Muhammad Tariq Mehr, Siraj Uddin, Noor-ul Iman.
Is universal screening of individuals for HBV, HCV and HIV before endoscopy justified? an audit of the current practices.
J Med Sci Jan ;23(2):104-8.

Objective: To find out the current practices of sterilization and decontamination of endoscopy equipment, and to compare them with the current practical guidelines in rest of the world. Material and Methods: This was a retrospective study carried out from January 2014 to December 2014 in the Departments of Medicine HMC, KTH, Peshawar. All the patients scheduled for endoscopy are screened for any evidence of Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) by third generation ELISA test. The approximate cost of these screening tests from the hospital main laboratory is Rs 650 and it is between Rs 900 to 3000 from the outside private laboratory facilities. The endoscope is soaked in a decontaminant solution for 30 mins in the morning before the start of the procedures. The endoscope is the washed with water and air dried. In between the procedures, the endoscope is wiped cleaned with a gauze piece soaked in saline and then introduced in another patient. Results: As all the patients are screened for any evidence of HBV, HCV and HIV, it is presumed that the iatrogenic infection due to endoscope would be negligible. Universal screening for the evidence of these infections comes at average Rs 1000 per patient as compared to Rs 35 for the endoscope cleaning with the cleansing and rinsing of all the channels of the endoscope with 2% glutaraldehyde solution (Cidex, Johnson and Johnson Medical Inc., Arlington, TX) for 15 minutes through automated Endodisinfector followed by rinsing the channels with water and later purging with air. Conclusion: Timely intervention in terms of Endodisinfection and appropriate training of the staff in sterilization and disinfection of the endoscopes as per international guidelines is suggested before it becomes a human rights issue.

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