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SIGNpost 00868

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST

Post00868 PEP + NSI + Hands + Abstracts + News 31  August 2016

CONTENTS
0. Moderators Note
1. Abstract: Management of health care workers following occupational
exposure to hepatitis B, hepatitis C, and human immunodeficiency virus
2. Abstract: Effectiveness of Pharmacy-Based Needle/Syringe Exchange
Program for People Who Inject Drugs: A Systematic Review and Meta-
analysis
3. Abstract: Self-administration of injectable contraceptives: a
systematic review
4. Abstract: Hand coverage by alcohol-based handrub varies: Volume and
hand size matter
5. Abstract: Prevention and management of vision loss relating to facial
filler injections
6. Abstract: Assistive Device for Efficient Intravitreal Injections
7. Abstract: Corticosteroid injection for adhesive capsulitis in primary
care: a systematic review of randomised clinical trials
8. Abstract: Sixth Nerve Palsy Following Botulinum Toxin injection for
Facial Rejuvenation
9. No Abstract: Bare below the elbows: was the target the white coat?
10. News
– Oman: Oman generates 12 tonnes of medical waste daily: Averda
– West Virginia USA: New policy will allow Mid-Ohio Valley Health
Department to remove abandoned needles in W.Va
– Oman: Oman generates 12 tonnes of medical waste daily: Averda

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SIGNpost 00868

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1. Abstract: Management of health care workers following occupational
exposure to hepatitis B, hepatitis C, and human immunodeficiency virus
__________________________________________________________________

Free full text https://dx.doi.org/10.12809/hkmj164897

Hong Kong Med J. 2016 Aug 26.
Management of health care workers following occupational exposure to
hepatitis B, hepatitis C, and human immunodeficiency virus.

Sin WW1, Lin AW1, Chan KC1, Wong KH1.

1Special Preventive Programme, Centre for Health Protection, Department of
Health, Kowloon Bay Health Centre, Hong Kong.

INTRODUCTION: Needlestick injury or mucosal contact with blood or body
fluids is well recognised in the health care setting. This study aimed to
describe the post-exposure management and outcome in health care workers
following exposure to hepatitis B, hepatitis C, or human immunodeficiency
virus (HIV) during needlestick injury or mucosal contact.

METHODS: This case series study was conducted in a public clinic in Hong
Kong. All health care workers with a needlestick injury or mucosal contact
with blood or body fluids who were referred to the Therapeutic Prevention
Clinic of Department of Health from 1999 to 2013 were included.

RESULTS: A total of 1525 health care workers were referred to the
Therapeutic Prevention Clinic following occupational exposure. Most
sustained a percutaneous injury (89%), in particular during post-procedure
cleaning or tidying up. Gloves were worn in 62.7% of instances. The source
patient could be identified in 83.7% of cases, but the infection status
was usually unknown, with baseline positivity rates of hepatitis B,
hepatitis C, and HIV of all identified sources, as reported by the
injured, being 7.4%, 1.6%, and 3.3%, respectively. Post-exposure
prophylaxis of HIV was prescribed to 48 health care workers, of whom 14
(38.9%) had been exposed to known HIV-infected blood or body fluids. The
majority (89.6%) received HIV post-exposure prophylaxis within 24 hours of
exposure. Drug-related adverse events were encountered by 88.6%. The
completion rate of post-exposure prophylaxis was 73.1%. After a follow-up
period of 6 months (or 1 year for those who had taken HIV post-exposure
prophylaxis), no hepatitis B, hepatitis C, or HIV seroconversions were
detected.

CONCLUSIONS: Percutaneous injury in the health care setting is not
uncommon but post-exposure prophylaxis of HIV is infrequently indicated.
There was no hepatitis B, hepatitis C, and HIV transmission via sharps or
mucosal injury in this cohort of health care workers.

KEYWORDS: HIV infections; Hepatitis B; Hepatitis C; Mucous membrane;
Needlestick injuries; Occupational exposure

Free full text https://dx.doi.org/10.12809/hkmj164897
__________________________________________________________________
________________________________*_________________________________

2. Abstract: Effectiveness of Pharmacy-Based Needle/Syringe Exchange
Program for People Who Inject Drugs: A Systematic Review and Meta-
analysis
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27566970

Addiction. 2016 Aug 27.
Effectiveness of Pharmacy-Based Needle/Syringe Exchange Program for People
Who Inject Drugs: A Systematic Review and Meta-analysis.

