Blood-borne Illnesses Research Articles

ASAP: A pharmacy-level intervention to increase nonprescription syringe sales to reduce bloodborne illnesses

BackgroundPharmacy syringe sales are effective structural interventions to reduce bloodborne illnesses in populations, and are legal in all but two states. Yet evidence indicates reduced syringe sales in recent years. This study was designed as a feasibility test of an intervention to promote syringe sales by pharmacies in Arizona. MethodsA four-month pilot among three Arizona pharmacies measured feasibility and acceptability through monthly surveys to 18 enrolled pharmacy staff members. ResultsPharmacy staff reported increased ease of dispensing syringes across the study. Rankings of syringe dispensing as ‘easiest’ among 6 measured pharmacy practices increased from 38.9 % at baseline to 50.1 % post intervention module training, and to 83.3 % at pilot conclusion. The majority (72.2 %) of pharmacy staff agreed that intervention materials were easy to use. Over 70 % indicated that the intervention was influential in their “being more open to selling syringes without a prescription to someone who might use them for illicit drug use,” and 61.1 % reported that in the future, they were highly likely to dispense syringes to customers who would use them to inject drugs. A vast majority (92 %) reported being likely to dispense subsidized naloxone if available to their pharmacy at no cost. ConclusionsAn education-based intervention was found to be feasible and acceptable to pharmacy staff and had an observed impact on perceptions of ease and likelihood of dispensing syringes without a prescription to people who may use them to inject drugs.

Come back when you're infected: pharmacy access to sterile syringes in an Arizona Secret Shopper Study, 2023.

Pharmacies are critical healthcare partners in community efforts to eliminate bloodborne illnesses. Pharmacy sale of sterile syringes is central to this effort. A mixed methods "secret shopper" syringe purchase study was conducted in the fall of 2022 with 38 community pharmacies in Maricopa and Pima Counties, Arizona. Pharmacies were geomapped to within 2 miles of areas identified as having a potentially high volume of illicit drug commerce. Daytime venue sampling was used whereby separate investigators with lived/living drug use experience attempted to purchase syringes without a prescription. Investigator response when prompted for purchase rationale was "to protect myself from HIV and hepatitis C." A 24-item instrument measured sales outcome, pharmacy staff interaction (hostile/neutral/friendly), and the buyer's subjective experience. Only 24.6% (n = 28) of 114 purchase attempts across the 38 pharmacies resulted in syringe sale. Less than one quarter (21.1%) of pharmacies always sold, while 44.7% never sold. Independent and food store pharmacies tended not to sell syringes. There emerged distinct pharmacy staff interactions characterized by body language, customer query, normalization or othering response, response to purchase request and closure. Pharmacy discretion and pharmacy policy not to sell syringes without a prescription limited sterile syringe access. Investigators reported frequent and adverse emotional impact due to pharmacy staff negative and stigmatizing interactions. Pharmacies miss opportunities to advance efforts to eliminate bloodborne infections by stringent no-sale policy and discretion about syringe sale. State regulatory policy facilitating pharmacy syringe sales,limiting pharmacist discretion for syringe sales, and targetingpharmacy-staff level education may help advance the achievement of public health goals to eliminate bloodborne infections in Arizona.

Knowledge, attitude, and practices toward Hepatitis B infection among hemodialysis patients: A nationwide study in Jordan.

The Hepatitis B virus (HBV) is a prevalent blood-borne illness, posing a significant risk to hemodialysis patients particularly due to their potential immunosuppressed status. This study aimed to address HBV awareness among Jordanian hemodialysis patients, filling a gap in regional research. A descriptive cross-sectional study was conducted at a multicenter governmental hospital in Jordan, with 389 participants. Among them, 61.3% were male, and 80.7% were over 38 years old. While 34% demonstrated a high level of knowledge, Participants with a higher degree of education and those working in the medical field were more informed. Although most participants had an inadequate understanding of HBV symptoms and transmission, they maintained positive attitudes and engaged in infection preventative actions. Enhanced educational efforts are required to raise awareness among hemodialysis patients, and further research is needed to address any reluctance towards preventive practices and seeking treatment.

