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Estimating the Burden of Disease from Unsafe Injections in India: A Cost–benefit Assessment of the Auto-disable Syringe in a Country with Low Blood-borne Virus Prevalence

BACKGROUND: Unsafe medical injections are a prevalent risk factor for viral hepatitis and HIV in India. OBJECTIVES: This review undertakes a cost–benefit assessment of the auto-disable syringe, now being introduced to prevent the spread of hepatitis B virus, hepatitis C virus, and human immunodefici...

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Detalles Bibliográficos
Autor principal: Reid, Savanna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3361807/
https://www.ncbi.nlm.nih.gov/pubmed/22654281
http://dx.doi.org/10.4103/0970-0218.96093
Descripción
Sumario:BACKGROUND: Unsafe medical injections are a prevalent risk factor for viral hepatitis and HIV in India. OBJECTIVES: This review undertakes a cost–benefit assessment of the auto-disable syringe, now being introduced to prevent the spread of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus (HIV). MATERIALS AND METHODS: The World Health Organization methods for modeling the global burden of disease from unsafe medical injections are reproduced, correcting for the concentrated structure of the HIV epidemic in India. A systematic review of risk factor analyses in India that investigate injection risks is used in the uncertainty analysis. RESULTS: The median population attributable fraction for hepatitis B carriage associated with recent injections is 46%, the median fraction of hepatitis C infections attributed to unsafe medical injections is 38%, and the median fraction of incident HIV infections attributed to medical injections is 12% in India. The modeled incidence of blood-borne viruses suggests that introducing the auto-disable syringe will impose an incremental cost of $46–48 per disability adjusted life year (DALY) averted. The epidemiological evidence suggests that the incremental cost of introducing the auto-disable syringe for all medical injections is between $39 and $79 per DALY averted. CONCLUSIONS: The auto-disable syringe is a cost-effective alternative to the reuse of syringes in a country with low prevalence of blood-borne viruses.