Mass needle stick injury in children from the western cape

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dc.contributor.authorde Waal N.
dc.contributor.authorRabie H.
dc.contributor.authorBester R.
dc.contributor.authorCotton M.F.
dc.date.accessioned2011-05-15T16:17:12Z
dc.date.available2011-05-15T16:17:12Z
dc.date.issued2006
dc.description.abstractIllegal dumping of contaminated medical waste occurs commonly in South Africa. There is little information on the management and outcome of the children exposed to and injured by medical waste. On 15 September 1999, 54 children where involved in a mass exposure incident. 44 presented the same evening and 10 following day. Used needles and syringes were discarded on their soccer field. Children gave one another injections and played darts with the discarded needles. Parents were counselled and blood was drawn for HIV and Hepatitis B virus (HBV) serology. All were given HBV vaccination (HBVV). Stat doses of zidovudine (ZDV) and lamivudine (LMV) were given to all with visible wounds or history of percutaneous injury. Younger children were given prophylaxis as we considered their histories unreliable. Further visits were conducted at the community clinic for patient convenience. Children were reviewed at weeks 1 and 3 for drug adherence and side effects. At week 4, the second HBVV was given. At 3 months and 6 months HIV and HBV serology were repeated. 18/44 (40 per cent) had entry wounds. 44/54 (81 per cent) were given antiretroviral treatment (ART). Initial screening for HIV was negative in all, 6 had antibodies to HBV surface antigen, and 2 were HBV surface antigen positive. At week 1 all patients on ART were seen but at week 3 only 30 (55 per cent) attended. 41 (75 per cent) attended at 4 weeks, 8 non-attendees being located by primary healthcare workers. At 3 months, none of the 35 (64 per cent) children had seroconverted for either virus. 44 (81 per cent) attended at 6 months and all serology was negative. All were also Hepatitis C negative. The exposure incident sensitized the community to HIV. Follow up of patients after mass exposure is difficult and time-consuming. Adherence to ART was poor and should be carefully monitored. ZDV was probably adequate for this incident. In a non-mobile community a 3 month visit unnecessary. © 2006 Oxford University Press.
dc.description.versionArticle
dc.identifier.citationJournal of Tropical Pediatrics
dc.identifier.citation52
dc.identifier.citation3
dc.identifier.issn01426338
dc.identifier.other10.1093/tropej/fmi094
dc.identifier.urihttp://hdl.handle.net/10019.1/14113
dc.subjectantiretrovirus agent
dc.subjecthepatitis B surface antibody
dc.subjecthepatitis B surface antigen
dc.subjecthepatitis B vaccine
dc.subjectheppacine
dc.subjectlamivudine
dc.subjectzidovudine
dc.subjectadolescent
dc.subjectarticle
dc.subjectblood examination
dc.subjectchild
dc.subjectchildhood injury
dc.subjectcommunity care
dc.subjectcontrolled study
dc.subjectexposure
dc.subjectfollow up
dc.subjecthealth care personnel
dc.subjecthepatitis B
dc.subjectHepatitis B virus
dc.subjecthepatitis C
dc.subjecthuman
dc.subjectHuman immunodeficiency virus
dc.subjectHuman immunodeficiency virus infection
dc.subjectinfection prevention
dc.subjectmajor clinical study
dc.subjectneedlestick injury
dc.subjectnonhuman
dc.subjectoutpatient department
dc.subjectparent counseling
dc.subjectpatient compliance
dc.subjectpatient monitoring
dc.subjectprimary health care
dc.subjectscreening test
dc.subjectsensitization
dc.subjectseroconversion
dc.subjectserodiagnosis
dc.subjectSouth Africa
dc.subjectunspecified side effect
dc.subjectvaccination
dc.subjectAdolescent
dc.subjectAnti-HIV Agents
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectCommunicable Disease Control
dc.subjectEnvironmental Exposure
dc.subjectHepatitis B
dc.subjectHepatitis B Vaccines
dc.subjectHIV Infections
dc.subjectHumans
dc.subjectLamivudine
dc.subjectLongitudinal Studies
dc.subjectMedical Waste
dc.subjectNeedlestick Injuries
dc.subjectSouth Africa
dc.subjectTreatment Outcome
dc.subjectZidovudine
dc.titleMass needle stick injury in children from the western cape
dc.typeArticle
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