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Children in South Africa are being infected with HIV through
dirty needles, experts have claimed.
Researchers have suggested
hundreds of thousands of children may have contracted the virus
in this way.
The study is the latest to
point to contaminated needles as a major cause of HIV in Africa.
Some researchers believe as
many as 40% of HIV infections in African adults are linked to
injections.
United Nations agencies have
rejected this theory, saying most cases are linked to unsafe
sex.
Officials have also warned
that the theory could damage campaigns to get people in Africa
to use condoms to protect themselves from the disease.
High rates
This latest research looked
at a study carried out by the Human Sciences Research Council of
South Africa, published last year.
It revealed that 5.6% of
South African children between the ages of two and 14 have HIV.
This represents 670,000 children.
However, figures for
mother-to-baby transmission - believed to be the main cause of
HIV in children - are substantially lower.
This suggests children are
contracting the virus in another way.
Researchers from the
University of Tübingen in Germany said the findings indicated
contaminated needles were to blame.
They rejected claims that
children could have contracted HIV through unsafe sex or as a
result of abuse.
Writing in the Journal of
Obstetrics and Gynaecology, they said: "For hundreds of
thousands of South African children to have acquired HIV
sexually, inordinately high levels of childhood sexual exposure
would be required, a phenomenon unlikely to have been overlooked
by paediatricians. Recent reports from South Africa discourage
this hypotheses."
The researchers also examined
other studies. They said these also showed differences between
HIV rates in children and the number of mother-to-child
transmissions.
'Mounting evidence'
They said the findings showed
unsafe sex was no longer the main cause of HIV in Africa.
"The common belief that HIV
transmission in Africa is driven by heterosexual exposure is no
longer tenable," they wrote.
"There is mounting evidence
that rapid HIV transmission is fuelled by parenteral exposures
in health care settings, especially medical injections but also
including transfusion of untested blood and others.
"Not only are injections
popular among African patients, administered at an estimated 90%
of medical visits, but also often unnecessary and injection
equipment is often used."
The researchers said urgent
action is needed to improve standards in South African clinics.
"They must educate their
patients in the dangers of non-sterile injections and ensure
that their own practices are beyond reproach."
They said the findings could
also be applied to other countries on the continent.
"We must protect patients
from their own medical care system in all countries with similar
epidemiological characteristics."
Claims rejected
South Africa has the largest
HIV population in the world - one in five people are infected.
However, the South African
government rejected claims children were contracting HIV through
dirty needles.
Dr Nono Simelela, head of its
national HIV and Aids programme, told BBC News Online: "I have
worked in clinics and hospitals in various part of our country -
including some that were really poorly equipped.
"But nowhere have I seen
practices that would make me conclude that dirty needles are the
most probable explanation for this surprising rate of
HIV-infection in children. And I am confident my doubts would be
shared by many other clinicians.
"I believe the matter needs
to be much more closely interrogated before we form conclusions
about the cause."
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