans to launch its Harm Reduction program by mid-December.
As part of the program, health officers will hand out plastic containers
and teach people how to properly dispose of needles.
__________________________________________________________________
__________________________________________________________________

http://www.webmd.com/news/20151112/uk-nurse-ebola-free
UK: U.K. Nurse Who Had Ebola Relapse Now Free of Virus

WebMD News from HealthDay
Nov. 12, 2015 — A Scottish nurse who was hospitalized last month after
she suffered a relapse of Ebola is now free of the deadly virus and was
transferred from the Royal Free Hospital in London to Queen Elizabeth
University Hospital in Glasgow.

Pauline Cafferkey was diagnosed with Ebola after returning from Sierra
Leone. She was treated at the Royal Free Hospital and discharged in
January. However, she was readmitted to the hospital last month for
treatment of meningitis the developed due to lingering Ebola in her body,
the Associated Press reported.

She is in stable condition, according to Queen Elizabeth University
Hospital.

Ebola can remain in the body for months, even after patients have
recovered, experts say. In West Africa, thousands of Ebola survivors have
lingering health problems, the AP reported.

Copyright © 2013-2015 HealthDay. All rights reserved.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/ozyhjfr
Global: Analysis Shows Hepatitis C Infection Rate is Higher for Healthcare
Workers

Catherine Kolonko, MD Magazine (12.11.15)

Healthcare workers have a much higher prevalence of chronic hepatitis C
infection compared to the general population, according to a recently
published study.

Researchers looked systematically at data from 1989 to 2014 and conducted
a meta-analysis of 44 studies on hepatitis C in healthcare workers versus
a control group of the general population. Results were published in
October in the Online First section of Occupational & Environmental
Medicine.

The prevalence of infection among healthcare workers was found to be
significantly higher than in the general population, according to lead
author Claudia Westermann from the University Medical Center Hamburg-
Eppendorf, in Hamburg, Germany. The highest was among medical and
laboratory staff.

A pooled analysis of high and moderate quality observational studies
revealed a statistically significant increase in odds ratio of 1.6 for
hepatitis C virus infection among healthcare workers compared to
population-based controls, explained Westermann in an email. “This means
that according to our data, compared to the general population, healthcare
workers had 60 percent greater odds of getting hepatitis C,” she said.

One of the limitations of the analysis was that the population based
controls were mostly blood donors and it was unlikely that people in the
general population at risk for the virus were included, according to the
article. The studies also lacked consistent recording of personal risk
factors for hepatitis C infection.

The authors note that healthcare workers come into contact with body
fluids from infected patients and that the most frequently reported
occupational accidents are injuries from sharp or pointed objects. They
cite studies that indicate that about 80% of healthcare workers have been
affected by needle-stick injuries, many of which are not reported.

Contact with blood from being stuck by a needle continues to be a major
threat to healthcare workers. “Exposure to blood cannot completely be
avoided when using safe instruments/practices, but they can minimize
occupational exposure,” Westermann added.

Hepatitis C is a bloodborne virus, which the authors note is mainly
transmitted by contact with infected blood due to injuries to the skin or
mucous membranes. Public health officials estimate that 150 million people
across the globe have chronic infection of the virus, which if left
unchecked can seriously damage the liver over time.

Because acute infection of the virus is often asymptomatic, the disease is
frequently overlooked in its early stages of infection. However, the long-
term impact of the virus is significant and is the cause of an estimated
350,000 deaths worldwide each year, note the authors.

“Targeted prevention measures must be based on the epidemiological
detection and evaluation of work-related accidents,” the authors state in
the article. “Readily accessible reporting and treatment procedures, and
the use of safe practices for working with blood, can help to minimize
occupational exposure.”

The authors conclude that future studies are needed to shed light on
specific activities of healthcare workers as well as their personal risk
factors that could relate to infection of the virus.
__________________________________________________________________
________________________________*_________________________________

New WHO Injection Safety Guidelines

WHO is urging countries to transition, by 2020, to the exclusive use of
the new “smart” syringes, except in a few circumstances in which a syringe
that blocks after a single use would interfere with the procedure.

The new guideline is:

WHO Guideline on the use of Safety-Engineered Syringes for Intramuscular,
Intradermal and Subcutaneous Injections in Health Care

It is available for free download or viewing at this link:
www.who.int/injection_safety/global-campaign/injection-safety_guidline.pdf

PDF Requires Adobe Acrobat Reader [620 KB]
__________________________________________________________________
________________________________*_________________________________
Making all injections safe brochure

This is an illustrated summary brochure for the general public.

pdf, 554kb [6 pages]

www.who.int/injection_safety/global-campaign/injection-safety_brochure.pdf
__________________________________________________________________
________________________________*_________________________________

SIGN Meeting 2015

The Safe Injection Global Network SIGN meeting was held on 23-24 February
2015 at WHO Headquarters in Geneva Switzerland

The main topic of the meeting was the new injection safety policy
recommendation and developing the appropriate strategies for
implementation in countries worldwide.

A report of the meeting will be posted ASAP
__________________________________________________________________
________________________________*_________________________________
* SAFETY OF INJECTIONS brief yourself at: www.injectionsafety.org

A fact sheet on injection safety is available at:
http://www.who.int/mediacentre/factsheets/fs231/en/index.html

* Visit the WHO injection safety website and the SIGN Alliance Secretariat
at: http://www.who.int/injection_safety/en/

* Download the WHO Best Practices for Injections and Related Procedures
Toolkit March 2010 [pdf 2.47Mb]:
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