viernes, 24 de mayo de 2013

Iatrogenic Blood-borne Viral Infections in Refugee Children from War and Transition Zones ▲Medscape CME Activity - Vol. 19 No. 6 - June 2013 - Emerging Infectious Disease journal - CDC

full-text ► see below
Medscape CME Activity - Vol. 19 No. 6 - June 2013 - Emerging Infectious Disease journal - CDC

 EID cover artwork EID banner
CME Articles
Volume 19, Number 6–June 2013

Volume 19, Number 6—June 2013

CME ACTIVITY

Iatrogenic Blood-borne Viral Infections in Refugee Children from War and Transition Zones

Medscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit.
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians.
Medscape, LLC designates this Journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 70% minimum passing score and complete the evaluation at www.medscape.org/journal/eidExternal Web Site Icon; (4) view/print certificate.
Release date: May 22, 2013; Expiration date: May 22, 2014

Learning Objectives

Upon completion of this activity, participants will be able to:
•Describe observations regarding and factors contributing to iatrogenically transmitted blood-borne virus (BBV) infection in refugee children from central Asia, Southeast Asia, and Sub-Saharan Africa, based on a literature review and case reports
•Describe the role of contaminated injections and unsafe blood transfusions in health care settings in contributing to increased prevalence of BBVs in refugee children from central Asia, Southeast Asia, and Sub-Saharan Africa, based on a literature review and case reports
•Describe the role of other factors contributing to increased prevalence of BBVs in refugee children from central Asia, Southeast Asia, and Sub-Saharan Africa, based on a literature review and case reports.

CME Editor

Karen L. Foster, Technical Writer/Editor, Emerging Infectious Diseases. Disclosure: Karen L. Foster has disclosed no relevant financial relationships.

CME Author

Laurie Barclay, MD, freelance writer and reviewer, Medscape, LLC. Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.

Authors

Disclosure: Paul Goldwater, MD, has disclosed no relevant financial relationships.

   EID cover artwork EID banner
CME Articles
Volume 19, Number 6–June 2013


full-text ► large
Iatrogenic Blood-borne Viral Infections in Refugee Children from War and Transition Zones - Vol. 19 No. 6 - June 2013 - Emerging Infectious Disease journal - CDC

Volume 19, Number 6—June 2013

CME ACTIVITY

Iatrogenic Blood-borne Viral Infections in Refugee Children from War and Transition Zones

Paul N. GoldwaterComments to Author 
Author affiliation: Women’s and Children’s Hospital, Adelaide, South Australia, Australia; University of Adelaide, Adelaide
Suggested citation for this article

Abstract

Pediatric infectious disease clinicians in industrialized countries may encounter iatrogenically transmitted HIV, hepatitis B virus, and hepatitis C virus infections in refugee children from Central Asia, Southeast Asia, and sub-Saharan Africa. The consequences of political collapse and/or civil war—work migration, prostitution, intravenous drug use, defective public health resources, and poor access to good medical care—all contribute to the spread of blood-borne viruses. Inadequate infection control practices by medical establishments can lead to iatrogenic infection of children. Summaries of 4 cases in refugee children in Australia are a salient reminder of this problem.
Blood-borne viruses (BBVs) have benefitted from internal political strife, migration, prostitution, intravenous/injection drug use, and defective public health resources in some Central Asian republics and Southeast Asian and sub-Saharan African countries. Iatrogenic transmission of HIV in children in Romania (1) and the Russian republic of Kalmykia (2) are well-known examples. Refugee children are a special risk category for infection with BBVs (3). When iatrogenic transmission was encountered in a pediatric infectious diseases clinic in Adelaide, South Australia, Australia, concern was raised about whether it was an isolated or a more widespread phenomenon.
The United Nations High Commissioner for Refugees estimates that there were 43.7 million forcibly displaced persons worldwide at the end of 2010, the highest number in 15 years. Of these, 27.5 million were internally displaced persons, 15.4 million were refugees, and 837,500 were asylum seekers (4). Children constituted more than half of the humanitarian refugee population in Australia (5). A refugee is legally defined as a person who is outside his or her country of nationality and is unable to return due to a well-founded fear of persecution because of race, religion, nationality, political opinion, or membership in a particular social group. By receiving refugee status, persons are guaranteed protection of their basic human rights and cannot be forced to return to a country where they fear persecution (4).
Australia receives refugees from all countries experiencing internal conflict. Some arriving refugees have parasite infestations and bacterial and viral infections, especially undiagnosed BBVs (6,7). During 2010–2011, a total of 13,799 persons were admitted under Australia’s Humanitarian Program.
The extent of the unusual problem of iatrogenic transmission of BBVs remains unknown because modes of transmission of individual cases are difficult to document. This report summarizes cases in 4 children from South Asia that illustrate the conditions extant in 1 city in Uzbekistan (Andijan), where medical procedures have resulted in transmission of HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV). Among the case-patients are 2 children with BBV co-infection.

No hay comentarios:

Publicar un comentario