Use of injections in healthcare settings worldwide, 2000: literature review and regional estimates.

Objective: To describe injection practices worldwide in terms of frequency and safety.

Design: Literature review. The global burden of disease project of the World Health Organization defined 14 regions on the basis of geography and mortality patterns.

Best infection control practices for intradermal, subcutaneous, and intramuscular needle injections.

Objective: To draw up evidence-based guidelines to make injections safer.

Methods: A development group summarized evidence-based best practices for preventing injection-associated infections in resource-limited settings. The development process included a breakdown of the WHO reference definition of a safe injection into a list of potentially critical steps, a review of the literature for each of these steps, the formulation of best practices, and the submission of the draft document to peer review.

The cost-effectiveness of policies for the safe and appropriate use of injection in healthcare settings.

Objective: Poor injection practices transmit potentially life-threatening pathogens. We modelled the cost-effectiveness of policies for the safe and appropriate use of injections in ten epidemiological subregions of the world in terms of cost per disability-adjusted life year (DALY) averted.

Methods: The incidence of injection-associated hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections was modelled for a year 2000 cohort over a 30-year time horizon.