Sawangjit R1,2, Khan TM2,3, Chaiyakunapruk N2,4,5,6.

1Clinical Pharmacy Research Unit (CPRU), Department of Clinical Pharmacy,
Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand.
2School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan,
46150 Bandar Sunway, Selangor, Malaysia.
3Department of Pharmacy, Abasyn University Peshawar, Pakistan.
4Center of Pharmaceutical Outcomes Research, Department of Pharmacy
Practice, Faculty of Pharmaceutical Sciences, Naresuan University,
Phitsanulok, Thailand.
5School of Population Health, University of Queensland, Brisbane,
Australia.
6School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA.

AIMS: To critically appraise the evidence for effectiveness of pharmacy-
based needle/syringe exchange programs (Pharmacy-based NSPs) on risk
behaviors (RBs), HIV/HCV prevalence, and economic outcomes among people
who inject drugs (PWID).

DESIGN: Systematic review and meta-analysis SETTING: PRIMARY CARE SETTING:

PARTICIPANTS: Of 1,568 studies screened, 14 studies with N?=?7035 PWID
were included.

MEASURES: PubMed, Embase, Web of Sciences, CENTRAL, and Cochrane review
databases were searched without language restriction from their inception
through January 27, 2016. All published study designs with control group
that reported the effectiveness of Pharmacy-based NSP on outcomes of
interest were included. Outcomes of interest are RB, HIV/HCV prevalence,
and economic outcomes. The estimates of pooled effects of these outcomes
were calculated as pooled odds ratio (OR) with 95% CI using a random-
effects model. Heterogeneity was assessed by I2 and chi-squared tests.

FINDINGS: Most studies (9/14, 64.3%) were rated as having a serious risk
of bias, while 28.6% and 7.1% were rated as having a moderate risk and low
risk of bias, respectively. For sharing-syringe behavior, Pharmacy-based
NSPs were significantly better than no NSPs for both main (OR: 0.50
(95%CI?= 0.34-0.73; I2?=?59.6%)) and sensitivity analyses, excluding
studies with a serious risk of bias (OR: 0.52 (95%CI?=?0.32-0.84; I2?=?
41.4%)). For safe syringe disposal and HIV/HCV prevalence, the evidence
for Pharmacy-based NSPs compared with other NSP or No NSP was unclear
since few of the studies reported this and most of them had a serious risk
of bias. Compared with the total lifetime cost of 55,640 USD for treating
a person with HIV infection, the HIV prevalence among PWID has to be at
least 0.8% (for Pharmacy-based NSPs) or 2.1% (for other NSPs) to result in
cost- savings.

CONCLUSIONS: Pharmacy-based needle/syringe exchange programs appear to be
effective for reducing risk behaviors among people who inject drugs,
though their effect on HIV/HCV prevalence and economic outcomes is
unclear.

This article is protected by copyright. All rights reserved.

KEYWORDS: HCV prevalence; HIV prevalence; meta-analysis; people who inject
drugs (PWID); pharmacy-based needle/syringe exchange program; risk
behaviors (RB)
__________________________________________________________________
________________________________*_________________________________

3. Abstract: Self-administration of injectable contraceptives: a
systematic review
__________________________________________________________________

http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.14248/full

BJOG. 2016 Aug 23. Open Access Free Full Article
Self-administration of injectable contraceptives: a systematic review.

Kim CR1, Fønhus MS2, Ganatra B1.

1Department of Reproductive Health and Research, World Health
Organization, Geneva, Switzerland.
2Knowledge Centre for the Health Services, Norwegian Institute of Public
Health, Oslo, Norway.

BACKGROUND: The contraceptive injectable is a safe and effective method
that is used worldwide. With the variety of injectable delivery systems,
there is potential for administration by the woman herself. Self-
administration of the contraceptive injectable is the subject of this
systematic review.

OBJECTIVES: To assess how effective and safe the contraceptive injectable
method is when women themselves perform/administer it, compared with when
the usual healthcare providers administer it.

SEARCH STRATEGY: We searched PubMed, Popline, Cochrane, CINAHL, and Embase
for articles with subject headings or text words related to ‘self-
administration’ and ‘contraception’.

