Hostname: page-component-84b7d79bbc-4hvwz Total loading time: 0 Render date: 2024-08-05T06:19:25.233Z Has data issue: false hasContentIssue false

Nosocomial Transmission of HIV in Africa: What Tribute Is Paid to Contaminated Blood Transfusions and Medical Injections?

Published online by Cambridge University Press:  21 June 2016

Philippe Lepage*
Affiliation:
Department of Pediatrics, Centre Hospitalier de Kigali, Kigali, Rwanda; and AIDS Project, Belgian-Rwandese Medical Cooperation, Kigali, Rwanda
Philippe Van de Perre
Affiliation:
Department of Pediatrics, Centre Hospitalier de Kigali, Kigali, Rwanda; and AIDS Project, Belgian-Rwandese Medical Cooperation, Kigali, Rwanda
*
BP 1608, Kigali, Rwanda

Abstract

We reviewed the published data on the possible impact of medical injections and blood transfusions on the spread of human immunodeficiency virus (HIV) in Africa. We also compared these results to our experience in Rwanda, central Africa. The importance of medical injections in the epidemic of HIV infection seems to differ from one area to another. The excess of injections experienced by HIV seropositive subjects in Zaire could be secondary to the parenteral treatment of early HIV-related illness or to the treatment of sexually transmitted diseases, rather than being the cause of HIV infection, as suggested by Rwandese studies. In contrast, blood transfusions have been shown to represent an important source of nosocomial HIV infection in many African countries. Effective and relatively inexpensive measures to diminish the iatrogenic spread of HIV infection in developing countries are summarized.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1988

