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SIGNpost 00841

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST

Post00841 Cambodia + Abstracts + News 24 February 2016

CONTENTS
0. Moderators Note
1. Abstract: Cluster of HIV Infections Attributed to Unsafe Injection
Practices – Cambodia, December 1, 2014-February 28, 2015
2. Abstract: Safe Injection Practices in Primary Health Care Settings of
Naxalbari Block, Darjeeling District, West Bengal
3. Abstract: Influencing factors on use of standard precautions against
occupational exposures to blood and body fluids among nurses in China
4. Abstract: Should we continue to administer blind shoulder injections?
5. Abstract: Strengthening pharmaceutical systems for palliative care
services in resource limited settings: piloting a mHealth application
across a rural and urban setting in Uganda
6. Abstract: A needle in the haystack – the dire straits of needle
exchange in Hungary
7. Abstract: Zika without symptoms in returning travellers: What are the
implications?
8. Abstract: NICE says infection control should be the responsibility of
all staff
9. Abstract: Hand hygiene compliance in Penang, Malaysia: Human audits
versus product usage
10. News
– Angola: Health authorities warn of fake yellow fever vaccines
– India: Fast-acting anti-rabies drug set for India launch
– USA: Sharps Terminator, LLC Announces FDA Approval of Sharps Terminator®
Needle Disposal Device
– Cambodia Confronts HIV Epidemic
– Scotland UK: Dozens of former east Kent hospital patients contacted over
hepatitis C contamination fears
– Cambodia: Needle demand too high: report
– USA: Reacting to Colo. arrest, Scripps offers testing to 518
– Oregon USA: Syringe drop boxes get mixed reviews in Portland
– Cambodia: HIV cluster in Cambodia linked to unsafe medical injection
practices
– USA: US Disposable Syringe Market to Cross $ 18 Billion by 2021:
Pharmaion Consultants Report
– Cambodia: Cambodia HIV cluster highlights medical injection issues

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__________________________________________________________________
________________________________*_________________________________

0. Moderators Note
__________________________________________________________________
The word this week is Cambodia.

“Unlicensed doctor Yem Chroeum was sentenced to 25 years’ imprisonment in
December in connection with the Roka outbreak. ”

See below and below again …
__________________________________________________________________
________________________________*_________________________________

1. Abstract: Cluster of HIV Infections Attributed to Unsafe Injection
Practices – Cambodia, December 1, 2014-February 28, 2015
__________________________________________________________________

Free full text http://www.cdc.gov/mmwr/volumes/65/wr/mm6506a2.htm
Free full PDF http://www.cdc.gov/mmwr/volumes/65/wr/pdfs/mm6506a2.pdf

MMWR Morb Mortal Wkly Rep. 2016 Feb 19;65(6):142-5.
Cluster of HIV Infections Attributed to Unsafe Injection Practices –
Cambodia, December 1, 2014-February 28, 2015.

Vun MC, Galang RR, Fujita M, Killam W, Gokhale R, Pitman J, Selenic D, Mam
S, Mom C, Fontenille D, Rouet F, Vonthanak S; Roka Cluster Investigation
Team.

In December 2014, local health authorities in Battambang province in
northwest Cambodia reported 30 cases of human immunodeficiency virus (HIV)
infection in a rural commune (district subdivision) where only four cases
had been reported during the preceding year. The majority of cases
occurred in residents of Roka commune.

The Cambodian National Center for HIV/AIDS (acquired immunodeficiency
syndrome), Dermatology and Sexually Transmitted Diseases (NCHADS)
investigated the outbreak in collaboration with the University of Health
Sciences in Phnom Penh and members of the Roka Cluster Investigation Team.

By February 28, 2015, NCHADS had confirmed 242 cases of HIV infection
among the 8,893 commune residents, an infection rate of 2.7%. Molecular
investigation of the HIV strains present in this outbreak indicated that
the majority of cases were linked to a single HIV strain that spread
quickly within this community.

An NCHADS case-control study identified medical injections and infusions
as the most likely modes of transmission.

In response to this outbreak, the Government of Cambodia has taken
measures to encourage safe injection practices by licensed medical
professionals, ban unlicensed medical practitioners, increase local
capacity for HIV testing and counseling, and expand access to HIV
treatment in Battambang province.

Measures to reduce the demand for unnecessary medical injections and the
provision of unsafe injections are needed.

Estimates of national HIV incidence and prevalence might need to be
adjusted to account for unsafe injection as a risk exposure.

Free full text http://www.cdc.gov/mmwr/volumes/65/wr/mm6506a2.htm Free
full PDF http://www.cdc.gov/mmwr/volumes/65/wr/pdfs/mm6506a2.pdf
__________________________________________________________________
________________________________*_________________________________

2. Abstract: Safe Injection Practices in Primary Health Care Settings of
Naxalbari Block, Darjeeling District, West Bengal
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26894097

J Clin Diagn Res. 2016 Jan;10(1):LC21-4.
Safe Injection Practices in Primary Health Care Settings of Naxalbari
Block, Darjeeling District, West Bengal.

Chaudhuri SB1, Ray K2.

1Post Graduate Student, Department of Community Medicine, North Bengal
Medical College , Darjeeling, West Bengal, India .
2Assistant Professor, Department of Community Medicine, College of
Medicine & Sagar Datta Hospital , Kamarhati, N-24 Parganas, West Bengal,
India.

INTRODUCTION: Unsafe injection can transmit many diseases to patients,
injection providers and healthy people of community.

AIM: To find out critical steps whether executed according to recommended
best practice methods, availability of equipments in health facilities for
safe injection practices and some important steps of waste disposal
methods.

MATERIALS AND METHODS: This facility-based cross-sectional observational
study was conducted among 30 Auxiliary nurse midwives (ANM) & 27 nursing
staffs (NS) to assess certain aspects of their practice while
administrating injection and disposal of the disposables. Health
facilities were also observed to asses necessary equipments of safe
injection and waste disposal methods.

RESULTS: Among the health workers 93.3% ANM and 100% NS took sterile
syringe from sterile unopened packet, all of the study subjects washed
hand before giving injection, 13.3% of ANMs and 8% of NS are fully
vaccinated against Hep B, 53.3% of ANM and all NS are practices non
recapping. Only 13.33% sub centres along with PHC & BPHC had at least one
puncture resistant leak proof container, 86.7% sub centres, PHC are free
from loose needles. Transport for off side treatment is the method of
waste disposal in case of 73.3% cases sub centres, PHC & BPHC.

