Overview of injection practices in two governorates in Egypt.
OBJECTIVE
To describe the extent and characteristics of injection use and injection providers in Egypt, given that unsafe injections are associated with blood-borne pathogen transmission.


METHODS
Household surveys of a population-based sample of residents in the Nile Delta and in Upper Egypt; focus group discussions and in-depth interviews with community target groups, formal and informal medical providers.


RESULTS
Of 4197 persons interviewed, 26.2% reported receiving an injection in the past 3 months. Of these, 77% reported it was for therapeutic indications. The age-sex specific prevalence of injections was highest among children 0-2 years of age and among older adults. Women were more likely to report having an injection than men, particularly at the age above 20 years. Overall, respondents reported receiving on average 4.2 injections per year, indicating that up to 281 million injections are provided per year in Egypt. Injection administrators were public and private sector physicians, pharmacists, barbers, doctor assistants, housekeepers, relatives and friends. Injection prescribers were mostly private and public sector physicians. Of the 1101 respondents who received an injection in the past 3 months, 92 (8.4%) reported that the provider did not use a syringe taken from a closed sealed packet.


CONCLUSIONS
The frequency of therapeutic injection use is high in Egypt and may contribute to blood-borne pathogen transmission. The Ministry of Health and Population (MOHP) is developing interventions targeted towards promotion of injection safety and reduction of injection overuse on community basis as part of a comprehensive strategy to prevent blood-borne pathogen transmission in Egypt.
Talaat
Maha
M
US Naval Medical Research Unit, Cairo, Egypt. talaatm20@yahoo.com
el-Oun
Said
S
Kandeel
Amr
A
Abu-Rabei
Wafa
W
Bodenschatz
Caroline
C
Lohiniva
Anna-Lena
AL
Hallaj
Zoheir
Z
Mahoney
Frank J
FJ
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001294:Attitude to Health; D017848:Blood-Borne Pathogens; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D016000:Cluster Analysis; D003428:Cross Infection / Q000517:prevention & control; D004534:Egypt; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007114:Immunization / Q000592:standards / Q000706:statistics & numerical data; D007223:Infant; D007231:Infant, Newborn; D007267:Injections / Q000592:standards* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011364:Professional Practice / Q000592:standards* / Q000706:statistics & numerical data; D017678:Sex Distribution