Nested-PCR based Detection of Hepatitis C Virus: Low-cost Strategy in Pakistan

One of the most common blood-borne illnesses is hepatitis C virus (HCV), Hepatitis C is referred to as the inflammation of the liver and caused by the HCV virus, HCV is estimated to cause 53000 fatalities per year over the world. The majority of HCV-infected patients are unaware of their infection. No vaccine is available for HCV although Interferon is used to treat HCV but effective only 20-38 %, but at present, only a minority of infected persons have been tested and are aware of their diagnosis. The expense of testing may play a substantial role in patients' ability to get rid of the hepatitis C virus (HCV). Costs in many low- and middle-income nations, including Pakistan, force the development of novel and economically advantageous testing methods. The major aim of this study is about the effective diagnostic procedure for detecting Hepatitis C in the samples obtained from Balochistan, for this purpose the samples were collected from the health organization BINUQ (Balochistan Institute of Nephrology and Urology Quetta). Twenty (20) HCV antibodies positive patients in the Molecular Laboratory Department of Biotechnology were processed and then subjected to RNA extraction. cDNA was synthesized by reverse transcriptase enzyme. cDNA was used for qualitative analysis of HCV-RNA through nested PCR. According to the study, 09 samples were detected as positive and 7 samples were HCV negative out of 16 patients’ samples. The findings of the present study show comparison of the price for HCV- RNA tests per sample from patients with hepatitis C at various labs. When compared to the other five PCR-based tests in the laboratory-conducted anti-HCV, HCV qualitative, quantitative, and genotyping tests, Shoukat Khanum laboratory reported the most expensive costs for HCV -RNA tests. Dow laboratory HCV-RNA test is comparatively lower than Shoukat Khanum laboratory, while reported lowest and most cost-effective test of Molecular Diagnostic laboratory for anti-HCV. So, our molecular tests for HCV- RNA detection and quantitation showed very good diagnostic and clinical performance over all five public health laboratories.

Transfusion Transmitted Infections: A Present-Day Danger for Pakistan.

Over 1.5 million units of blood are collected in Pakistan each year, with around 65% of this donation coming from replacement donors-relatives or close friends of the affected who willingly donate blood to support the patient. Although blood transfusion is a life-saving therapy, it also involves the danger of spreading blood-borne illnesses if not appropriately screened. It has been extensively discussed that the precise number of transfusion transmitted infections (TTIs) in the Pakistani population is still unclear, and the estimates reported by the Sindh Blood Transfusion Authority may be a major underestimation because of the country's lack of inexpensive and effective screening tests. Regular blood transfusions are the mainstay of treatment of patients with blood diseases such as thalassemia and anemia. They are also commonly used to handle acute injuries, surgery, bleeding, and birthing difficulties. However, the risk of getting a TTI results in an increased hesitancy among blood transfusion recipients. Hence, to reduce the occurrence of TTIs, effective and vigorous measures must be implemented.

The End of Exceptionalism or Exceptionalism by other Means? Unraveling the Contradictions of HIV/AIDS Governance in Canada

ABSTRACT How is HIV/AIDS both exceptional yet no longer worthy of a distinct state response? Reflecting on state efforts in Canada to normalize HIV/AIDS and fold it into a more integrated response to sexually transmitted infections and bloodborne illnesses, we examine how ‘end of HIV/AIDS exceptionalism’ narratives obscure the new ways in which state power is being deployed such that, at the level of bodies and community organizations, actors are still subjected to exceptional state surveillance and control. In spite of continued efforts to normalize HIV/AIDS and blunt the advocacy of AIDS organizations, we argue that state power has intensified in ways that suggest that HIV/AIDS is still exceptional after all.

