The global burden of disease attributable to contaminated injections given in health care settings
The global burden of disease attributable to contaminated injections given in health care settings
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DOI：
10.1258/095646204322637182
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发表时间：
2004-01-01
影响因子：
1.4
通讯作者：
Hutin, YJF
中科院分区：
文献类型：
--
作者：
Hauri, AM;Armstrong, GL;Hutin, YJF
作为2000年全球疾病负担研究的一部分，我们量化了注射相关感染乙肝病毒(乙肝病毒)、丙型肝炎病毒(丙型肝炎病毒)和人类免疫缺陷病毒(艾滋病毒)造成的死亡和残疾。我们根据每年的注射次数、使用重复使用的设备注射的比例、经皮接触后传播的可能性、活动性感染的流行率、免疫力的流行率和总的发病率来模拟2000年因健康护理注射而发生的感染的比率。使用自然病史参数、背景死亡率、病程、伤残权重、年龄权重和3%的贴现率，将2000年的感染换算成20002030年的伤残调整寿命年。四个全球疾病负担地区被排除在分析之外，这些地区在没有消毒的情况下重复使用注射设备的情况可以忽略不计。在其余10个地区，2000年，人们平均每年接受3.4次注射，其中39.3%是通过重复使用的设备注射的。2000年，受污染的注射估计造成2100万人感染乙肝病毒、200万人感染丙型肝炎病毒和26万人感染艾滋病毒，分别占新感染人数的32%、40%和5%，在2000至2030年间造成了9177,679个DALY的负担。注射过度和不安全的做法在全世界造成了巨大的死亡和残疾负担。在做法欠佳的国家，需要制定安全和适当使用注射的政策和计划。
As part of the 2000 Global Burden of Disease study, we quantified the death and disability from injection-associated infections with hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). We modelled the fraction of incident infections attributable to health care injections in the year 2000 on the basis of the annual number of injections, the proportion of injections administered with reused equipment, the probability of transmission following percutaneous exposure, the prevalence of active infection, the prevalence of immunity and the total incidence. Infections in 2000 were converted into disability-adjusted life years (DALYs) in 20002030 using natural history parameters, background mortality, duration of disease, disability weights, age weights and a 3% discount rate. Four Global Burden of Disease regions where reuse of injection equipment in the absence of sterilization was negligible were excluded from the analysis. In the remaining 10 regions, in 2000, persons received an average of 3.4 injections per year, 39.3% of which were given with reused equipment. In 2000, contaminated injections caused an estimated 21 million HBV infections, two million HCV infections and 260,000 HIV infections, accounting for 32%, 40% and 5%, respectively, of new infections for a burden of 9,177,679 DALYs between 2000 and 2030. Injection overuse and unsafe practices account for a substantial burden of death and disability worldwide. There is a need for policies and plans for the safe and appropriate use of injections in countries where practices are poor.