title: Injection practices in a metropolis of North India: perceptions, determinants and issues of safety.
abstract: BACKGROUND
  At least 50 percent of the injections administered each year are unsafe, more particularly in developing countries, posing serious health risks. An initial assessment to describe injection practices; their determinants and adverse effects can prevent injection-associated transmission of blood borne pathogens by reducing injection frequency and adoption of safe injection practices.
  
  
  OBJECTIVE
  To assess the injection practices in a large metropolitan city encompassing varied socio-cultural scenarios. STUDY SETTING AND DESIGN: Field based cross sectional survey covering urban non-slum, slum and peri-urban areas of a large metropolitan city.
  
  
  METHODS
  Injection prescribers, providers and community members selected by random sampling from the study areas. Pre tested questionnaires assessed knowledge and perceptions of study subjects towards injections and their possible complications. Observation of the process of injection and prescription audit also carried out.
  
  
  METHODS
  MS Access for database and SPSS ver 11 for analysis. Point estimates, 95% confidence intervals, Chi Square, t test, one-way ANOVA.
  
  
  RESULTS
  The per capita injection rate was 5.1 per year and ratio of therapeutic to immunization injections was 4.4:1. Only 22.5%of injections were administered with a sterile syringe and needle. The level of knowledge about HIV and HBV transmission by unsafe injections was satisfactory amongst prescribers and community, but inadequate amongst providers. HCV was known to a very few in all the groups. The annual incidence of needle stick injuries among providers was quite high.
  
  
  CONCLUSIONS
  A locally relevant safe injection policy based on multi disciplinary approach is required to reduce number of injections, unsafe injections and their attendant complications.
authors.affiliation: Center of Social Medicine & Community Health, Jawaharlal Nehru University, New Delhi - 110 064, India. atuljyoti2710@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Kotwal
authors.forename: R
authors.initials: R
authors.lastname: Priya
authors.forename: R
authors.initials: R
authors.lastname: Thakur
authors.forename: V
authors.initials: V
authors.lastname: Gupta
authors.forename: J
authors.initials: J
authors.lastname: Kotwal
authors.forename: T
authors.initials: T
authors.lastname: Seth
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India; D007267:Injections / Q000009:adverse effects / Q000592:standards*; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012449:Safety; D019037:Urban Health Services