Coronavirus Disease 2019: Corona Viruses and Blood Safety - A Review

The main aim of the study is to understand the current information of corona transmission and bloodsafety measures taken during handling blood safety products of corona infected patients.Coronaviruses arein the subfamily Ortho Coronaviridae of the Coronaviridae family.It is a type of viral virus that causesinflammation in your nose, sinus, or upper throat.Most coronaviruses are not harmful.The virus may resultfrom pneumonia, respiratory failure, septic shock, and death. Many complications of Coronavirus disease2019 (COVID 19) may result from a condition known as cytokine release syndrome or a cytokine storm.This study mainly aims at the awareness and perception of rural and urban people about covid-19 virus..Finding advance in blood safety to avoid blood contamination. It will help to provide a proper diagnosisof the disease and understand current information on coronavirus transmission and blood safety measuresduring the course of the infected patient’s blood safety procedures.To assess public health risks and therisk of occupationally acquired disease which may be associated with the management of infectious waste,understanding these factors is required.The storage, processing and examination of blood specimens fromCovid?19 patients must be carried out by qualified staff in suitably equipped laboratories, previously educatedon the technical and safety procedures.A blood-borne illness is a disease which can spread by blood andother body fluids contamination. Blood can contain various types of pathogens, mainly microorganisms likebacteria and parasites, and non-living infectious agents such as viruses. Through taking preventive steps inthe handling of blood products and storage of blood products for infection, contamination will be reducedand the public will not be affected.

Bridging the Gap between Theory, Practice, and Policy: A Decision-Making Process Based on Public Health Evidence Feasible in Multi-Stage Research on Biological Risk Factors in Poland.

Stakeholder input into the decision-making process when developing public health programs and policies is crucial. This article presents an innovative approach, involving online participation with a wide group of stakeholders located in different geographic locations for policy consensus. The results of the project have been used to propose assumptions regarding a strategy for preventing blood-borne diseases in Poland. The research was conducted iteratively using a multi-stage qualitative methodology to explore risk assessment involving blood-borne infections. The final output of the study is a list of key problems/challenges and potential solutions associated with medical and nonmedical services that are connected to the breakage of tissue continuity. Qualitative research is rare in risk assessment, as priority is generally given to statistical data and endpoints. In addition to policy preparation for blood-borne illnesses, the methodology employed in the study can also be used to successfully explore other areas of public health.

Current Perspectives on the Impact of Pre-Exposure Prophylaxis Stigma Regarding Men Who Have Sex with Men in the United States.

Pre-exposure prophylaxis or PrEP is a Food and Drug Administration approved human immunodeficiency virus (HIV) prevention tool that reduces the risk of infection by greater than 90%. While it does not provide protection against other sexually transmittable infections and blood-borne illnesses such as hepatitis C, syphilis, chlamydia, and gonorrhea, it is a highly effective in reducing the risk of transmission of HIV among men who have sex with men. Despite the success of PrEP, there remain barriers to PrEP uptake rooted in stigmatized perspectives shared by health professionals, patients, and community members. The insidious impact of stigma associated with HIV/AIDS has permeated throughout the LGBTQ+ community, healthcare system, society in general and to this day, continues to exacerbate structural and social determinants of health disparities amongst sexual and gender minorities. While the initial resistance to PrEP has abated over time, stigmatized perspectives regarding PrEP continue to impede those at greatest risk from benefiting from effective preventive care.