SELECTION CRITERIA: Studies that compared the administration of the
contraceptive injectable by the woman herself versus administration by the
healthcare provider were included. Outcomes of interest were continuation
rates, safety, and the women’s overall satisfaction with the contraceptive
provider and method.

DATA COLLECTION AND ANALYSIS: We undertook data extraction, descriptive
analysis, and assessment of risk of bias.

MAIN RESULTS: Three studies met the inclusion criteria. The best available
evidence shows that there may be little or no difference in continuation
rates when women self-administer contraceptive injections (326 per 1000
women; 95% CI 192-554 per 1000 women) compared with administration by
healthcare providers (304 per 1000 women).

Safety was not estimable as no serious adverse events were reported in any
of the studies.

With regards to overall satisfaction towards the provider and the method,
the effect of the intervention was uncertain.

AUTHORS’ CONCLUSIONS: Findings suggest that with appropriate information
and training the provision of contraceptive injectables for the woman to
self-administer at home can be an option in some contexts.

TWEETABLE ABSTRACT: This review assessed the continuation rates and safety
of self-administration of the contraceptive injection.

© 2016 World Health Organization; licensed by John Wiley & Sons Ltd on
behalf of Royal College of Obstetricians and Gynaecologists.

KEYWORDS: Contraception; injectable; self-administration
__________________________________________________________________
________________________________*_________________________________

4. Abstract: Hand coverage by alcohol-based handrub varies: Volume and
hand size matter
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27566875

Am J Infect Control. 2016 Aug 24. pii: S0196-6553(16)30690-3.
Hand coverage by alcohol-based handrub varies: Volume and hand size
matter.

Zingg W1, Haidegger T2, Pittet D3.

1Infection Control Program and WHO Collaborating Centre on Patient Safety,
University of Geneva Hospitals and Faculty of Medicine, Geneva,
Switzerland. Electronic address: walter.zingg@hcuge.ch.
2Antal Bejczy Center for Intelligent Robotics, Óbuda University, Budapest,
Hungary; Austrian Center for Medical Innovation and Technology, Wiener
Neustadt, Austria.
3Infection Control Program and WHO Collaborating Centre on Patient Safety,
University of Geneva Hospitals and Faculty of Medicine, Geneva,
Switzerland.

Visitors of an infection prevention and control conference performed hand
hygiene with 1, 2, or 3?mL ultraviolet light-traced alcohol-based handrub.
Coverage of palms, dorsums, and fingertips were measured by digital
images.

Palms of all hand sizes were sufficiently covered when 2?mL was applied,
dorsums of medium and large hands were never sufficiently covered.

Palmar fingertips were sufficiently covered when 2? or 3?mL was applied,
and dorsal fingertips were never sufficiently covered.

Copyright © 2016 Association for Professionals in Infection Control and
Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

KEYWORDS: Dorsum; Hand hygiene; Hand sanitizer; Palm
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Prevention and management of vision loss relating to facial
filler injections
__________________________________________________________________
https://dx.doi.org/10.11622/smedj.2016134

Singapore Med J. 2016 Aug;57(8):438-43. Free Full PDF Article
Prevention and management of vision loss relating to facial filler
injections.

Loh KT1, Chua JJ2, Lee HM3, Lim JT4, Chuah G5, Yim B6, Puah BK7.

1David Loh Surgery, Singapore.
2JJ Chua Rejuvenative Cosmetic & Laser Surgery, Singapore.
3Lee Hung Ming Eye Centre, Gleneagles Hospital, Singapore.
4Joyce Lim Skin and Laser Clinic, Singapore.
5Total Eyecare Center, Singapore.
6Dr Benjamin Yim Clinical Aesthetics & Laser Centre, Singapore.
7Amaris B Clinic, Singapore.

INTRODUCTION: With the increased use of filler and fat injections for
aesthetic purposes, there has been a corresponding increase in the
incidence of complications. Vision loss as an uncommon but devastating
vascular side effect of filler injections was the focus of this paper.

METHODS: A review committee, consisting of plastic surgeons, aesthetic
medical practitioners, ophthalmologists and dermatologists from Singapore,
was convened by the Society of Aesthetic Medicine (Singapore) to review
and recommend methods for the prevention and management of vision loss
secondary to filler injections.

