New Delhi: An outbreak of HIV cases at the Integrated Counselling and Testing Center (ICTC) located in Uttar Pradesh’s Unnao district in 2017, was caused by the use of unsterilised injection equipment, a study has found.
Researchers at the Indian Council of Medical Research (ICMR)-National AIDS Research Institute, Uttar Pradesh State AIDS Control Society and National AIDS Control Organisation conducted the study from September through December 2018, across the three UP districts of Premganj, Karimuddinpur and Chakmeerapur.
At least 46 cases of HIV were reported over a period of 10 months, starting July 2017, after several rounds of screening were conducted in Unnao. The cases were linked to a quack who had reused syringes, infecting patients.
The findings of the study were published on 4 December in Plos One, an open access, peer-reviewed scientific journal.
Talking about the sample size, the study reads: “We conducted a case-control study to identify factors associated with this increased detection; 33 cases and 125 controls were enrolled. Cases were individuals detected HIV sero-reactive (presence of anti-bodies) during November 2017-April 2018 from three locations namely Premganj, Karimuddinpur and Chakmeerapur in the Bangarmau block of the district of Unnao. Controls hailed from the same geographical setting and tested HIV sero-nonreactive either in health camps or at ICTC centers from where the cases were detected.”
One of the authors of the study, Dr Samiran Panda, director, ICMR-National AIDS Research Institute, Pune said, “The study has been critical to understanding the outbreak and the challenges associated with unsafe injection practices. A comprehensive approach to tackle the problem should be adopted with interventions like increasing access of auto-disabled (single use) syringes and needles, empowering the local communities and implementing effective regulatory practices across care settings.”
According to UN data for India, there were 21 lakh people living with HIV in 2017. The same year, 88,000 new HIV cases were recorded, while 69,000 people died from AIDS-related illnesses.
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What the study found
Upon investigation of the cases and controls, the study found that those infected with HIV fell sick more often, exposing them further to the risk of unsterilised needles and spreading the disease.
“A significantly greater proportion of cases sought professional help for fever, body ache, common cold and cough experienced in the last one year compared to controls; plausibly indicating more illness experiences in them. We also compared cases (PLHIV) against controls regarding receipt of intravenous fluid and intramuscular injection during treatment-seeking within the last five years, which turned out to be significantly different. This difference could be explained by the greater proneness of PLHIV to fall sick compared to controls,” the study said.
Cases of similar outbreaks due to use of unsterilised equipment were also found in Pakistan and Cambodia. These cases were linked to use of unsafe injection during treatment, contaminated blood transfusion and male circumcision with equipment that had not been sterilised.
The study suggested that availability of auto-disabled syringes and needles, empowerment of local communities and effective regulatory practices across care settings will serve as important intervention measures in order to curb the spread of the disease.
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