Syringe services programs and real-world research: An overview for pharmacists

ObjectiveTo review key arguments supporting and criticizing syringe services programs (SSPs). Data sourcesPeer-reviewed literature and publicly available documents. SummaryPharmacy organizations—including the American Pharmacists Association and the American Society of Health-System Pharmacists—have stated that pharmacists should support programs that supply sterile injection materials to persons who use injection drugs. SSPs may include needle exchanges or other programs that meet these aims. Pharmacists should know that observational public health research demonstrates that SSPs can lower the transmission of blood-borne illnesses, improve linkage to care for substance use disorders, reduce health care expenditures, and reduce drug overdoses. Concerns about SSPs and increases in syringe litter or crime have not been borne out by research. Despite these findings and the positions of professional organizations, contemporary research suggests that pharmacists may be reluctant to support SSPs and other programs that would increase supply of sterile injection supplies to their communities. ConclusionThe review of evidence in this commentary should help pharmacists better understand the evidence in favor of SSPs, the potential criticisms of SSPs, and the reasons that their profession is moving to support these programs.

Impacts of mandated data collection on syringe distribution programs in the United States

ObjectivesSyringe Distribution Programs (SDPs) are a well-proven public health response to the spread of HIV and other blood borne illnesses among people who inject drugs. Many SDPs in the United States are required to collect data from service users as a condition of either legal authorization to operate or as a condition of funding. We sought to describe the prevalence of such externally mandated data collection and impact on service delivery at syringe distribution programs (SDPs) in the United States via an online survey. MethodsOnline survey of SDPs in the US. Results63 SDPs participated. 95•2% collected data about individual service users, with 76•7% being mandated to do so by an external entity as a condition of legal authorization, and/or as a condition of funding. Only 21•7% of mandated respondents received any report back on how data was used. 60•0% reported that data collection acted as a barrier to providing syringes to people who use drugs due to service user fears about loss of anonymity and/or law enforcement. 33•3% reported that the computer literacy and language skills required to collect data meant otherwise appropriate members of the community could not he hired as staff or volunteers. ConclusionsData collection at SDPs may act as a barrier to service provision to populations at high risk for HIV and other blood born viruses, and place considerable logistic burdens on often under-resourced public health programs. Further, it is often unclear to SDPs what purpose their data is being put to. We argue that to be ethical, the purpose of data collection should be carefully considered and regularly reviewed to ensure data is being put to meaningful purpose which is commensurate with impacts on service delivery.

Harm Reduction: A Concept Analysis

Background Over the last 25 years, harm reduction has shifted to focus on public health and addressing the opioid crisis. Nurses working in addictions treatment utilize the principles of harm reduction to improve the health of clients. Aims Concept clarity assists healthcare providers to understand the applications and attributes of a concept. Method A concept analysis of harm reduction using the Rodgers (1989) method of evolutionary analysis was undertaken. A comprehensive review of the literature was conducted using CINAHL Plus and Social Work Abstracts. Findings The key attributes of harm reduction include safety, supplies, education, partnerships, and policy. Applications of harm reduction include needle exchange programs, supervised consumption sites, medication-assisted treatment, and increased access to take-home naloxone kits. The main antecedent to harm reduction is the presence of harm. Consequences explored include safer injection practices, decreased transmission of blood-borne illnesses, improved client relationships, and decreased overdose-related deaths. Stigma, health promotion, and pragmatism are the related concepts discussed. A model case is provided. Conclusion The principles of harm reduction are becoming increasingly popular as an inclusive and evidence-based nursing approach to addictions treatment and management. As using substances continues to shift and increase, harm reduction strategies must remain malleable and available in both the community and hospital settings to address the issue and decrease the associated healthcare costs. Future implications for nursing practice and research are provided.

CME: Postexposure Prophylaxis Following Needlestick Injuries and Non-Occupational Exposures

CME: Postexposure Prophylaxis Following Needlestick Injuries and Non-Occupational Exposures Abstract. Occupational exposures following needlestick injuries are far from being uncommon and require a standardised approach in counselling the respective healthcare worker. In addition, non-occupational exposures likewise cause consultations of A & E services. To inform the medical public on state of the art, postexposure prophylaxis following exposures that potentially carry a risk of infection with bloodborne illnesses (HBV, HCV, HIV), we summarized current policies. Special instances may require expert consultation, but will not be discussed here in detail as it would exceed the scope of our article.