RESULTS: The committee agreed that prevention through proper understanding
of facial anatomy and good injection techniques was of foremost
importance. The committee acknowledged that there is currently no standard
management for these cases. Based on existing knowledge, injectors may
follow a proposed course of action, which can be divided into immediate,
definitive and supportive. The goals were to reduce intraocular pressure,
dislodge the embolus to a more peripheral location, remove or reverse
central ischaemia, preserve residual retinal function, and prevent the
deterioration of vision. Dissolving a hyaluronic acid embolus remains a
controversial option. It is proposed that injectors must be trained to
recognise symptoms, institute immediate actions and refer patients without
delay to dedicated specialists for definitive and supportive management.

CONCLUSIONS: Steps to prevent and manage vision loss based on current
evidence and best clinical practices are outlined in this paper. Empirical
referral to any emergency department or untrained doctors may lead to
inordinate delays and poor outcomes for the affected eye.

Copyright: © Singapore Medical Association.

KEYWORDS: aesthetic medicine; blindness; facial fillers; filler injection;
hyaluronic acid

Free full text https://dx.doi.org/10.11622/smedj.2016134
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Assistive Device for Efficient Intravitreal Injections
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27548453

Ophthalmic Surg Lasers Imaging Retina. 2016 Aug 1;47(8):752-62.
Assistive Device for Efficient Intravitreal Injections.

Ullrich F, Michels S, Lehmann D, Pieters RS, Becker M, Nelson BJ.

Intravitreal therapy is the most common treatment for many chronic
ophthalmic diseases, such as age-related macular degeneration. Due to the
increasing worldwide demand for intravitreal injections, there exists a
need to render this medical procedure more time- and cost-efficient while
increasing patient safety.

The authors propose a medical assistive device that injects medication
intravitreally. Compared to the manual intravitreal injection procedure,
an automated device has the potential to increase safety for patients,
decrease procedure times, allow for integrated data storage and
documentation, and reduce costs for medical staff and expensive operating
rooms.

This work demonstrates the development of an assistive injection system
that is coarsely positioned over the patient’s head by the human operator,
followed by automatic fine positioning and intravitreal injection through
the pars plana. Several safety features, such as continuous eye tracking
and iris recognition, have been implemented. The functioning system is
demonstrated through ex vivo experiments with porcine eyes.

[Ophthalmic Surg Lasers Imaging Retina. 2016;47:752-762.].

Copyright 2016, SLACK Incorporated.
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Corticosteroid injection for adhesive capsulitis in primary
care: a systematic review of randomised clinical trials
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27570870

Singapore Med J. 2016 Aug 29. Free Full Text PDF
Corticosteroid injection for adhesive capsulitis in primary care: a
systematic review of randomised clinical trials.

Koh KH1.

1SingHealth Polyclinics – Tampines, Singapore.

Adhesive capsulitis is a common cause of shoulder pain and limited
movement.

The objectives of this review are to assess the efficacy and safety of
corticosteroid injections for adhesive capsulitis and to evaluate the
optimum dose and anatomical site of injections. PubMed and CENTRAL
databases were searched for randomised trials and a total of ten trials
were included.

Results revealed that corticosteroid injection is superior to placebo and
physiotherapy in the short-term (up to 12 weeks).

There was no difference in outcomes between corticosteroid injection and
oral nonsteroidal anti-inflammatory drugs at 24 weeks.

Dosages of intra- articular triamcinolone at 20 mg and 40 mg showed
identical outcomes, while subacromial and glenohumeral corticosteroid
injections had similar efficacy.

The use of corticosteroid injection is also generally safe, with
infrequent and minor side effects. Physicians may consider corticosteroid
injection to treat adhesive capsulitis, especially in the early stages
where pain is the predominant presentation.

KEYWORDS: adhesive capsulitis; corticosteroids; frozen shoulder; injection

Free Full Text PDF
http://www.smj.org.sg/sites/default/files/RA-2015-276-epub.pdf
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Sixth Nerve Palsy Following Botulinum Toxin injection for
Facial Rejuvenation
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27558865

Cutan Ocul Toxicol. 2016 Aug 25:1-5.
Sixth Nerve Palsy Following Botulinum Toxin injection for Facial
Rejuvenation.

