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  3. Friday, 22 August 2008
POST 01309E: SAFE INJECTION PRACTICES AND TRAINING MORE IMPORTANT FOLLOW-UP ON POST 01308E 22AUGUST 2008 ******************************************* Hello Group, My response to the questions raised by Dr. Sood are as follows:- [list=1] Are the results generalisable to children in developing countries with higher malnutrition rates and less subcutaneous fat? Will the needles in such settings be required to be shorter due to less subcutaneous fat? Can data from nutritional surveys give an answer or do we need more studies? [/ol] As mentioned in the paper, the objective of this study was to accurately determine the muscle layer depth beneath the skin surface of the thigh and the shoulder in a large sample of US children from birth to 18 years of age. There is no question of generalization since the source population is totally different from US to developing countries. Adjusting nutritional surveys, even done at best can only control for some of the crude measures such as mid-arm circumference or mid-thigh circumference. What we need to know is the general built of children physiologically. Also, the injection practices differ largely between US and developing practice. No adjustment can validly estimate whether CDC recommendations are applicable in developing country settings. Alternatively, a similar study can be replicated in developing countries at different locations (since there is so much of difference based on region, socio-economic status) and then we can look at different recommendations. [list=1] The current length of Kojak Selinge used in immunisation programme in India is 1.2/1.0 inches. How can the current recommendation be adapted in the current supplied syringes- for instance- insert 1¾ of the needle? [/ol] The major issue in India is safe injection practices. Safe practices are to be ensured before going further into changing the length of needle and other specifications. The intermittent supply of AD syringes, different sets of safe practices (across states in India) make it difficult for uniform recommendation of particular length. As of now, I feel that it would be more efficient to train the workers for proper administration of injections rather than coming up with new set of recommendations (before studies can actually prove their worth in India) Regards Dr.Giridhara R Babu ([email=giridharbabur@GMAIL.COM]giridharbabur@GMAIL.COM[/email]), MBBS, MBA, MPH Department of Epidemiology, University of California Los Angeles PhD Scholar, FFP, Public Health Foundation of India Post generated using Mail2Forum (http://www.mail2forum.com)


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