The Occupational Health of Nurses in the Economic Community of West African States: A Review of the Literature.

Nurses provide the majority of health care in sub-Saharan Africa, which has high rates of Hepatitis B Virus (HBV) and human immunodeficiency virus (HIV). This systematic review used PRISMA methodology to synthesize the literature published between January 2008 and December 2018 examining the occupational health of nurses practicing in the Economic Community of West African States (ECOWAS). The United States' National Institute for Occupational Safety and Health's Hierarchy of Controls is used to frame the findings. This research was mostly conducted in Nigeria and Ghana and focused on administrative controls. Nurses practicing in ECOWAS are at high risk of acquiring a bloodborne illness due to inadequate engineering and administrative controls, as well as limited access to personal protective equipment (PPE). These findings indicate interventions to improve these controls would likely lower the occupational risks faced by nurses practicing in ECOWAS. Research in more countries in ECOWAS would likely find differences in occupational health practices in Nigeria and Ghana, which are relatively wealthy, and other countries in the region. This literature showed nurses practicing in ECOWAS did not have adequate protection from biological hazards. Regional health groups, such as the West African Health Organization, should commit to improving occupational health practice. Needle recapping and double gloving must be discontinued, and PPE must be made more widely available in ECOWAS. Occupational health professionals in the region should advocate for better distribution of PPE and consider offering trainings on these behaviors.

Occupational Hazards among Healthcare Workers in Africa: A Systematic Review.

Background:While all healthcare workers are exposed to occupational hazards, workers in sub-Saharan Africa have higher rates of occupational exposure to infectious diseases than workers in developed countries. Identifying prevalence and context of exposure to blood and bloodborne pathogens may help guide policies for prevention.Objective:This systematic review examined occupational exposure rates to blood and bloodborne pathogen among healthcare workers in sub-Saharan Africa.Methods:In November 2017, a comprehensive literature search was conducted to identify studies reporting exposure of health workers in African coutnries to blood and bodily fluids. Title, abstract and full text screening were used to narrow our search. Studies more than 10 years old, or published in non-English languages were excluded.Findings:Fifteen studies reported a variety of exposures. The lifetime prevalence of needlestick injury ranged from 22–95%, and one-year prevalence ranged from 39–91%. Studies included a range of descriptive statistics of knowledge, attitudes, practice and access factors related to exposures. Two studies reported 21–32% of respondents linked poor knowledge or training with prevention of needlestick injuries. Rates of recapping needles ranged from 12–57% in four studies. Attitudes were generally positive toward occupational safety procedures while access was poor.Conclusions:The high burden of blood and bloodborne pathogen exposures demonstrated here indicates a high risk for contracting bloodborne illnesses. Although the data are sparse, implementation of preventative policies based on current knowledge remains critical to minimize risk and reduce exposure. There remains a pressing need for high quality data on occupational hazards to identify the burden of exposures and inform preventive policies in Sub-Saharan Africa. Additional studies are needed to determine whether differential exposures exist between professions and the associations with knowledge, attitudes, practices, and access factors to create targeted strategies to diminish occupational hazards.

Reduced Bias for Respondent-Driven Sampling: Accounting for Non-Uniform Edge Sampling Probabilities in People Who Inject Drugs in Mauritius

Summary People who inject drugs are an important population to study to reduce transmission of blood-borne illnesses including human immunodeficiency virus and hepatitis. We estimate the human immunodeficiency virus and hepatitis C prevalence among people who inject drugs in Mauritius. Respondent-driven sampling (RDS), which is a widely adopted link tracing sampling design used to collect samples from hard-to-reach human populations, was used to collect this sample. The random-walk approximation underlying many common RDS estimators assumes that each social relationship (edge) in the underlying social network has an equal probability of being traced in the collection of the sample. This assumption does not hold in practice. We show that certain RDS estimators are sensitive to the violation of this assumption. To address this limitation in current methodology, and the effect that it may have on prevalence estimates, we present a new method for improving RDS prevalence estimators using estimated edge inclusion probabilities, and we apply this to data from Mauritius.