CONCLUSION: There is need to educate, train and motivate service providers
in proper methods of giving injection along with improve the adequacy of
supply of required equipments.

KEYWORDS: ANM; Availability of equipments; Critical steps; Nursing staffs
__________________________________________________________________
________________________________*_________________________________

3. Abstract: Influencing factors on use of standard precautions against
occupational exposures to blood and body fluids among nurses in China
__________________________________________________________________

Free PMC Article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4730013/

Int J Clin Exp Med. 2015 Dec 15;8(12):22450-9. eCollection 2015.
Influencing factors on use of standard precautions against occupational
exposures to blood and body fluids among nurses in China.

Quan M1, Wang X2, Wu H1, Yuan X1, Lei D1, Jiang Z1, Li L3.

1The Affiliated Hospital of Zunyi Medical College Zunyi 558400, Guizhou,
China.
2The Zunyi Medical College Zunyi 558400, Guizhou, China.
3Xiangya Nursing School of Central South University (Second Xiangya
Hospital, Central South University) Changsha 410011, Hunan, China.

AIMS: To investigate how specific factors, including knowledge, attitude,
use of protective devices, safety climate, workload, and nurses’ behaviors
can influence standard precautions in China through structural equation
modeling techniques.

BACKGROUND: Although a number of empirical studies have been conducted, an
investigation of how multiple variables influence behaviors of standard
precautions among the nurses is still needed.

METHODS: The study was conducted by selecting registered nurses from 25
public hospitals that operate approximately 500 beds located in different
areas of Guizhou Province in China. An anonymous, self-administered
questionnaire was distributed to 1000 nurses, and 964 (96.4%) completed
questionnaires were returned. exploratory factor analysis was employed to
examine associations of attitudes, protective devices, safety climate,
workload, and nurses’ behaviors with standard precautions. The identified
factors were integrated in the proposed structural equation model.

FINDINGS: Protective devices had a positive and major influence on nurses’
use of standard precautions. Knowledge had a positive impact on the use of
standard precautions through attitude mediation, and the safety climate
had a positive impact on the use of standard precautions. In contrast,
increasing workload had a negative effect on the use of standard
precautions. The factors affecting the use of standard precautions among
nurses in order of decreasing effect size were: protective devices,
knowledge, attitude, safety climate, and workload.

CONCLUSIONS: This study offer valuable information for healthcare
management regarding the use of standard precautions to reduce
occupational exposure among nurses.

KEYWORDS: Nurses; behavior; blood-borne pathogens; occupational exposure;
standard precautions

Free PMC Article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4730013/
__________________________________________________________________
________________________________*_________________________________

4. Abstract: Should we continue to administer blind shoulder injections?
__________________________________________________________________

Free full text http://www.tevak.org/pdf/dergi/2016/pdfsno1/27_1_29_33.pdf

Eklem Hastalik Cerrahisi. 2016 Apr;27(1):29-33.
Should we continue to administer blind shoulder injections?

Agirman M1, Leblebicier MA, Durmus O, Saral I, Gündüz OH.

1Department of Physical Medicine and Rehabilitation, Medical Faculty of
Istanbul Medipol University, 34214 Bagcilar, Istanbul, Turkey.
mehmetagirman@yahoo.com.

OBJECTIVES: This study aims to investigate the accuracy and effectiveness
of blind and fluoroscopic-guided intra-articular shoulder injections in
patients with shoulder pain.

PATIENTS AND METHODS: The study included 17 patients (6 males, 11 females;
mean age 52.6±9.9 years; range 36 to 66 years) with shoulder pain more
than three months. First intra-articular joint injections were performed
with anterior approach blindly. Following the injection and after
confirming that the needle tip was intra-articular with fluoroscopy and
contrast distribution, the procedure was completed using 3 mL of local
anesthetic (prilocaine and bupivacaine) and 1 mL of steroid (40 mg
methylprednisolone). When the contrast distribution was observed to be
extra-articular at the first administration, a second injection was
continued under fluoroscopy guidance. All of the injections were intra-
articular with the continuation of the procedure. Pain intensity was
measured with visual analog scale (VAS).

RESULTS: According to the contrast distribution viewed with fluoroscopy,
first blind injections were intra-articular in 11 of the 17 shoulders
(64.7%). Mean of initial VAS score was 7.11. Improved pain was observed in
the clinical follow-ups at the first hour (mean VAS: 2.35), third day
(mean VAS: 2.64), and at the end of the first month (mean VAS: 2.23). The
mean durations for blind and fluoroscopic-guided procedures excluding
patients’ preparation time were 0.8 minutes and 4.2 minutes, respectively.

CONCLUSION: Although blind intra-articular shoulder injections are
inexpensive and easily applicable, injections should be performed under
fluoroscopy or another guide to ensure that the needle is intra-articular,
not peri-articular.

Free full text http://www.tevak.org/pdf/dergi/2016/pdfsno1/27_1_29_33.pdf
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Strengthening pharmaceutical systems for palliative care
services in resource limited settings: piloting a mHealth application
across a rural and urban setting in Uganda
__________________________________________________________________

BMC Palliat Care. 2016 Feb 19;15(1):20.

Free BMC Article
http://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-016-0092-9
Strengthening pharmaceutical systems for palliative care services in
resource limited settings: piloting a mHealth application across a rural
and urban setting in Uganda.

Namisango E1, Ntege C2, Luyirika EB3, Kiyange F4, Allsop MJ5.
Author information
1African Palliative Care Association, Kampala, Uganda.
eve.namisango@africanpalliativecare.org.
2Hospice Africa Uganda, Kampala, Uganda. ntegechris@gmail.com.
3African Palliative Care Association, Kampala, Uganda.
emmanuel.luyirika@africanpalliativecare.org.
4African Palliative Care Association, Kampala, Uganda.
fatia.kiyange@africanpalliativecare.org.
5Academic Unit of Palliative Care, Leeds Institute of Health Sciences,
Faculty of Medicine and Health, University of Leeds, Leeds, UK.
m.j.allsop@leeds.ac.uk.