Dolar Bilge A1,2, Sadigov F3, Salar-Gomceli S4.

1a Emsey hospital, Ophthalmology , Camlik mahallesi , Istanbul, 34953
Turkey.
2b Ms, Dumankaya Gizlibahce evleri Selale sitesi B5 D3 , Turkey.
3c Medera Hospital, Ophthalmology , Azerbeijan , Bakü , Azerbaijan.
4d Bronx-Lebanon Hospital Center, Ophthalmology , Bronx, 10456-3499 United
States.

BACKGROUND: Botulinum toxin A (BTX) has been widely used for a variety of
facial aesthetic procedures within the last couple of decades. Efficacy
and safety of BTX for facial rejuvenation has been extensively studied in
multiple randomized prospective controlled trials.Focal weakness is
amongst the most commonly reported adverse effects. Adverse reactions tend
to occur most commonly due to errors in dosing formulation and errors with
the techniques of the application. No serious long term complications have
been reported.

MAIN OBSERVATION: We present the case of a 52 year old female presenting
with diplopia one week following the injection of BTX for facial
rejuvenation at glabella, forehead and crow’s feet areas.

CONCLUSIONS: Injection of BTX adjacent to periorbital area may be
associated with extra-ocular muscle paralysis.

KEYWORDS: Botulinum toxin; diplopia; sixth nerve palsy; strabismus
__________________________________________________________________
________________________________*_________________________________

9. No Abstract: Bare below the elbows: was the target the white coat?
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26364208

J Hosp Infect. 2015 Dec;91(4):299-301.
Bare below the elbows: was the target the white coat?

Tse G1, Withey S2, Yeo JM2, Chang C3, Burd A4.

1School of Medicine, Imperial College London, UK. Electronic address:
gary.tse@doctors.org.uk.
2School of Medicine, Imperial College London, UK.
3Department of Medicine, Queen Mary Hospital, University of Hong Kong,
Pokfulam Road, Hong Kong Special Administrative Region.
4Department of Regenerative Medicine and Translational Science, School of
Tropical Medicine, Kolkata, India.

Free Preview page 1 at https://tinyurl.com/h7pgr87
__________________________________________________________________
________________________________*_________________________________

10. News

– Oman: Oman generates 12 tonnes of medical waste daily: Averda

– West Virginia USA: New policy will allow Mid-Ohio Valley Health
Department to remove abandoned needles in W.Va

– Oman: Oman generates 12 tonnes of medical waste daily: Averda

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/z2da4cg
Oman: Oman generates 12 tonnes of medical waste daily: Averda

Zawya (Thomson Reuters), Muscat Daily, Muscat Oman (30.08.16)

Muscat – The number of hospitals around the country keeps growing, so does
the amount of medical waste generated. According to conservative estimates
about 12 tonnes of medical waste is generated in Oman every day.
The rapid growth in the healthcare industry has led to an increase in
waste generated which needs specialised attention from collection to
disposal as it is classified as hazardous.

Averda is the only company in Oman treating medical waste. It has two
facilities in Amerat and Liwa. Rajan Makkal, sales executive at Averda,
said, “Some 360 tonnes of medical waste is generated in a month in Oman
which is collected, transported, treated and disposed of from all
government-operated hospitals, public and private clinics and health
centres, under the supervision and guidance of Be’ah.”

Medical waste may include items that are contaminated with or suspected of
being contaminated with body fluids, blood or blood products, chemicals,
used catheters, gloves, needles, soiled dressings and medical devices that
can be loaded with viruses and bacteria. Makkal said, “Hospitals and
clinics are advised to segregate medical waste and keep it in special
yellow bins in the basement at a cool temperature.

“The waste is collected and burnt in the incinerator at 800°C in our
facility in Amerat. This produces fly ash, which significantly reduces
health risk for public. The waste is not dumped into landfills or burnt in
the open. The fly ash is stored as hazardous waste and it could be used in
chemicals or industrial products.”

He added, “We have 40 vehicles and a team of 120 people who collect
medical waste from around 590 clinics and nearly 300 hospitals in Muscat.
Our teams work 24×7 as the market is really big. The entire process is
risky and our workers are administered Hepatitis B vaccine as any
needlestick injury with contamination could be fatal.”

