Other Cases Link Hospitals, HIV Infections
Kazakhstan is not the first country where large numbers of children have been infected with HIV at hospitals.
In Romania, some 10,000 children tested positive for HIV in the early 1990s. A CDC study in the port city of Constanta found 57 percent of a group of 1,086 HIV-infected children, many of them orphans, were infected through multiple therapeutic injections and the improper use of syringes and needles.
"This outbreak demonstrates the serious potential for HIV transmission in medical facilities that intensively and improperly use parenteral [injection] therapy and have poor sterilization technique," the CDC report concluded.
In Libya in 1998, more than 400 children were found to have contracted HIV the town of Benghazi. In this politically charged case, the Libyan government accused five Bulgarian nurses and a Palestinian physician, of deliberately infecting the children. The six foreign health-care workers have been sentenced to death after a second trial; they are awaiting another appeal.
A subsequent investigation by led by Luc Montaignier, president of the World Foundation for AIDS Research and Prevention, concluded that the virus was spread in a Benghzai hospital through "certain incorrect practices used by the medical and nursing staff," during a period prior to the arrival of the foreign health workers in Libya.
The report concluded: "A large introduction of invasive procedures, the shortage of disposable materials leading to the re-use of injection materials, are all possible reasons which may explain this massive nosocomial [hospital-acquired] infection."
"It's a very interesting question why it's happening so massively with kids," says Nina Ferencic, an HIV/AIDS expert with the United Nations Children's Fund in Geneva. "Whatever it is, it's wrong."
The CDC's Central Asia director Michael Favorov has a theory for why children are particularly vulnerable to hospital-acquired HIV infections.
"They are young and cannot speak up for themselves when medical staff are inserting used/dirty/infected/contaminated catheters or any other medical instruments," he explained in an e-mail.
"For example, if an adult saw a doctor use a needle or catheter that was not prepackaged and clean the adult would refuse the injection but children do not know the difference."
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