BACKGROUND: Medicine availability is improving in sub-Saharan Africa for
palliative care services. There is a need to develop strong and
sustainable pharmaceutical systems to enhance the proper management of
palliative care medicines, some of which are controlled. One approach to
addressing these needs is the use of mobile technology to support data
capture, storage and retrieval. Utilizing mobile technology in healthcare
(mHealth) has recently been highlighted as an approach to enhancing
palliative care services but development is at an early stage.

METHODS: An electronic application was implemented as part of palliative
care services at two settings in Uganda; a rural hospital and an urban
hospice. Measures of the completeness of data capture, time efficiency of
activities and medicines stock and waste management were taken pre- and
post-implementation to identify changes to practice arising from the
introduction of the application.

RESULTS: Improvements in all measures were identified at both sites. The
application supported the registration and management of 455 patients and
a total of 565 consultations. Improvements in both time efficiency and
medicines management were noted.

Time taken to collect and report pharmaceuticals data was reduced from 7
days to 30 min and 10 days to 1 h at the urban hospice and rural hospital
respectively. Stock expiration reduced from 3 to 0.5 % at the urban
hospice and from 58 to 0 % at the rural hospital. Additional observations
relating to the use of the application across the two sites are reported.

CONCLUSIONS: A mHealth approach adopted in this study was shown to improve
existing processes for patient record management, pharmacy forecasting and
supply planning, procurement, and distribution of essential health
commodities for palliative care services.

An important next step will be to identify where and how such mHealth
approaches can be implemented more widely to improve pharmaceutical
systems for palliative care services in resource limited settings.

Free BMC Article
http://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-016-0092-9
__________________________________________________________________
________________________________*_________________________________

6. Abstract: A needle in the haystack – the dire straits of needle
exchange in Hungary
__________________________________________________________________

Free Full Article https://tinyurl.com/gpskg75

BMC Public Health. 2016 Feb 16;16(1):157. doi: 10.1186/s12889-016-2842-2.
A needle in the haystack – the dire straits of needle exchange in Hungary.

Gyarmathy VA1,2, Csák R3,4, Bálint K5, Bene E6, Varga AE7, Varga M8,
Csiszér N9, Vingender I10, Rácz J11,12,13.

1Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
vgyarmat@jhsph.edu.
2Semmelweis University, Faculty of Health Sciences, Budapest, Hungary.
vgyarmat@jhsph.edu.
3Blue Point Drug Counselling and Outpatient Centre, Budapest, Hungary.
csakrobert@gmail.com.
4Eötvös Loránd University, Institute of Psychology, Budapest, Hungary.
csakrobert@gmail.com.
5Semmelweis University, Faculty of Health Sciences, Budapest, Hungary.
bkati18@gmail.com.
6Semmelweis University, Faculty of Health Sciences, Budapest, Hungary.
beneszter@gmail.com.
7Semmelweis University, Faculty of Health Sciences, Budapest, Hungary.
vargaae@hotmail.com.
8Drug Prevention Foundation, Budapest, Hungary. vargaseparate@gmail.com.
9Drug Prevention Foundation, Budapest, Hungary. csiszernora@freemail.hu.
10Semmelweis University, Faculty of Health Sciences, Budapest, Hungary.
vingenderi@se-etk.hu.
11Semmelweis University, Faculty of Health Sciences, Budapest, Hungary.
raczjozsef0428@gmail.com.
12Blue Point Drug Counselling and Outpatient Centre, Budapest, Hungary.
raczjozsef0428@gmail.com.
13Eötvös Loránd University, Institute of Psychology, Budapest, Hungary.
raczjozsef0428@gmail.com.

BACKGROUND: The two largest needle exchange programs (NEPs) in Hungary
were forced to close down in the second half of 2014 due to extreme
political attacks and related lack of government funding. The closures
occurred against a background of rapid expansion in Hungary of injectable
new psychoactive substances, which are associated with very frequent
injecting episodes and syringe sharing. The aim of our analysis was to
predict how the overall Hungarian NEP syringe supply was affected by the
closures.

METHODS: We analyzed all registry data from all NEPs in Hungary for all
years of standardized NEP data collection protocols currently in use
(2008-2014) concerning 22 949 client enrollments, 9 211 new clients, 228
167 client contacts, 3 160 560 distributed syringes, and 2 077 676
collected syringes.

RESULTS: We found that while the combined share of the two now closed NEPs
decreased over time, even in their partial year 2014 they still
distributed and collected about half of all syringes, and attended to over
half of all clients and client contacts in Hungary. The number of
distributed syringes per PWID (WHO minimum target?=?100) was 81 in 2014 in
Hungary, but 39 without the two now closed NEPs.

CONCLUSIONS: There is a high probability that the combination of decreased
NEP coverage and the increased injection risk of new psychoactive
substances may lead in Hungary to a public health disaster similar to the
HIV outbreaks in Romania and Greece. This can be avoided only by an
immediate change in the attitude of the Hungarian government towards harm
reduction.

Free Full Article https://tinyurl.com/gpskg75
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Zika without symptoms in returning travellers: What are the
implications?
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26876061

Travel Med Infect Dis. 2016 Feb 5. pii: S1477-8939(16)00014-4.
Zika without symptoms in returning travellers: What are the implications?

Ginier M1, Neumayr A2, Günther S3, Schmidt-Chanasit J3, Blum J4.

1University of Lausanne, Switzerland; Swiss Tropical and Public Health
Institute, Basel, Switzerland.
2Swiss Tropical and Public Health Institute, Basel, Switzerland;
University of Basel, Switzerland. Electronic address:
andreas.neumayr@unibas.ch.
3WHO Collaborating Centre for Arbovirus and Haemorrhagic Fever Reference
and Research, Bernhard-Nocht Institute for Tropical Medicine, Hamburg,
Germany; German Centre for Infection Research (DZIF), Partner Site
Hamburg-Luebeck-Borstel, Hamburg, Germany.
4Swiss Tropical and Public Health Institute, Basel, Switzerland;
University of Basel, Switzerland.

Against the background of the emergence and rapid spread of Zika virus
(ZIKV) in the Americas, we report the case of an afebrile ZIKV infection
in a traveller returning from Central America to highlight relevant
clinical and diagnostic aspects.

ZIKV should be considered in the differential diagnosis of patients with
clinical symptoms suggestive of dengue or chikungunya fever. Given the
frequent subfebril and afebrile manifestations of ZIKV infections, we
propose abstaining from the term “Zika fever (ZF)” in favour of “Zika
virus disease (ZVD)”.

