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Standard precautions are not routinely implemented in public and even less so in private practices such as among dentists, and in hemodialysis centers. Public health systems in these countries are over-stretched leading to some lapses in safety measures. A few countries in this region such as Afghanistan, Pakistan, Somalia and Yemen, still lack the resources necessary to screen all blood donations and to sterilize medical equipment. Parenteral transmission of blood-borne pathogens has been documented to occur, particularly in resource-limited settings including different MENA countries.
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The region has also witnessed the largest documented nosocomial outbreak in HIV and acquired immune deficiency syndrome (AIDS) history which occurred in a children’s hospital in Libya and involved 402 children, 19 mothers (through breast feeding), and two nurses. These include the world’s largest iatrogenic transmission of a blood-borne pathogen the hepatitis C virus (HCV) epidemic in Egypt during the era of parenteral antischistosomal therapy (PAT), and two human immunodeficiency virus (HIV) outbreaks in renal dialysis centers also in Egypt. The Middle East and North Africa (MENA) region has endured several major events of parenteral transmission of infectious diseases. More precautions, including infection control training programs, surveillance systems for nosocomial infections and wider coverage and evaluation of hepatitis B virus immunization programs need to be implemented to avoid the unnecessary spread of HIV, HCV, and other blood-borne pathogens along the parenteral modes of transmission.
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Though there have been steady improvements in safety measures related to parenteral modes of transmission in the region, these improvements have not been uniform across all countries. Nonetheless, there could be opportunities for localized HIV outbreaks and transmission of other blood-borne infections in some settings such as healthcare facilities. Relatively low prevalence of HCV infection in the general population groups was reported in most MENA countries indicating that parenteral HIV transmission at endemic levels does not appear to be a cause for concern. In this review, we use data on the prevalence of HCV infection antibody (seroprevalence) among general population and high risk population groups to assess the potential for HIV parenteral transmission in MENA. Recent work has established the utility of using hepatitis C virus (HCV) as a proxy biomarker for assessing the epidemic potential for human immunodeficiency virus (HIV) parenteral transmission. The Middle East and North Africa (MENA) region has endured several major events of infection parenteral transmission.