scholarly journals Health programmes and services addressing the prevention and management of infectious diseases in people who inject drugs in Canada: a systematic integrative review

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e047511
Author(s):  
Katrina Bouzanis ◽  
Siddharth Joshi ◽  
Cynthia Lokker ◽  
Sureka Pavalagantharajah ◽  
Yun Qiu ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Drug Use ◽  
Infectious Diseases ◽  
Harm Reduction ◽  
Bacterial Infections ◽  
People Who Inject Drugs ◽  
Integrative Review ◽  
Future Research ◽  
Structural Factors ◽  
Health Programmes

ObjectivesPeople who inject drugs (PWID) experience a high burden of injection drug use-related infectious disease and challenges in accessing adequate care. This study sought to identify programmes and services in Canada addressing the prevention and management of infectious disease in PWID.DesignThis study employed a systematic integrative review methodology. Electronic databases (PubMed, CINAHL and Web of Science Core Collection) and relevant websites were searched for literature published between 2008 and 2019 (last search date was 6 June 2019). Eligible articles and documents were required to address injection or intravenous drug use and health programmes or services relating to the prevention or management of infectious diseases in Canada.ResultsThis study identified 1607 unique articles and 97 were included in this study. The health programmes and services identified included testing and management of HIV and hepatitis C virus (n=27), supervised injection facilities (n=19), medication treatment for opioid use disorder (n=12), integrated infectious disease and addiction programmes (n=10), needle exchange programmes (n=9), harm reduction strategies broadly (n=6), mobile care initiatives (n=5), peer-delivered services (n=3), management of IDU-related bacterial infections (n=2) and others (n=4). Key implications for policy, practice and future research were identified based on the results of the included studies, which include addressing individual and systemic factors that impede care, furthering evaluation of programmes and the need to provide comprehensive care to PWID, involving medical care, social support and harm reduction.ConclusionsThese results demonstrate the need for expanded services across a variety of settings and populations. Our study emphasises the importance of addressing social and structural factors that impede infectious disease care for PWID. Further research is needed to improve evaluation of health programmes and services and contextual factors surrounding accessing services or returning to care.PROSPERO registration numberCRD42020142947.

scholarly journals Young and invisible: an explanatory model for service engagement by people who inject drugs in India

2021 ◽  
Author(s):  
Lakshmi Ganapathi ◽  
Aylur K Srikrishnan ◽  
Clarissa Martinez ◽  
Gregory M Lucas ◽  
Shruti H Mehta ◽  
...  
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
Opioid Dependence ◽  
People Who Inject Drugs ◽  
Structured Interview ◽  
Explanatory Model ◽  
List Type ◽  
Structural Factors ◽  
Injection Initiation ◽  
Service Engagement

ABSTRACTIntroductionThe HIV epidemic in India is concentrated in key populations such as people who inject drugs (PWID). New HIV infections are high among young PWID (≤ 30 years of age), who are hard to engage in services. We assessed perspectives of young PWID across three Indian cities representing historic and emerging drug use epidemics to guide development of youth-specific services.MethodsWe conducted focus group discussions (FGDs) with PWID (ages 18-35 years) and staff at venues offering services to PWID in three cities (Aizawl and Imphal, Northeast India and Amritsar, Northwest India). A semi-structured interview guide was used to elicit participants’ narratives on injection initiation experiences, motivating factors and barriers to seeking harm-reduction services, service-delivery gaps, and recommendations to promote engagement.Thematic analysis was used to develop an explanatory model for engagement for each temporal stage across the injection continuum: (a) pre-injection initiation, (b) peri-injection initiation and (c) established injection behavior.Results43 PWID (81% male, 19% female) and 10 staff members participated in FGDs. Injection initiation followed non-injection opioid dependence. Lack of services for non-injection opioid dependence was a key gap in the pre-injection initiation phase. Lack of knowledge and reliance on informal sources for injecting equipment were key reasons for non-engagement in the peri-injection phase. Additionally, low risk perception resulted in low motivation to seek services.Psychosocial and structural factors shaped engagement after established injection. Housing and food insecurity, and stigma disproportionately affected female PWID while lack of confidential adolescent friendly services impeded engagement by adolescent PWID.ConclusionsDevelopment of youth-specific services for young PWID in India will need to address unique vulnerabilities and service gaps along each stage of the injection continuum. Scaling-up of tailored services is needed for young female PWID and adolescents, including interventions that prevent injection initiation and provision of confidential harm-reduction services.STRENGTHS AND LIMITATIONSThe findings in this study represent some of the first qualitative data to explore engagement with services, specifically among young PWID in India.The study was conducted in multiple cities representing older and emerging injection drug use epidemics. The inclusion of multiple cities adds strength to the findings.We did not recruit adolescent PWID due to constraints rendered by laws pertaining to informed consent in India.Although all PWID we recruited had initiated injection in adolescence or young adulthood, the preponderance of older PWID in our study limits the conclusions we can draw about the needs of adolescent PWID.

scholarly journals High levels of used syringe use and unsafe sex among people who inject drugs in Kumasi, Ghana: an urgent call for a comprehensive harm reduction approach