Owing to its unspecific clinical presentation and cross-reactivity in
serological assays, ZVD may easily be missed or misdiagnosed as dengue
fever.

Until conclusive data on the currently suspected link between ZIKV
infection in pregnancy and foetal microcephaly become available, pregnant
women and women who are trying to become pregnant should be advised
against travelling to regions with ongoing ZIKV transmission. In addition,
male travellers returning from regions with ongoing transmission should be
informed of the potential risk of sexual transmission until conclusive
data on the significance of this mode of transmission become available.

Although probably low and seasonally restricted, there is a risk of ZIKV
importation to Aedes mosquito-infested regions in temperate climates
(including regions of North America and Europe) with consecutive
autochthonous transmission.

Copyright © 2016 Elsevier Ltd. All rights reserved.

KEYWORDS: Flavivirus infection; Travel medicine; Zika virus
__________________________________________________________________
________________________________*_________________________________

8. Abstract: NICE says infection control should be the responsibility of
all staff
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26884005

Nurs Stand. 2016 Feb 17;30(25):11.
NICE says infection control should be the responsibility of all staff.

Kleebauer A.

Nurses could be set objectives to ensure all staff entering their ward
follow infection control procedures, a nurse consultant has suggested.
__________________________________________________________________
________________________________*_________________________________

9. Abstract: Hand hygiene compliance in Penang, Malaysia: Human audits
versus product usage
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26897697

Am J Infect Control. 2016 Feb 17. pii: S0196-6553(16)00009-2.
Hand hygiene compliance in Penang, Malaysia: Human audits versus product
usage.

Lee YF1, Merican H1, Nallusamy R2, Ong LM3, Mohamed Nazir P4, Hamzah HB2,
McLaws ML5.

1Penang State Health Department, Ministry of Health, Georgetown, Malaysia.
2Infection Control Unit, Penang Hospital, Ministry of Health, Georgetown,
Malaysia.
3Clinical Research Centre, Penang Hospital, Ministry of Health,
Georgetown, Malaysia.
4Medical Development Division, Ministry of Health, Putrajaya, Malaysia.
5School of Public Health and Community Medicine, UNSW Medicine, Sydney,
NSW, Australia. Electronic address: m.mclaws@unsw.edu.au.

Hand hygiene auditing is mandatory for all Malaysian public hospitals;
nonetheless, the burden of auditing is impacting the support and
sustainability of the program.

We report an alternative method to routinely measure hand hygiene
compliance with the aim to test whether alcohol-based handrub purchase
data could be used as a proxy for usage because human auditing has
decreased validity and reliability inherent in the methodology.

Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

KEYWORDS: Hand hygiene compliance; alcohol-based handrub; hand sanitizer
purchase data; human auditing; product usage; validity
__________________________________________________________________
________________________________*_________________________________

10. News

– Angola: Health authorities warn of fake yellow fever vaccines

– India: Fast-acting anti-rabies drug set for India launch

– USA: Sharps Terminator, LLC Announces FDA Approval of Sharps Terminator®
Needle Disposal Device

– Cambodia Confronts HIV Epidemic

– Scotland UK: Dozens of former east Kent hospital patients contacted over
hepatitis C contamination fears

– Cambodia: Needle demand too high: report

– USA: Reacting to Colo. arrest, Scripps offers testing to 518

– Oregon USA: Syringe drop boxes get mixed reviews in Portland

– Cambodia: HIV cluster in Cambodia linked to unsafe medical injection
practices

– USA: US Disposable Syringe Market to Cross $ 18 Billion by 2021:
Pharmaion Consultants Report

– Cambodia: Cambodia HIV cluster highlights medical injection issues

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/zgrsdhu
Angola: Health authorities warn of fake yellow fever vaccines

AngolaPress, Luana Angola (23.02.16)

Luanda – The General Inspection Department of the Health Ministry is
warning the public of the existence of fake yellow fever vaccines on the
international market.

The information is contained in a press note from the health authorities
that reached Angop on Tuesday.

The health authorities inform and bans the import, trade, distribution and
use of the batch 2265 of the “Amaril” vaccine throughout the country for a
period of three days.

According to the source, the warning 2/2016 of the World Health
Organisation (WHO) states that it has been found the existence on the
international market of the forged batch 2265 of the “Amaril” vaccine,
with the characteristics ” “vacina “Amaril” contra a febre-Amarela, lote
nº2265, data de fabrico 7/2012,validade 07/2017,laboratório Institut
Pasteur de Dakar”.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/j2ru6q7
India: Fast-acting anti-rabies drug set for India launch

Umesh Isalkar, TNN, Times of India, India (24.02.16)

PUNE: The first fast-acting anti-rabies drug of the world, which instantly
deactivates the rabies virus and provides immediate protection in severe
dog bite cases, is set for a launch in India this year.

The drug, rabies human monoclonal antibody (RMAb), has been developed by
Pune-based Serum Institute of India (SII) and US-based Mass Biologics of
the University of Massachusetts Medical School. It has been found safe and
effective during various phases of human clinical trials spanning nine
years in India and abroad.

“Our new drug – Rabishield – is a first-of-its-kind rabies human
monoclonal antibody in the world and has been developed in a laboratory
set up. It automatically precludes chances of transmitting blood-borne
infections that are present in rabies immunoglobulin, the current line of
treatment for severe dog bite cases,” Adar Poonawalla, the chief executive
officer of SII, told TOI.

The drug has been manufactured using recombinant DNA technology. “We have
completed the scale-up of the manufacturing process as well as the
clinical development of Rabishield. The drug will have its global launch
in India this year. Since the new drug will be 25% cheaper than the
existing rabies immunoglobulins, it would meet the needs of the poor
countries,” Poonawalla said.

The World Health Organisation (WHO) defines category III animal bites as
single or multiple transdermal bites or scratches, contamination of mucous
membrane with saliva from licks on broken skin and exposures to bats.
According to WHO, most of the estimated 55,000 deaths caused by rabies
each year worldwide occur in the rural areas of Africa and Asia. In India
alone, 20,000 deaths (about two per one-lakh population at risk) are
estimated to occur every year.

A ready antibody is required for immediate protection because the present
vaccine generally takes 14 days to produce antibodies. The virus can reach
the brain within 14 days if a dog bite is severe or closer to the head.
“The potential risk of contamination with blood borne pathogens is avoided
and skin hypersensitivity testing is not required while using Rabishield,”
Poonawalla said.

