HIV, nosocomial transmission - Kazakhstan

International Society for Infectious Diseases
<http://www.isid.org>

[1]
Source: IWPR (Institute for War and Peace Reporting) [edited]
< http://www.iwpr.net/?p=bkz&s=b&o=324016&apc_state=henh>


Kazakhstan: HIV Scandal in South Kazakhstan
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The announcement that 55 children in the South Kazakhstan region have
been diagnosed with HIV [human immunodeficiency virus] has
highlighted major defects in the healthcare system. NBCA [News
Briefing Central Asia] analysts say the scandal undermines public
confidence in the medical services. The existence of an HIV outbreak
in South Kazakhstan has been public knowledge for 3 months, and the
media have covered it in some detail. But news that the figure had
climbed to 55 came in an announcement by Kazakh health minister
Yerbolat Dosaev on Mon 18 Sep 2006. Health experts say this figure
comes close to epidemic proportions.

The minister indicated that the mass infections were caused by poor
hygiene standards during blood transfusions, the re-use of disposable
equipment, and shortcomings in the system for registering blood
donors. The Kazakh authorities have launched a criminal case under a
provision making it illegal to infect others with HIV. Checks are
being run on hospital staff, and Nursulu Tasmagambetova, the head of
the South Kazakhstan region's health department, has stepped down.
None of these actions have so far helped identify those responsible
for allowing the HIV infection, or to find out what the source of the
outbreak is, and more cases are continuing to be diagnosed. The
diagnosis of so many children as HIV-positive has made this a hugely
political case, and some members of Kazakhstan's parliament are
already calling for the health minister's resignation.

Some NBCA [News Briefing Central Asia] analysts believe the case
should serve as a wake-up call for a profoundly flawed healthcare
system. For instance, they assert that corruption flourishes from top
management down to the lowliest medical staff selling off syringes
and medicines on the side. And as long as healthcare employees remain
among the worst paid workers in the country, negligence is going to
be a problem. Even the government's hasty allocation of more than 53
million US dollars for an HIV/AIDS program running from 2006 to 2010
may not be enough to redress matters, say the analysts. One of the
gravest consequences of this scandal, say NBCA analysts, is that
people's trust in state healthcare provision will be left badly shaken.

******
[2]
Source: Moscow Times [edited]
< http://www.themoscowtimes.com/stories/2006/09/21/017.html>


Kazakh Health Minister Fired for HIV Infections
-----------------------------------------------
Kazakh President Nursultan Nazarbayev on Wednesday [20 Sep 2006]
sacked the country's health minister and the governor of a southern
region after 55 toddlers were infected with HIV while receiving
medical treatment.

Nazarbayev fired Health Minister Erbolat Dosayev and South Kazakhstan
region Governor Bolat Zhylkyshiyev for "serious shortcomings in their
work," deputy Security Council chief Nurlan Abdirov said.

Abdirov said the dismissals were linked to 55 young children
contracting HIV while receiving treatment, including blood
transfusions and injections, at the regional children's hospital in
the city of Shymkent.

The 1st cases of HIV among children less than 3 years old in the city
were reported this summer.

Nearly 5000 children under 3 who were treated at the hospital and had
contact with the infected children have been tested. More than 4000
others are to be examined.

Officials said prosecutors were investigating and that any medical
staff found to be responsible for the infections would face criminal charges.

Abdirov said Wednesday [20 Sep 2006] that Nazarbayev would personally
supervise the investigation.

Authorities are looking for 17 donors who are suspected of carrying
the virus that causes AIDS, and whose blood had been used at the
hospital, according to the Health Ministry.

The ministry has said the infected children would be provided with
treatment free of charge and that their families would receive financial aid.

According to health officials, Kazakhstan recorded 828 new HIV
carriers and 70 AIDS patients in the 1st 6 months of this year
[2006], a 70 percent increase in new cases over 2005.

The precise circumstances of the escalating epidemic of HIV
infection in children are not fully discussed in the reports above,
apart from general deficiencies of the health care system in South
Kazakhstan. Such apparent outbreaks of HIV in children elsewhere have
been associated with the abandonment of children by their parents and
their subsequent upbringing in poorly resourced institutions.

The newswires seem to suggest there may be an association with blood
transfusions and injections.  A common practice in the not too
distant past was to transfuse red blood cells to ill children to
improve upon anemia that may have been secondary to other causes such
as malaria in malaria zones and malnutrition.  If blood is transfused
without adequate testing for blood borne pathogens, the risk of
transmission of HIV and hepatitis (B and C) is there.  The mention
that this may have been associated with injections alone is further
disturbing as it suggests that syringes and needles were being reused
without adequate sterilization.

A map of Kazakhstan, a country of 15 million people extending from
the plains of western Siberia to the deserts of Central Asia, can be
accessed via
<http://www.blythe.org/afghan-maps/kazakhstan_map.jpg>.