Report: Medical injections linked to new HIV infections in Kenya

By GATONYE GATHURA

NAIROBI, KENYA: A significant number of Kenyans are getting HIV infections from contaminated medical injections, according to a new insight into the Kenya Aids Indicator Survey.

In a rare public admission, a report for the May issue of the Journal of Acquired Immune Deficiency Syndromes says a number of new HIV infections in Kenya are from injections either self-administered or from health facilities and traditional healers.

“In 2008, it was estimated that 2.2 per cent of new HIV infections in Kenya were a result of unsafe injections received in health facilities,” says the special supplement of the detailed analysis of the Kenya Aids Indicator Survey, 2012.

Since then, the report says, more people, including those who are HIV-positive, are receiving injections in all types of health facilities, creating serious problems of coping for the medical systems.

An initiative of the Kenya Government and US agencies, this particular study was led by Dr Daniel Kimani of the Centre for Disease Control and Prevention, supported by a team from the Ministry of Health and the National Public Health Laboratory Services.

The study, carried out from October 2012 to February last year, says the problem is pegged on several factors such as a love among Kenyans for the needle against a pill, poor disposal of used medical waste and a high number of injections for people who are also HIV positive. The other problem is the possible reuse of needles by medical workers and especially traditional practitioners.

A total of 13,720 adults and adolescents aged 15–64 participated in the survey and one out of 15 reported having seen a used syringe or needle near their home or in their community in the past 12 months.

The authors demonstrate a high possibility that such a needle or syringe could be contaminated with the Aids-causing virus. They confirmed that more people who were injected in the last 12 months leading to the study period were more likely to have been HIV positive compared to people who never received an injection in the same period.

This follows the logic that most people with HIV are more likely to have more health problems than others and consequently most likely to visit a hospital.

“At the same time high HIV prevalence was noted among persons who had received injections from traditional practitioners,” reveals the report. Apart from the danger of the reuse of such an injection, the study concludes there is a real risk of poor disposal of needles particularly in urban estates. “This has led to increases in risk of injury to community members, especially children and domestic waste handlers.”

PREVIOUSLY MARRIED

The paper, one of the 16 reports in the final analysis of the KAIS 2012, and to be published in a sponsored section of the international journal in May, says women more than men receive medical injections. This is true even when family planning injections are excluded.

Such a woman, says the report, is most likely married or previously married, with higher wealth and education, and a resident of Nyanza and Western regions.

Given a choice, the team says, half of Kenyan adults and adolescents prefer an injection to a pill for medication. “This preference can influence injection use, which could potentially lead to unnecessary and unsafe injections.”

Women were found to be more likely than men to prefer injections to pills and accounted for 70 per cent of medical injections administered, with at least 40 per cent for contraceptive purposes.

Because of the huge use of injectable contraceptives among women, the team recommends that the national reproductive health programme integrate injection safety practices in reproductive health services. Fearing that unsafe injections and their poor disposal could be contributing to unintended infections the Ministry of Health a few years ago mounted a campaign to persuade Kenyans to abandon their love for injections in favour of pills and other oral medications. In 2000, it was estimated that unsafe medical injections led to 260,000 HIV infections, two million hepatitis C infections, and 21 million hepatitis B virus infections globally.