SII executive director Rajeev Dhere said, “When used in combination with
the rabies vaccine, the fast-acting rabies human monoclonal antibody does
away with the expensive human rabies immunoglobulin (hRIG), making the
treatment more cost-effective. The new drug, however, is not a substitute
for the existing rabies vaccine.”

He said, “Rabies infection can be prevented to a great extent using a
rabies vaccine and human rabies immunoglobulins (hRIG) soon after
exposure. However, hRIG, which is derived from human blood, is often not
available in countries like India and also quite expensive. Presently, the
horse-derived equine rabies immunoglobulin (eRIG) is used in many parts of
the world. But equine serum has several side effects.”

The new drug is a human IgG1 monoclonal antibody that specifically binds
to a conformational epitope of G glycoprotein of rabies virus and
instantly deactivates it. “This is a first of its kind recombinant human
monoclonal antibody for rabies prophylaxis in the world,” Dhere said. Why
the monoclonal antibody?

Human rabies immune globulin (hRIG), derived from human blood, is an
expensive product and carries a potential risk of contamination with
blood-borne pathogens. Equine immune globulin (eRIG), derived from horse
serum, is used in many parts of the world but its use is associated with
significant adverse effects such as anaphylaxis or serum sickness
__________________________________________________________________
__________________________________________________________________

http://www.prweb.com/releases/2016/02/prweb13227330.htm
USA: Sharps Terminator, LLC Announces FDA Approval of Sharps Terminator®
Needle Disposal Device

Press Release, Lubbock Tx USA, PRweb (23.02.16)

The Sharps Terminator® has been approved by the Food & Drug Administration
(FDA) for commercial use in the United States.

We are extremely excited to gain marketing approval from the FDA for the
Sharps Terminator®. It is our greatest hope that we can now begin to help
reduce this worldwide problem; one needle at a time.

Sharps Terminator, LLC announced today that their flagship product, the
Sharps Terminator® gained approval this week from the FDA for marketing in
the US. The Sharps Terminator® is a portable, re-chargeable needle
destruction device designed to destroy hypodermic needles attached to
syringes 18 – 27 gauge and up to two inches in length in less than three
seconds. It is a Class III medical device regulated by the Food & Drug
Administration (FDA.)

The device is specifically designed to help reduce the potential for
accidental needlestick injuries in the workplace caused by needles left on
syringes after one use. Needlestick injuries sustained from contaminated
needles can often lead to more catastrophic illnesses from viruses such as
Ebola, HIV and hepatitis C.

Sharps Terminator, LLC spokesperson Robert Blasingame stated: “the CDC
guidelines for Sharps Safety in Healthcare Settings continues to stress
One Needle, One Syringe and Only One Time; we want to take that one step
further by providing a light weight portable device to destroy needles
immediately after one use at their point of use, or point of procedure.”

The Needlestick Safety & Prevention Act (the Act) was signed into law by
the President 16 years ago and still the problem persists. Contaminated
needles are now a global problem of epic proportions. There are now over
25 million persons living with HIV in the Sub Saharan Africa according to
the World Health Organization (WHO) and nearly 2.5 million in India.

Worldwide there are more than 35 million people living with HIV and
everyday more than 5,700 people contract HIV – nearly 240 every hour. And
when you consider this is only one of at least twenty bloodborne pathogens
that contaminated needles can carry, it places many at risk from injuries
caused by needles.

“We are extremely excited to gain marketing approval from the FDA for the
Sharps Terminator®. It is our greatest hope that we can now begin to help
reduce this worldwide problem; one needle at a time.”
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/j8j7wdj
Cambodia Confronts HIV Epidemic

By Beatrice Asuncion, Youth Health Magzine (23.02.16)

Cambodia is currently experiencing an HIV outbreak allegedly caused by an
unlicensed doctor reusing dirty needles on patients.

Villagers from Peam have since been in a rush to get to a group of health
officials who are taking blood samples for HIV screening. Most of them
anxious to find out if they are infected by the virus especially
considering that majority of the people go to the alleged unlicensed
doctor to get vaccinated.

Kouy Bunthoeun, director of the provincial health department has since
confirmed that from the past week, a significant number of people coming
from the Peam village have been reported to have HIV. This led the
director and his department to conduct a mass HIV screening to find out if
majority of the villagers are infected and to find out the source of the
outbreak

“I received information from an organization yesterday that 14 people
tested positive for HIV, but I am not sure because we are now collecting
the data and testing the blood of the villagers,” quipped Bunthoeun.

Following the startling discovery, the village doctor named Sok Thornn was
automatically thrust into the spotlight since some reports claim that the
doctor allegedly use dirty needles in vaccinating his patients.

Dr. Thornn has remained adamant about his innocence. According to him, he
is a well-trained and educated doctor. By no means would he in his right
mind use methods that might spread a disease like HIV.

“Please give me the names of the people you interviewed today and I will
give it to my lawyer because they have defamed me,” added Thornn.

World Bank figures states that Cambodia is one of the countries that have
the lowest rate for health care which has the ratio of 0.2 doctors against
100,000 people which explains how easy it was for an outbreak to start.
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__________________________________________________________________

https://tinyurl.com/jz3xm5z
Scotland UK: Dozens of former east Kent hospital patients contacted over
hepatitis C contamination fears

Luke May, Kent News, UK (23.02.16)

46 people have been contacted by a hospitals trust

Nearly 50 patients at William Harvey Hospital have been contacted 10 years
on from receiving treatment, to receive a blood test.

The test comes after it was revealed a former healthcare worker who worked
at the hospital between January and April 2006, test positive for
hepatitis C in 2008.

In Scotland close to 9,000 patients have been contacted in relation to the
former worker.

But in Kent 46 people have been contacted by East Kent Hospitals
University NHS Foundation Trust, who is responsible for running the
Ashford hospital.

The trust has assured the public only those contacted need to come in for
a blood test, while safe and effective treatments are available for the
infection.

Dr James Nash, consultant microbiologist at EKHUFT said: “We would like to
reassure patients who have received the letter that the likelihood of them
having acquired the virus from a procedure carried out by the healthcare
worker is low.

“We know that some people will be concerned about what this means for them
and we have apologised to patients for any worry caused by this situation.
Fortunately there are safe and effective treatments available to treat
hepatitis C infection.

