Model-based estimates of risks of disease transmission and economic costs of seven injection devices in sub-Saharan Africa
OBJECTIVE: To investigate and compare seven types of injection devices for their risks of iatrogenic transmission of bloodborne pathogens and their economic costs in sub-Saharan Africa. METHODS: Risk assumptions for each device and cost models were constructed to estimate the number of new hepatitis...
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| Format: | Article |
| Language: | English |
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The World Health Organization
2002-01-01
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| Series: | Bulletin of the World Health Organization |
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| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862002001100005 |
| _version_ | 1827333888543817728 |
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| author | Ekwueme Donatus U. Weniger Bruce G. Chen Robert T. |
| author_facet | Ekwueme Donatus U. Weniger Bruce G. Chen Robert T. |
| author_sort | Ekwueme Donatus U. |
| collection | DOAJ |
| description | OBJECTIVE: To investigate and compare seven types of injection devices for their risks of iatrogenic transmission of bloodborne pathogens and their economic costs in sub-Saharan Africa. METHODS: Risk assumptions for each device and cost models were constructed to estimate the number of new hepatitis B virus (HBV) and human immunodeficiency virus (HIV) infections resulting from patient-to-patient, patient-to-health care worker, and patient-to-community transmission. Costs of device purchase and usage were derived from the literature, while costs of direct medical care and lost productivity from HBV and HIV disease were based on data collected in 1999 in Côte d'Ivoire, Ghana, and Uganda. Multivariate sensitivity analyses using Monte Carlo simulation characterized uncertainties in model parameters. Costs were summed from both the societal and health care system payer's perspectives. FINDINGS: Resterilizable and disposable needles and syringes had the highest overall costs for device purchase, usage, and iatrogenic disease: median US$ 26.77 and US$ 25.29, respectively, per injection from the societal perspective. Disposable-cartridge jet injectors and automatic needle-shielding syringes had the lowest costs, US$ 0.36 and US$ 0.80, respectively. Reusable-nozzle jet injectors and auto-disable needle and syringes were intermediate, at US$ 0.80 and US$ 0.91, respectively, per injection. CONCLUSION: Despite their nominal purchase and usage costs, conventional needles and syringes carry a hidden but huge burden of iatrogenic disease. Alternative injection devices for the millions of injections administered annually in sub-Saharan Africa would be of value and should be considered by policy-makers in procurement decisions. |
| first_indexed | 2024-03-07T17:39:06Z |
| format | Article |
| id | doaj.art-875665f6f9f1439b840b598b3a42e4f5 |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T17:39:06Z |
| publishDate | 2002-01-01 |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-875665f6f9f1439b840b598b3a42e4f52024-03-02T16:13:37ZengThe World Health OrganizationBulletin of the World Health Organization0042-96862002-01-018011859870Model-based estimates of risks of disease transmission and economic costs of seven injection devices in sub-Saharan AfricaEkwueme Donatus U.Weniger Bruce G.Chen Robert T.OBJECTIVE: To investigate and compare seven types of injection devices for their risks of iatrogenic transmission of bloodborne pathogens and their economic costs in sub-Saharan Africa. METHODS: Risk assumptions for each device and cost models were constructed to estimate the number of new hepatitis B virus (HBV) and human immunodeficiency virus (HIV) infections resulting from patient-to-patient, patient-to-health care worker, and patient-to-community transmission. Costs of device purchase and usage were derived from the literature, while costs of direct medical care and lost productivity from HBV and HIV disease were based on data collected in 1999 in Côte d'Ivoire, Ghana, and Uganda. Multivariate sensitivity analyses using Monte Carlo simulation characterized uncertainties in model parameters. Costs were summed from both the societal and health care system payer's perspectives. FINDINGS: Resterilizable and disposable needles and syringes had the highest overall costs for device purchase, usage, and iatrogenic disease: median US$ 26.77 and US$ 25.29, respectively, per injection from the societal perspective. Disposable-cartridge jet injectors and automatic needle-shielding syringes had the lowest costs, US$ 0.36 and US$ 0.80, respectively. Reusable-nozzle jet injectors and auto-disable needle and syringes were intermediate, at US$ 0.80 and US$ 0.91, respectively, per injection. CONCLUSION: Despite their nominal purchase and usage costs, conventional needles and syringes carry a hidden but huge burden of iatrogenic disease. Alternative injection devices for the millions of injections administered annually in sub-Saharan Africa would be of value and should be considered by policy-makers in procurement decisions.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862002001100005Disease transmissionIatrogenic disease/epidemiologyInjections/instrumentationInjections/economicsNeedles/adverse effectsNeedles/economicsSyringes/adverse effectsSyringes/economicsInjections, JetHepatitis B/transmissionHIV infections/transmissionRisk factorsCosts and cost analysisModels, TheoreticalAfrica South of the Sahara |
| spellingShingle | Ekwueme Donatus U. Weniger Bruce G. Chen Robert T. Model-based estimates of risks of disease transmission and economic costs of seven injection devices in sub-Saharan Africa Bulletin of the World Health Organization Disease transmission Iatrogenic disease/epidemiology Injections/instrumentation Injections/economics Needles/adverse effects Needles/economics Syringes/adverse effects Syringes/economics Injections, Jet Hepatitis B/transmission HIV infections/transmission Risk factors Costs and cost analysis Models, Theoretical Africa South of the Sahara |
| title | Model-based estimates of risks of disease transmission and economic costs of seven injection devices in sub-Saharan Africa |
| title_full | Model-based estimates of risks of disease transmission and economic costs of seven injection devices in sub-Saharan Africa |
| title_fullStr | Model-based estimates of risks of disease transmission and economic costs of seven injection devices in sub-Saharan Africa |
| title_full_unstemmed | Model-based estimates of risks of disease transmission and economic costs of seven injection devices in sub-Saharan Africa |
| title_short | Model-based estimates of risks of disease transmission and economic costs of seven injection devices in sub-Saharan Africa |
| title_sort | model based estimates of risks of disease transmission and economic costs of seven injection devices in sub saharan africa |
| topic | Disease transmission Iatrogenic disease/epidemiology Injections/instrumentation Injections/economics Needles/adverse effects Needles/economics Syringes/adverse effects Syringes/economics Injections, Jet Hepatitis B/transmission HIV infections/transmission Risk factors Costs and cost analysis Models, Theoretical Africa South of the Sahara |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862002001100005 |
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