The State of Needlestick Training for Undergraduate Medical Students at Canadian Universities.

Canadian undergraduate medical students sustain needlestick injuries, which have adverse implications, including blood-borne illnesses and personal anxiety. This study sought to determine students' needle handling efficacy and to examine the prevalence of formal training around needlestick safety and reporting procedures both nationally and, specifically, within the University of Toronto in Toronto, Ontario (U of T). A seven-question survey electronic survey was distributed to 116 undergraduate medical education (UME) leaders practising in high-risk rotations at 13 Canadian universities. Additionally, an eight-question survey was delivered electronically to 428 residents, fellows, and faculty in the Department of Obstetrics and Gynaecology at the U of T. A total of 34% of UME leaders and 36% from the U of T responded. Of UME respondents, 53% reported that their institution lacks needlestick training, and 35% were unsure whether their institution provides reporting instruction. At the U of T, 53% were "concerned" or "very concerned" that students pose a risk to themselves, and 27% "disagreed" or "strongly disagreed" that students handle instruments correctly. Our findings suggest that needlestick safety training for medical students across Canadian universities is insufficient. It is concerning that students are frequently exposed to patients in high-risk and surgically intensive rotations, despite their inexperience with needles. Furthermore, non-reporting among students may prevent them from receiving early prophylaxis or treatment. There is a need for the national implementation of a standardized and formalized needlestick safety curriculum for medical students before and during clerkship.

Gauging Needlestick Safety in Undergraduate Medical Education: a Canadian Survey

Objectives: A concerning proportion of undergraduate medical students sustain needlestick injuries, which have adverse implications, including anxiety and bloodborne illnesses. However, there is lack of data in the literature on needlestick safety at Canadian medical schools. Therefore, our study sought to determine the prevalence of formal training for undergraduate medical students around safe needle handling, suturing, and protocols for reporting needlestick injuries to Occupational Health across Canadian medical schools.

Careful, Clerks! a Survey of Needlestick Safety in OB/GYN at the University of Toronto

Objectives: Needlestick injuries among undergraduate medical students are exceedingly common and present a serious cause for concern among educators, particularly due to the adverse implications of these injuries, including anxiety and bloodborne illnesses. Our study seeks to determine students' needle handling efficacy, and examine the prevalence of formal training around needlestick safety and reporting procedures within the Obstetrics and Gynaecology (Ob/Gyn) rotation at the University of Toronto (UofT).

The impact of occupational splash, sharps and needlestick injuries (SSNIs) on the quality of life of healthcare workers in a Kenyan university hospital.

Infection as a consequence of splash sharps and needlestick injuries (SSNIs) is a hazard faced by healthcare workers. Little is known about the impact this has on quality of life particularly in countries where the risk of infection is high. This study aims to describe the impact SSNIs have on the quality of life of healthcare workers in Kenya, where blood borne illness prevalence is high. A hospital-wide survey of a facility in Nairobi was conducted. Data was collected online from at risk healthcare workers using Burckhardt and Anderson's Quality of Life Scale (QOLS) and a 10-item symptoms questionnaire. Of the 416 participants, 192 (46.2%) had experienced SSNIs. Their mean QOLS scores were considerably lower than that predicted for a healthy population. The relationship between symptoms and QOLS scores showed a strong positive correlation (Pearson's r = 0.753). Tests of association between QOLS scores and SSNI type, anti-retroviral (ARV) drug use, educational level and staff cadre revealed significant association (p < 0.05). However, on key demographic variables, the association was non-dependent, indicating that the impact was felt similarly by many staff. SSNIs clearly impact on healthcare workers quality of life. Hospital management should ensure measures are taken to reduce SSNIs and provide appropriate personal protection equipment. For staff experiencing an SSNI, psychological wellbeing should be assessed and appropriate expert help provided.