“We are committed to supporting patients and are ensuring they have every
opportunity to ask any questions they have about hepatitis C and getting
tested.”
__________________________________________________________________
__________________________________________________________________

http://www.phnompenhpost.com/national/needle-demand-too-high-report
Cambodia: Needle demand too high: report

by Alessandro Marazzi Sassoon, The Phnom Penh Post (22.02.16)

As a Kandal village braces for an investigation into a cluster of HIV
cases, the US Centers for Disease Control on Friday published a new report
on the now-infamous HIV outbreak in Battambang’s Roka commune, pointing to
high demand for medical injections and a lack of training as risk factors
the government should address.

Between December 2014 and February 2015, the National Centre for HIV,
AIDS, Dermatology and STDs recorded 242 HIV infections among nearly 8,900
Roka commune residents – with even more cases detected later. The re-use
of tainted needles by an unlicensed doctor was ultimately blamed.

“A majority of the confirmed cases in this outbreak were from a population
not associated with commercial sex work, men who have sex with men [MSM],
or injection drug use, the primary risk factors driving Cambodia’s HIV
epidemic,” according to the CDC.

Despite progress in reducing HIV among these usual at-risk populations,
the report says, the Roka “outbreak highlights the risk for HIV
transmission in the general population through unsafe medical injections”.

While the government’s response to the Roka commune outbreak included
initiatives to encourage safe injection practices and a purported
crackdown on unlicensed medical practitioners, the report says “measures
to reduce the demand for unnecessary medical injections and the provision
of unsafe injections are needed”.

While a causal relationship between unsafe medical injections and HIV
infection could not be established by the authors of the report, a clear
association exists – which is noteworthy as “demand for medical injections
among Cambodian adults is high, averaging 2.6 injections per person”
yearly compared with 1.5 in neighbouring Vietnam.

Mey Sovannara, policy and advocacy manager for the Cambodian People Living
with HIV Network, agreed that “it’s the government’s responsibility” to
promote safe practices, although he said authorities should not “kick out”
unlicensed practitioners, but instead provide them training.

Unlicensed doctor Yem Chroeum was sentenced to 25 years’ imprisonment in
December in connection with the Roka outbreak. Sovannara, however, said he
blamed “no one”, as Chroeum was the only practitioner available at the
time.
__________________________________________________________________
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www.sandiegouniontribune.com/news/2016/feb/22/scripps-green-testing-HIV/
USA: Reacting to Colo. arrest, Scripps offers testing to 518

Says surgical tech accused of drug theft worked at Scripps Green for 20
days in 2013

By Paul Sisson, The San Diego Union-Tribune, San Diego CA USA (22.02.16)

The Colorado arrest of a former surgical technician trainee who briefly
worked at Scripps Green Hospital in 2013 has prompted the facility offer
free hepatitis and HIV testing to more than 500 patients.

Scripps said Monday that it contacting patients who underwent surgical
procedures during shifts worked by Rocky Allen, 28, during a 20-day period
from May 9 to June 7 of 2013, to offer them the testing.

Federal agents arrested Allen on Feb. 16 on charges of tampering with a
consumer product and obtaining a controlled substance by deceit, after he
was allegedly caught diverting drugs from Swedish Medical Center in
Englewood, a Denver suburb.

On Friday, federal investigators detailed Allen’s employment history in
court, noting that, when he worked at Green, a hospital worker saw him try
“to switch a syringe of fentanyl citrate — a pain medication — with a
syringe of saline.”

Scripps officials said Monday that it was a nurse who spotted Allen’s
attempted sleight of hand, and he was immediately pulled from duty and
eventually fired. It was a similar incident at the Colorado hospital on
Jan. 22 that tipped authorities off, leading to a wider investigation.

Every hospital where Allen worked is now offering free testing for blood-
borne infections — hepatitis B, Hepatitis C and HIV — to anyone who
underwent surgery while he was present. Swedish in Englewood is reportedly
testing 2,900 patients. Two hospitals in Phoenix are offering tests to
thousands more.

According to accounts of a recent hearing in Colorado, Allen carries an
unnamed blood-borne pathogen, giving rise to concerns that he may have
inadvertently passed an infection to a patient when exchanging syringes.

It was a sharp-eyed nurse, Scripps said, that spotted the technician try
to swap syringes while helping set up for a surgery. Because he was a
trainee, he was under supervision of a proctor at all times.

Dr. Maida Soghikian, chief of staff at Green, said that there are no
indications that any syringes handled by Allen were ever used with an
actual patient.

“We are going along with public health recommendations out of an abundance
of caution,” Soghikian said, adding that Allen was scheduled to be in 55
different surgeries during the 20-day span that he worked at Green.

The incident points up a larger problem in health care known as medication
diversion. Though hospitals have drastically increased oversight of
narcotic painkillers in recent years — even installing automated “Pyxis”
machines that make it difficult for drugs to go missing — powerful drugs
still do go missing.

A 2014 report from the U.S. Centers for Disease Control and Prevention
documented 100 infections, and nearly 30,000 patients potentially exposed
to infections, due to drug theft.

Kim New, owner of Diversion Specialists, a Tennessee consultancy that
specializes in helping hospitals get better control of their drugs, said
trying to swap syringes in an operating room with other health care
workers was particularly brazen. More often, she said, workers find less
easily-spotted ways to take drugs without getting noticed.

“I’ve worked on cases where masters-prepared nurses, we’re talking
extremely-well-educated professionals, have been involved in diverting
drugs from sharps waste containers,” New said.

Scripps said its surgical teams were given extra training in how to spot
drug theft after the Allen incident in 2013.

Scripps officials also said they made the U.S. Drug Enforcement
Administration aware of the reasons for Allen’s termination.

Allen remained employed in patient care. Investigators said he worked for
John C. Lincoln Hospital in Phoenix in October, 2014, when he tested
positive for fentanyl while employed as a surgical attendant. He also
worked for Banner Thunderbird Medical Center in Glendale, Arizona, for six
weeks in 2014.

A Scripps official said Allen passed the routine background check, drug
test and reference check administered to all new hires by the company’s
human resources department.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/j2mytnl
Oregon USA: Syringe drop boxes get mixed reviews in Portland

By Cole Miller and KOIN 6 News Staff, Oregon USA (22.02.16)

“We take in more than 2 million used syringes a year” Video at the link

PORTLAND, Ore. (KOIN) — The homeless population at Portland’s Waterfront
Park and Eastbank Esplanade is growing, and with that comes a spike in
drug use.

