Injection practices in southern part of India

The World Health Organization defines 'a safe injection' as one that does not harm the recipient, does not expose the provider to any avoidable risk, and does not result in any waste that is dangerous to the community. Irrational and unsafe injection practices are rife in developing countries. The objective of the present study was to assess the injection practices in the state of Tamilnadu, India, using the Rapid assessment and response guide of the Safe Injection Global Network of the World Health Organization. Thirty-nine prescribers, 62 providers, and 175 members of the general public were interviewed. The areas were chosen out of convenience while at the same time adhering to the guidelines. The study was carried out between April and June 2001. The per capita injection rate was 2.4 per year. The ratio of therapeutic to immunization injections was 6.5:1, and the proportion of injections given with a disposable syringe and needle was 35.4%. Knowledge about diseases transmitted by unsafe injections, for example involving human immunodeficiency virus and hepatitis B virus, was greater among all the study groups. The annual incidence of needlestick injuries among providers was 23.6, which is extremely high. It is concluded that there are deficiencies in practice such as an excessive, unwarranted usage of injections, a sizeable prevalence of unsafe injection practices, the short supply of injection equipment leading to a high incidence of needlestick injuries, a low proportion of hepatitis B virus immunization among providers, and a lack of adequate sharps containers and disposal facilities in this part of India. It is suggested that immediate and long-term remedial measures, such as the education of prescribers to reduce the number of injections to a bare minimum, an adequate supply of injection equipment, provider protection with immunization for hepatitis B virus, the provision of adequate sharps containers with safe disposal facilities and, not least, community education, be undertaken to avoid the future epidemic of transmissible diseases.