March 20, 2007
Twenty-one doctors in Shymkent, Kazakhstan, are on trial for medical malpractice following an HIV outbreak among children who received blood transfusions at their hospital, the New York Times reports. Since summer 2006, 100 children who received blood transfusions at the children's hospital in Shymkent have tested positive for HIV. A medical investigation conducted by CDC identified the transfusions of tainted blood as the source of the Shymkent HIV outbreak. According to the Times, the parents of the HIV-positive children say that doctors charged them $20 for 14 ounces of blood and shared the profits with the local blood bank. Although "pervasive corruption encourages many unnecessary" blood transfusions, many patients "frequently demand" the procedure, according to the Times. Some patients and doctors in Russia, Eastern Europe, Central Asia, and parts of China and India "believe that fresh infusions of blood can fortify a healthy body and remedy diseases that are not blood-related," the Times reports. As a result, local doctors in Central Asia and other parts of the developing world prescribe "tens of millions of unnecessary" blood transfusions, increasing the risk of spreading HIV and other bloodborne diseases. Some of the doctors in Shymkent say their low wages force them to find ways of earning additional income, and a profit of up to $10 on each blood transfusion is a "considerable amount" because doctors' salaries begin at $175 monthly, the Times reports. "Salaries are very low, and even increases don't make a difference because of inflation," Amangeldy Shopaer -- deputy chief physician at the Shymkent Infectious Diseases Hospital, where all 100 HIV-positive children have received treatment -- said. The children's families say government neglect has compounded their situation. In addition, many of the children's families have been forced to move after experiencing HIV/AIDS-related discrimination. Despite the CDC investigation, Shopaer has concluded that the cause for the HIV outbreak remains "not concretely known." He also has defended the practice of ordering blood transfusions for nonblood-related illnesses, including pneumonia. "In some cases it is required," he said, adding, "It depends on what kind of pneumonia." Kazakhstan's government has responded to the HIV outbreak by firing the health minister and starting construction on a pediatric HIV/AIDS facility in downtown Shymkent, the Times reports. Government health officials also have hired a Russian-speaking pediatric HIV/AIDS specialist from Israel to oversee treatment of the HIV-positive children. In addition, officials have conducted HIV tests among 8,800 children nationwide who are on record for recently receiving blood transfusions and found no new HIV cases (Greenberg, New York Times, 3/20).
NPR's "All Things Considered" on Sunday reported on the trial. The segment includes comments from Michael Favorov, director of CDC's Central Asia office, and family members of HIV-positive children (Watson, "All Things Considered," NPR, 3/18). Audio of the segment and expanded NPR coverage are available online.
Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2007 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.