Now, there’s a push to keep dirty needles off walking paths and open
spaces.

Earlier this month, 2 syringe drop boxes were set up on the west end of
the Burnside Bridge and on the Eastbank Esplanade near Salmon Street.

“They look like mailboxes or trashcans, they’re well-marked” Kim Toevs
with Harm Reduction Services said. “We take in more than 2 million used
syringes a year.”

According to Toevs, the drug problem is only getting worse in Portland.

“It’s been an increase every year for about the past 5 years,” she
explained. “Heroin has definitely been on the increase in Portland.”

The syringe drop boxes were implemented as part of a year-long pilot
project for the Healthy Streets Initiative. It aims to make certain areas
of the city safer and cleaner.

“Until they can have access to treatment and they’re ready to engage in
treatment, we look to help mitigate some of the other harms that can
happen,” Toevs said.

But not everyone is on board with the plan. Toevs says there’s a “public
perception of nervousness” associated with the drop boxes, and many worry
they’ll get accidentally pricked by dirty needles that can carry Hepatitis
B, C or even HIV.

“I think it’s enabling and encouraging,” Portland resident Rachelle
Jacover said. “It’s a huge problem and I get that and it’s unfortunate,
but that isn’t the answer.”

More syringe drop boxes could pop up once the pilot project ends.

The boxes are emptied every 2 weeks. The program costs around $20,000 and
has reportedly been successful in other cities, including Seattle.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/zouyvb2
Cambodia: HIV cluster in Cambodia linked to unsafe medical injection
practices

by Gerard Gallagher, Healio Infectious Disease (22.02.16)

HIV cluster in Cambodia linked to unsafe medical injection practices
Vun MC, et al. MMWR Morb Mortal Wkly Rep. 2016;doi:10.15585/mmwr.mm6506a2.
www.cdc.gov/mmwr/volumes/65/wr/mm6506a2.htm

Researchers who studied a large cluster of new HIV infections in Cambodia
attributed to unsafe injection practices have recommended that national
prevention strategies be expanded to monitor the risk for HIV transmission
via unsafe injections.

The recommendation came after nearly 3% of the residents of one rural
community in northwest Cambodia recently were diagnosed with HIV after a
surge in testing prompted by fears among residents that they were at risk
for exposure.

“Cambodia’s current national HIV prevalence and incidence estimates are
based on models that do not include risk factors associated with unsafe
injections or blood transfusion,” Mean Chhi Vun, MD, MPH, director of
Cambodia’s National Center for HIV/AIDS, Dermatology and STDs (NCHADS),
and colleagues wrote in MMWR. “Given the high prevalence of medical
injection use in Cambodia, the contribution of medical injection overuse
to Cambodia’s national HIV burden might be higher than estimated.”

The team that investigated the outbreak in the commune of Roka excluded
patients with existing HIV diagnoses by reviewing data from ART sites and
registers of community-based HIV/AIDS care programs. Specimens that tested
positive for HIV via rapid-test kits were laboratory confirmed, and risk
factors associated with infection were identified via a case-control
study.

A total of 2,045 residents of Roka underwent HIV testing from November
2014 to February 2015 — a surge triggered after three members of one
family tested positive for HIV and claimed they were infected by medical
injections given by an unlicensed health practitioner. The family included
the index patient, aged 74 years, a resident of the commune with
tuberculosis who was diagnosed with HIV in November 2014.

By the end of February, NCHADS had confirmed HIV infection in 2.7% of the
8,893 residents of the commune, with most cases linked to a single strain
that spread rapidly within the community. According to the NCHADS case-
control study, medical injections and infusions were the most likely modes
of transmission, with preliminary results showing that cases were nearly
five times as likely as controls to have received an IV or intramuscular
injection, and four times as likely to have received an IV infusion during
the previous 6 months, Vun and colleagues wrote. Test results suggested
that 30% of the infections in the Roka cluster could be classified as
having occurred within 130 days before specimen collection.

The investigators noted a high demand for medical injections among adults
in Cambodia — an average of 2.6 per person annually. Although the
proportion of injections administered with reused equipment in the cluster
is unknown, a 2013 study estimated 5% of reuse in the region in 2010. Vun
and colleagues pointed to a recent HIV epidemic in Indiana as an example
of the “explosive outbreak potential” of HIV in a setting where
contaminated needles are shared.

A majority of the patients in the Roka outbreak were not associated with
populations that are primarily driving Cambodia’s HIV epidemic, including
commercial sex workers, men who have sex with men and IV drug users.
Whereas the country has reduced the incidence of HIV among those
populations, the Roka outbreak highlights the risk for transmission
through unsafe medical injections, which has historically not been a
priority of Cambodia’s national HIV prevention strategy, Vun and
colleagues wrote.

“Efforts should be made to educate health care workers and communities at
large on safe injection practices to reduce the demand for unnecessary
medical injections and increase injection safety,” they wrote. “National
HIV prevention strategies should be expanded to monitor unsafe injections
as a mode of transmission. Globally, a need exists for tools to estimate
HIV risk in low-prevalence countries where substantial proportions of the
population are regularly exposed to unnecessary and potentially unsafe
injections.”

Disclosure: The researchers report no relevant financial disclosures.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/gl7bbd6
USA: US Disposable Syringe Market to Cross $ 18 Billion by 2021: Pharmaion
Consultants Report

Pharmaion Press Release, PR Newswire Europe, (15.02.16)

BURNABY, Canada, Feb 15, 2016 (PR Newswire Europe via COMTEX) — BURNABY,
Canada, February 15, 2016 /PRNewswire/ —

Growing awareness about cross-contamination and rising incidence of
accidental needlestick injuries, coupled with effective implementation of
government regulations to drive United States disposable syringe market
through 2021

According to Pharmaion report, “United States Disposable Syringe Market [
http://www.pharmaion.com/report/united-states-disposable-syringe-market-
opportunities-2011–2021/49.html ] Opportunities, 2011 – 2021”, the
disposable syringe market in the United States is projected to cross US$
18 billion by 2021. Some of the major factors boosting the demand for
disposable syringes in the United States include increasing technological
advancements, growing awareness about various infections from blood-borne
pathogens and rising incidence of accidental needlestick injuries.
Moreover, owing to the country’s increasing disease burden and presence of
a large number of hospitals, demand for disposable syringes in the US is
projected to grow over the next five years.