According to the latest WHO estimates, injuries from contaminated needles
could cause Hepatitis B, Hepatitis C and HIV infections. Makkal, who has
been in the industry for 15 years said, “The concept of medical waste was
new here before Averda came in 2006. There was a facility for government
hospitals but the private hospitals used to dump their waste into
landfills illegally which was extremely dangerous for people and the
environment. The amount of waste generated increases by 15 per cent
annually.

“On time collection of waste is a massive challenge for us as it can be
hazardous if kept for a longer time. “There are a few clinics or even
people who use insulin at home and dump the needles in general waste.
These could cause injuries to workers who are collecting waste. I would
request the people to dispose their medical waste at homes separately.
They can use small bins provided by us at homes. It will save the people
who serve us.”

© Muscat Daily 2016 © Copyright Zawya.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/hjght9x
West Virginia USA: New policy will allow Mid-Ohio Valley Health Department
to remove abandoned needles in W.Va

By Carrie Hodousek, West Virginia MetroNews, West Virginia USA (28.08.16)

PARKERSBURG, W.Va. — The Mid-Ohio Valley Health Department is working to
respond to the public’s concern about abandoned needles.

“All of them are contaminated with blood or could be contaminated with
blood and they’re all to be treated suspiciously. We just want to that
make sure people know there’s an avenue for removal for it,” said Carrie
Brainard, the department’s public information specialist.

On July 28, the MOVHD board passed a needle-syringe removal policy in
which sanitarians and other staff members will be taught how to safely and
properly dispose needles in the community.

Several calls have been coming in to MOVD with reports of used needles
being left in public places, private businesses and residential sites
where public harm could occur from contact, Brainard said.

“It is a public health issue and therefore, we should be responsible for
assisting with that,” she said. “We don’t want people just randomly
picking them up.”

Employee training workshops got underway last week at all six of the
MOVD’s offices in Calhoun, Pleasants, Ritchie, Roane, Wirt and Wood
counties.

Brainard said they also want to inform the public about basic universal
precautions and correct storage techniques.

“If they want to remove it themselves or they don’t want to wait for the
health department to get there — how to do it safely and properly,” she
said.

It’s unclear how many needles have actually been abandoned, so Brainard
said they’ll find out as they go along.

“We’re trying to promise the community that at the very least, within 24
hours, we will have it taken care of,” she said.

To learn more about the policy, visit MOVHD.com. http://www.movhd.com/
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/zz6rmvh
Indonesia: 1,500 children exposed to fake vaccines, minister says

By Marguerite Afra Sapiie, The Jakarta Post, Jakarta Indonesia (24.08.16)

Health Minister Nila Moeloek revealed on Wednesday that at least 1,500
children in Banten, Jakarta and West Java had been exposed to fake
vaccines.

[Photo] A health official from the Waelengga community health center
(Puskesmas) in Watunggene subdistrict, Kota Komba district, East Manggarai
regency, Flores, East Nusa Tenggara, prepares a polio vaccine for a baby
on the first day of national polio immunization week in March.
(thejakartapost.com/Markus Makur)

She said the data was from investigations conducted by a fake vaccine
investigation task force, which also included officers from the National
Police’s Criminal Investigation Department (Bareskrim).

The investigations were conducted in 14 hospitals and six clinics reported
for having received fake vaccines since 2014, she said.

Of the total, Nila said, 915 children were exposed to fake vaccines in
health facilities in Jakarta, followed by 374 children in West Java and
211 in Banten.

“After we obtained the data from Bareskrim, we carried out a verification
process in those health facilities based on the medical records and data
they provided to us,” Nila told journalists after a meeting with the House
of Representatives’ Commission IX overseeing health affairs.

The minister said 975 of the children who received fake vaccines had been
re-vaccinated, while parents of 303 children had refused re-vaccination.
The rest were not re-vaccinated for various reasons, such as their failure
to respond to re-vaccination calls or invitations. Some of them failed to
show up during vaccination schedules while others refused to have their
children re-vaccinated, saying there were no problems with their health.

Nila said parents should not worry about the authenticity of vaccines
their children had received. She said the government would provide
vaccines to children free of charge. (ebf)
__________________________________________________________________
________________________________*_________________________________

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
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