Related Experiment Videos
Risk factors for HIV infection among abandoned Romanian children
B S Hersh1, F Popovici, Z Jezek
1Centers for Disease Control and Prevention, Division of HIV/AIDS, Atlanta, Georgia.
Insights
Indiscriminate injections with contaminated needles and syringes in a Romanian orphanage led to human immunodeficiency virus (HIV) transmission among children. This study identified reuse of unsterilized equipment as a significant risk factor for HIV infection in this vulnerable population.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Abandoned infants and children in public institutions are a vulnerable population.
- Understanding transmission routes of infectious diseases like HIV is crucial for public health interventions.
Purpose of the Study:
- To identify risk factors for human immunodeficiency virus (HIV) infection in abandoned Romanian infants and children.
- To investigate the role of medical practices in HIV transmission within an orphanage setting.
Main Methods:
- A cross-sectional study of 101 children (aged 0-4 years) in a Romanian orphanage.
- Case-control study comparing HIV-positive and HIV-negative children, analyzing medical records and serologic testing for HIV and Hepatitis B.
- Review of sterilization records and interviews with healthcare workers regarding injection practices.
Main Results:
- 20% of children were HIV-positive.
- HIV-positive children received significantly more therapeutic injections (mean 280 vs. 142) compared to HIV-negative children.
- Reuse of needles and syringes without proper disinfection was identified as the likely cause of HIV transmission, excluding blood transfusions and mother-to-child transmission.
Conclusions:
- Indiscriminate injections using contaminated needles and syringes are strongly implicated as the cause of HIV transmission in this population.
- Findings highlight the critical importance of sterile medical equipment and safe injection practices in institutional settings to prevent disease spread.
Objective:
To determine risk factors for HIV infection among abandoned Romanian infants and children living in a public institution.
Methods:
A cross-sectional study was conducted in June 1990 among 101 children between 0 and 4 years of age living in an orphanage. Orphanage and hospital records were reviewed and a blood specimen for hepatitis B and HIV serologic testing obtained from each child. A case-control study was conducted using data from the cross-sectional study. Cases were HIV-positive children; one HIV-negative control, matched by age, was selected for each case.
Results:
Overall, 20 (20%) children were HIV-positive, 88 (87%) tested positive for antibody to hepatitis B core antigen, and 32 (32%) were hepatitis B surface antigen-positive. In the case-control study, HIV-positive children had received more therapeutic injections [mean, 280; median, 231] than age-matched HIV-negative children [mean; 142, median, 155; P = 0.02]. Cases were more likely than controls to have received over 200 lifetime injections (odds ratio, 5.7; 95% confidence interval, 1.2-32.7). Blood transfusions and mother-to-child transmission were excluded as routes of HIV transmission. By reviewing sterilization records and interviewing local health-care workers, we determined that needles and syringes were often re-used without proper disinfection in the orphanage.
Conclusions:
These data provide strong epidemiologic evidence that indiscriminate injections with contaminated needles and syringes were responsible for HIV transmission in this population.