WHO guideline on the use of safety-engineered syringes for intramuscular, intradermal and subcutaneous injections in health care settings

Overview

Injections are one of the most common health care procedures. Every year at least 16 billion injections are administered worldwide. The vast majority – around 90% – are given in curative care. Immunization injections account for around 5% of all injections, with the remaining covering other indications, including transfusion of blood and blood products, intravenous administration of drugs and fluids and the administration of injectable contraceptives.

Injection practices worldwide and especially in low- and middle-income countries (LMICs) include multiple, avoidable unsafe practices that ultimately lead to the large-scale transmission of bloodborne viruses among patients, health care providers and the community at large. While data are not available on the associated burden of all possible diseases, unsafe injection practices would logically impact on other bloodborne diseases transmitted through the re-use of injection equipment e.g. haemorrhagic fevers such as Ebola and Marburg viruses, malaria, and others. Re-use and unsafe practices also increase the risk of bacterial infections and abscesses at the injection site, which can cause long-term damage.