Healthcare workers, such as physicians, nursing staff and laboratory
staff, are at high risk of accidental needlestick injuries. It has been
observed that the most frequent cause of sharp injuries in different
healthcare set-ups in the United States is syringes, followed by IV
catheter stylet and butterfly needle. Disposable syringes market in the US
has significantly benefited from the implementation of US Needle Stick
Safety and Prevention Act of 2000, which advocates usage of safer medical
devices to eliminate or minimize exposure to pathogensfrom needlestick
injuries.

United States disposable syringe market has been segmented into two
categories, namely, conventional syringes and safety syringes. Out of
these two categories, conventional syringes dominated the overall
disposable syringe market in the United States in 2015. The segment is
anticipated to continue its dominance through 2021 on account of low
prices of conventional syringes coupled with their effectiveness in
mitigating the spread of blood borne infections and diseases. However, in
terms of growth, safety syringe segment is projected to outpace
conventional syringe segment during 2016 – 2021.

“United States disposable syringe market is expected to continue
exhibiting promising growth over the next five years. Innovations and new
product launches by the existing market players and new entrants is the
major factor, which is anticipated to drive the disposable syringe market
of the United States during forecast period. Moreover, growing adoption of
Pre-Filled Safety Syringes (PFS), Disposable Dental Syringes, Needle-Free
Injectors and Auto-Retractable Safety Syringes is expected to have a
positive influence on the country’s disposable syringe market, going
forward.” said Mr. Brijesh Khurana, Research Manager with Pharmaion [
http://www.pharmaion.com ], a research based global management consulting
firm focused on pharma and healthcare industry.

“United States Disposable Syringe Market Opportunities, 2011 – 2021” has
analyzed the potential of disposable syringe market in the United States
and provides statistics and information on market sizes, shares and
trends. The report intends to provide cutting-edge market intelligence and
help decision makers take sound investment evaluation. Besides, the report
also identifies and analyzes the emerging trends along with essential
drivers and key challenges faced in the United States disposable syringe
market.

About Pharmaion

Pharmaion is a research based management consulting firm focused
exclusively on Healthcare & Pharmaceutical industry.

Copyright (C) 2016 PR Newswire Europe
__________________________________________________________________
________________________________*_________________________________

https://tinyurl.com/jhgye3f
Cambodia: Cambodia HIV cluster highlights medical injection issues

By Antigone Barton, Science Speaks: HIV & TB News (18.02.16)

Cambodia had seen success in its efforts to lower its numbers of new HIV
infections and to address the impacts of HIV among men who have sex with
men, people who inject drugs and people who earn income through sex. But
it was not until about a year ago, when the numbers of people known to
have HIV in the rural community of Roka jumped from four to 30, that the
consequences of MMWRCambodiaHIVanother high risk became clear. While more
than 5 percent of medical injections administered in the Western Pacific
region were estimated in 2013 to have been performed with reused
equipment, investigators note, it was the sharp rise of new infections in
Roka that drew Cambodian health authorities’ attention to the dangers of
unnecessary and unsafe injections for medical purposes, often administered
by unlicensed practitioners.

This week’s Morbidity and Mortality Weekly Report from the U.S. Centers
for Disease Control and Prevention details the findings of an
investigation of a cluster of HIV infections that began in November 2014
with the diagnosis of a 74-year-old man in Roka, followed by the diagnoses
of two more of his family members, all of whom had received medical
injections from an unlicensed practitioner. In the next three months, more
than 2,000 residents of the community were tested for HIV and a team that
had come to Roka to investigate the cluster had confirmed 242 cases there.
Investigators found indications that those diagnosed with HIV were about
five times as likely to have have received a medical injection, and four
times as likely to have received an intravenous infusion than those who
were not diagnosed with HIV.

The investigators’ report makes note of the cluster of HIV infections in
rural Indiana propelled by shared needles and syringes among people
injecting drugs that drew notice shortly after the Roka investigation.
Both, they point out illustrate “the explosive outbreak potential when HIV
is introduced into settings where contaminated needles are shared.”

Cambodian officials, according to the report, are responding with guidance
to local health departments, heightened enforcement of medical licensing
regulations and increased access to HIV testing and treatment. Still ahead
will be work to promote awareness of infection control and alternatives to
injections among health workers.
__________________________________________________________________
________________________________*_________________________________

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]:
http://whqlibdoc.who.int/publications/2010/9789241599252_eng.pdf

Use the Toolbox at: http://www.who.int/injection_safety/toolbox/en/

Get SIGN files on the web at: http://signpostonline.info/signfiles-2
get SIGNpost archives at: http://signpostonline.info/archives-by-year

Like on Facebook: http://facebook.com/SIGN.Moderator

The SIGN Secretariat, the Department of Health Systems Policies and
Workforce, WHO, Avenue Appia 20, CH-1211 Geneva 27, Switzerland.
Facsimile: +41 22 791 4836 E- mail: sign@who.int
__________________________________________________________________
________________________________*_________________________________
All members of the SIGN Forum are invited to submit messages, comment on
any posting, or to use the forum to request technical information in
relation to injection safety.

The comments made in this forum are the sole responsibility of the writers
and does not in any way mean that they are endorsed by any of the
organizations and agencies to which the authors may belong.

Use of trade names and commercial sources is for identification only and
does not imply endorsement.

The SIGN Forum welcomes new subscribers who are involved in injection
safety.

* Subscribe or un-subscribe by email to: sign.moderator@gmail.com, or to
sign@who.int

The SIGNpost Website is http://SIGNpostOnline.info

The SIGNpost website provides an archive of all SIGNposts, meeting
reports, field reports, documents, images such as photographs, posters,
signs and symbols, and video.

We would like your help in building this archive. Please send your old
reports, studies, articles, photographs, tools, and resources for posting.

Email mailto:sign.moderator@gmail.com
__________________________________________________________________
________________________________*_________________________________

The SIGN Internet Forum was established at the initiative of the World
Health Organization’s Department of Essential Health Technologies.

The SIGN Secretariat home is the Service Delivery and Safety (SDS)
Health Systems and Innovation (HIS) at WHO HQ, Geneva Switzerland.

The SIGN Forum is moderated by Allan Bass and is hosted on the University
of Queensland computer network. http://www.uq.edu.au
__________________________________________________________________

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