[Intramuscular injections in Sub-saharan African children, apropos of a frequently misunderstood pathology: the complications related to intramuscular quinine injections].
In West Africa, the incidence of poliomyelitis has decreased in the past years thanks to intensive immunization campaigns. Nowadays intramuscular injection is the main reason for paralysis of the legs in African children as well as attendance at Rehabilitation Centres. Intramuscular injection of quinine is the most frequently reported. Faced with the lack of sterile material, health workers do not rationalize the use of intramuscular injections. Although the use of the same needle has decreased, using the same syringe for many patients, with only a rapid washing between, is still commonplace Poor septic conditions and abuse of prescriptions also contribute to the transmission of severe diseases (hepatitis, malaria, syphilis, filariasis, Ebola virus, tetanus and HIV). Paralysis due to injection is often confused with poliomyelitis and health workers are often not aware of the sequelae of injection. It seems important to prevent risk related to intramuscular injection in Africa through educating health workers and the local population. Rationalization of practises, promotion of oral therapy and alternatives to intramuscular administration should be carried out. In this respect, the intrarectal administration of an injectable solution of diluted quinine--its efficiency and pharmacokinetic having been studied over the last ten years--offers interesting opportunities.
Barennes
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Unité de vaccinologie et de recherche opérationnelle, Centre Muraz, Bobo-Dioulasso, Burkina-Faso.
D017954:Africa South of the Sahara; D000962:Antimalarials / Q000008:administration & dosage; D002648:Child; D003906:Developing Countries; D006801:Humans; D007239:Infections / Q000635:transmission; D007273:Injections, Intramuscular / Q000009:adverse effects*; D010243:Paralysis / Q000209:etiology; D011803:Quinine / Q000008:administration & dosage*
D000962:Antimalarials; D011803:Quinine