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Van de Perre, P, Rouvroy, D, Lepage, P. et al: Acquired immunodeficiency syndrome in Rwanda. Lancet 1984; ii;6265.CrossRefGoogle Scholar
2. Piot, P, Quinn 1%. Taelman, H, et al: Acquired immunodeficiency syndrome in a heterosexual population in Zaire. Lance/ 1984; ii;6569.CrossRefGoogle Scholar
3. Bayley, AC, Downing, RG, Cheinsong-Pope, \* R., et al: HTLV-III serology distinguishes atypical and endemic Kaposi's sarcoma in Africa. Lancet 1985; ii;359361.CrossRefGoogle Scholar
4. Serwadda, D, Mugerwa, RD, Sewankambo, NK, et al: Slimdisease: A new disease in Uganda and its association with HTLV-III infection. Lancet 1985; ii:849852.CrossRefGoogle Scholar
5. Kreiss, JK, Koech, D, Plummer, FA, et al: AIDS virus in Nairobi prostitutes. Spread of the epidemic to East Africa. N Engl J Med 1986; 314:414418.CrossRefGoogle ScholarPubMed
6. Mann, JM, Francis, H, Quinn, TC. et al: Surveillance for AIDS in a central African city. Kinshasa, Zaire. JAMA 1986; 255:32553259.CrossRefGoogle Scholar
7. Denis, F, Barin, F, Gershy-Damet, G, et al: Prevalence of human T-cell lymphotropic vit uses tvpe III (HIV) and type IV in Ivory Coast. Lancet 1987; i:408411.CrossRefGoogle Scholar
8. Clumeck, N, Van de Perre, P, Caraël, M, et al: Heterosexual promiscuity in African patients with AIDS. N Engl J Med 1985; 313:182.Google Scholar
9. Van de Perre, P, Clumeck, N, Caraël, M, et al: Female prostitutes: A risk group for infection with human T-cell lymphotropic virus type III. Lancet 1985: ii:524527.CrossRefGoogle Scholar
10. Mann, JM, Francis, H, Davachi, F, et al: Risk factors for human immunodeficiency virus seropositivity among children 1 to 24 months old in Kinshasa, Zaire. Lancet 1986; ii:654657.CrossRefGoogle Scholar
1 I. Lepage, P, Van de Perre, P, Carael, M, et al: Are medical injections a risk factor tor HIV infection in children? Lancet 1986: ii: 11031104.CrossRefGoogle Scholar
12. Update. Acquired immunodeficiency syndrome-United States. MMWR 1986; 35:1721.Google Scholar
13. Hirsch, MS, Worsmer, GP, Schooley, RT, et al: Risk of nosocomial infection with human T-cell lymphotropic virus III. N Engl J Med 1985: 312:14.CrossRefGoogle ScholarPubMed
14. Weiss, SH. Saxinger, C, Rechtmau, D, et al: HTLV-III infection among health care workers. Association with needlestick injuries. JAM. 4 1985; 254:20892093.CrossRefGoogle Scholar
15. McCray, E, The Cooperative Needlestick Surveillance Group: Occupational risk of the acquired immunodeficiency syndrome among health-c-are worker/. N Engl J Med 1986; 314:11271132.CrossRefGoogle Scholar
16. Henderson, DK, Saah, AJ. Zak, BJ, et al: Risk of nosocomial infection with human T-cell lymphotropic virus type Ill/lymphadenopathy associated virus in a large cohort of intensively exposed health-c-are workers. Ann Intern Med 1986: 104:644647.CrossRefGoogle Scholar
17. Gerberding, JL, Bryant Leblanc, CE, Nelson, K, et al: Risk of transmitting the human immunodeficiency virus, hepatitis B virus, and cytomegalovirus to health-care workers exposed to patients with AIDS or AIDS-related conditions. J Infect Dis 1987; 156: 18.CrossRefGoogle ScholarPubMed
18. McEvoy, M, Porter, K, Mortimer, P, et al: Prospective study of clinical, laboratory, and ancillary staff with accidental exposures to blood or body fluids from patients infected with HIV. Brit Med J 1987; 294:15951597.CrossRefGoogle ScholarPubMed
19. Recommendations for preventing transmission of infection with human I-lymphotropic virus type Ill/lymphadenopathy-associated virus in the work place. MMWR 1985: 34:682695.Google Scholar
20. Editorial Needlestick transmission of HTLV-III from a patient infected in Africa, editorial. Lancet 1984; ii: 13761377.Google Scholar
21. Stricof, RL, Morse, DL: HTLV-III/LAV seroconversion following a deep intramuscular needlestick injury. N Engl J Med 1986; 314:1115.Google ScholarPubMed
22. Veison-Vernant, C, Arfi, S, Mathez, D, et al: Needlestick HIV seroconversion in a nurse. Lancet 1986; ii:814.CrossRefGoogle Scholar
23. Van de Perre, P. Carael, M, Nzaramba, D, et al: Risk factors for human immunodeficiency virus seropositivity in selected urban-based Rwandese adult/. AIDS 1Y87; 1:207211.Google Scholar
24. Sandström, EG, Schooley, RT, Ho, DD, et al: Detection of anti-HTLV-III antibodies by indirect immunofluorescence using fixed cells. Transfusion 1985; 25:308312.CrossRefGoogle ScholarPubMed
25. Sarngadharan, MG, Popovic, M, Bruch, L. et al: Antibodiesreactive with human T lymphotropic viruses (HTLV-III) in the serum of patients with AIDS. Science 1984; 224:506508.CrossRefGoogle Scholar
26. Mann, JM, Francis, H, Quinn, TC. et al: HIV seroprevalence among hospital workers in Kinshasa, Zaire. JAMA 1986; 256:30993102.CrossRefGoogle ScholarPubMed
27. Quinn, TC, Mann, JM, Curran, JW, et al: AIDS in Africa: An epidemiologic paradigm. Science 1986; 234:955963.CrossRefGoogle ScholarPubMed
28. Mann, JM, Francis, H. Davachi, F, et al: Human immunodeficiency virus seroprevalence in pediatric patients 2 to 14 years of age at Mama Ye mo Hospital, Kinshasa, Zaire. Pediatrics 1986; 78:673677.CrossRefGoogle Scholar
29. Curran, JW, Lawrence, DN. Jaffe, H, et al: Acquired immunodeficiency syndrome (AIDS) associated with transfusion. N Engl J Med 1984; 310:6975.CrossRefGoogle Scholar
30. Van de Perre, P. Munyambuga, D, Zissis, G, et al: Antibodies to HTLV-III in blood donors in central Africa. Lancet 1985; i;336337.CrossRefGoogle Scholar
31. AIDS-A public health crisis. Population Reports 1986; 14:193228.Google Scholar
32. Melbye, M, Njelesani, EK, Bayley, A, et al: Evidence for heterosexual transmission and clinical manifestations of human immunodeficiency virus infection and related conditions in Lusaka, Zambia. Lancet 1986; ii:11131115.CrossRefGoogle Scholar
33. Spire, B. Dormont, D, Barré-Sinoussi, F. et al: Inactivation of lymphadenopathy associated virus by heat, gamma rays, and ultraviolet light. Lancet 1985: i:188189.CrossRefGoogle Scholar
34. Martin, LS, McDougal, JS. Lokoski, SL: Disinfection and inactivation of the human T lymphotropic virus, type III/lymphadenopathy-associated virus. J Infect Dis 1985; 152:400403.CrossRefGoogle Scholar
35. Michel, JM: Why do people like medicines? A perspective from Africa. Lancet 1985; i:210211.CrossRefGoogle Scholar