The prevalence of therapeutic injections in Ethiopia: from the patients’ and health care providers’ perspectives

Tedaviyle ilgili enjeksiyon uygulanması sağlık sektöründe en sık uygulanan tıbbi işlemler arasındadır. Enjeksiyonların çoğu gereksiz, etkisiz veya uygun değildir, ve infeksiyöz hastalığın bulaşmasına yol açar. Çalışmanın amacı, tedavi ile ilgili enjeksiyonda sağlık hizmeti verenler ve hastalarda algılama ve prevalansını saptamaktı. Sağlık hizmeti verenler, yatan ve ayakta tedavi edilen hastalardan toplanan verilerden oluşan bu tanımlayıcı çalışma, Holeta kasabasında Şubat-Mart 2010’da gerçekleştirildi. Sağlık hizmeti verenler ve hastalar için yapılandırılmış anket, tedaviyle ilgili enjeksiyon kullanımının hastalardaki algılaması ve sıklığını belirlemek için dizayn edildi. Veriler düzenlendi ve Epi Info sürüm 6.0’a girildi, ve sosyal bilimler için istatistik paketi (SPSS) sürüm 16.0 kullanılarak analizleri yapıldı. Toplam 200 hasta ve 10 sağlık hizmeti veren çalışmaya katıldı. Hastaların 84’ü (%42) hastalıkları için enjeksiyonu tercih etti. Yirmi üç hasta (%31) enjeksiyonların, oral yoldan tedaviye göre daha çabuk etki ettiğine inanmıştı. Hastaların 75’i (%37.5) enjeksiyonun diğer dozaj şekillerinden daha etkili olduğunu düşünürken, 83’ü (%42.5) enjeksiyon ve diğer dozaj şekillerinin eşit etkinlikte olduğunu söyledi. Hastaların çoğu (93’ü) (%46.5) güvenli olmayan enjeksiyonların ölümcül hastalığı bulaştırabileceğini düşünürken, 62’si (%31) uygun olmayan enjeksiyonlara herhangi bir riskin eşlik edebileceğini bilmiyordu ve 55’i (%24.5) kulla nılmış iğne ucunun hastalığı bulaştıramayacağını düşünüyordu. Sağlık hizmeti verenler enjeksiyonla daha iyi tedavi edilen hastalıkların pnömoni, tonsillit, idrar yolu enfeksiyonu, tüberküloz, akut febril hastalıklar, menenjitler ve şiddetli ağrı olduğuna inanıyordu. Bu çalışma sağlıkta tedavi için enjeksiyon kullanımı sıklığının düşük olduğunu ortaya koydu. Birçok insan genelde enjeksiyonu tercih etmemektedir. Çalışmaya katılanların çoğu HIV infeksiyonlarının kontamine olmuş keskin aletler aracılığıyla bulaştırılabileceğinin farkındaydı. Fakat, HIV hakkında insanların farkındalığını daha da artırmak için topluma sağlık eğitimi verilmelidir. Enjeksiyon şeklinin reçetelendirilmesi için bildirilen başlıca nedenler hastalığın şiddeti ve hastanın oral yoldan ilaç alamadığı zaman olmasıydı. Sağlık çalışanlarının rasyonel reçetelendirme konusunda eğitimi teşvik edilmelidir.

Etiyopya’da tedaviyle ilgili enjeksiyonların prevalansı: hasta ve sağlık hizmeti verenler açısından

Administration of therapeutic injection is among the most frequently performed medical procedures in the healthcare sector. Most of the injections are unnecessary, ineffective or inappropriate and result in transmission of infectious disease. The aim of the study was to determine the prevalence and perception of the patients and health care providers of therapeutic injection. A descriptive study where data was collected from inpatient, outpatient and health care providers was conducted from February to March 2010 in Holeta town. A structured questionnaire for patients and health care providers was designed to assess the frequency and perception of patients of the therapeutic injection use. The data was edited and were entered in Epi Info Version 6.0 and analysis was conducted using statistical package for social sciences (SPSS) version 16.0. A total of 200 patients, 10 health care providers were participated. Eighty four (42%) of the patients preferred injection for their illness. Twenty three (31%) patients believed that injections were quicker acting than oral medications. Seventy five (37.5%) of the patients thought that injection was more effective than other dosage forms, while 83 (42.5%) said injection and other dosage forms were equally effective. Most (93) of the patients (46.5%) thought that unsafe injections could transmit a fatal disease, 62 (31%) did not know any risk associated with inappropriate injections, and 55(24.5%) thought that used needle could not transmit disease. The health care providers believed that diseases which were better treated with injection medication were pneumonia, tonsillitis, urinary tract infection, tuberculosis, acute febrile illness, meningitides and severe pain. The study revealed that the frequency of the therapeutic injection use in health facility was low. Most people, in general, do not have preference for injection. Most of the study participants were aware that HIV infections could be transmitted through contaminated sharp tools. However, health education to the community should be given to further increase the awareness of the people about HIV. The main reasons reported for prescribing injection were severity of illness and when the patient cannot take oral medications. Training of health workers on rational prescribing should be promoted.

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