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Lisa J. Messersmith ◽  
Rose Adjei ◽  
Jennifer Beard ◽  
Angela R. Bazzi ◽  
Joel J. Earlywine ◽  
...  
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
Population Size ◽  
Sex Workers ◽  
People Who Inject Drugs ◽  
Syringe Sharing ◽  
Unsafe Sex ◽  
Lack Of Information ◽  
Sex With Men ◽  
Major Drug

Abstract Background Drug use is a growing concern in Ghana. People who inject drugs (PWID) are highly vulnerable to HIV and other infectious diseases. Ghana’s National Strategic Plan for HIV/AIDS 2016–2020 identifies PWID as a key population, but efforts to address the needs of PWID have lagged behind those targeting sex workers and men who have sex with men. Lack of information about PWID is a critical barrier to implementing effective HIV prevention and treatment. We aimed to learn more about the vulnerability of the PWID population in order to inform much-needed harm reduction interventions. Methods From April to July 2018, we conducted a mixed methods study in Kumasi, Ghana, to identify all major drug using locations, count the numbers of PWID to obtain rough population size estimations, and administer anonymous surveys to 221 PWID regarding drug use and sexual behavior. We also tested for HIV, HCV, and HBV from syringes used by survey participants. Results Key informants identified five major drug using locations and estimated the total PWID population size to be between 600 and 2000. Enumerators counted between 35 and 61 individuals present at each of the five bases. Sharing syringes and reusing discarded syringes are common practices. Over half of survey participants (59%) reported past-month syringe sharing (34% used a used syringe and 52% gave away a used syringe). Individuals with higher injection frequency (≥ 21 times weekly) and who injected with four or more people had higher odds of syringe sharing. Of the survey participants reporting sex in the last month (23%), most reported having one partner, but only 12% used condoms. Nearly all women (11/13) reported exchanging sex for drugs and 6/13 reported exchanging sex for money in the last six months. Fifteen percent of participants (all men) reported paying for sex using drugs or money. Of the used syringes, prevalence estimates were 3% (HIV), 2% (HCV), and 9% (HBV). Conclusions Our findings confirm the urgent need to implement harm reduction interventions targeting PWID and to build a strong and enabling legal and policy environment in Ghana to support these efforts.

scholarly journals Spread of Infectious Disease Modeling and Analysis of Different Factors on Spread of Infectious Disease Based on Cellular Automata

2019 ◽  
Vol 16 (23) ◽  
pp. 4683 ◽  
Author(s):  
Sheng Bin ◽  
Gengxin Sun ◽  
Chih-Cheng Chen
Keyword(s):  
Infectious Disease ◽  
Cellular Automata ◽  
Infectious Diseases ◽  
Pandemic Influenza ◽  
Influenza A ◽  
Disease Modeling ◽  
Real Life ◽  
Automata Theory ◽  
Future Research ◽  
Influenza A H1n1

Infectious diseases are an important cause of human death. The study of the pathogenesis, spread regularity, and development trend of infectious diseases not only provides a theoretical basis for future research on infectious diseases, but also has practical guiding significance for the prevention and control of their spread. In this paper, a controlled differential equation and an objective function of infectious diseases were established by mathematical modeling. Based on cellular automata theory and a compartmental model, the SLIRDS (Susceptible-Latent-Infected-Recovered-Dead-Susceptible) model was constructed, a model which can better reflect the actual infectious process of infectious diseases. Considering the spread of disease in different populations, the model combines population density, sex ratio, and age structure to set the evolution rules of the model. Finally, on the basis of the SLIRDS model, the complex spread process of pandemic influenza A (H1N1) was simulated. The simulation results are similar to the macroscopic characteristics of pandemic influenza A (H1N1) in real life, thus the accuracy and rationality of the SLIRDS model are confirmed.

scholarly journals Bridging Epidemiology and System Dynamics Modeling to Better Understand HCV Risk Among Young People Who Inject Drugs.

2021 ◽  
Author(s):  
Pedro Mateu-Gelabert ◽  
Nasim Sabounchi ◽  
Honoria Guarino ◽  
Courtney Ciervo ◽  
Kellie Joseph ◽  
...  
Keyword(s):  
Risk Factors ◽  
System Dynamics ◽  
Harm Reduction ◽  
People Who Inject Drugs ◽  
Positive Impact ◽  
Self Report ◽  
Structural Factors ◽  
Dynamics Modeling ◽  
Antibody Testing ◽  
Sd Model

Abstract Background Injection drug use is the leading risk factor for hepatitis C virus (HCV) transmission in the US. Despite the knowledge of the risk factors for HCV among people who inject drugs (PWID), there is a need to better understand how these multiple factors interact and impact young PWID.MethodsData originated from a study of 539 New York City (NYC) residents ages 18-29 recruited via Respondent-Driven Sampling, who reported past-month nonmedical use of prescription opioids and/or heroin. Analyses are based on a subsample of 337 (62%) who reported injecting any drug 12 months prior to the interview. All variables were assessed via self-report, except HCV status, which was established via rapid antibody testing. Building on the statistical associations found we developed a qualitative system dynamics (SD) model to integrate into a single framework key risk and preventive factors for HCV.ResultsHCV antibody prevalence is 31% with an overall incidence of 10 per 100 person-years. HCV status was independently correlated with sharing cookers with two or more people (AOR=2.17); injecting drugs 4-6 years (AOR=2.49) and 7 or more (AOR=4.95); lifetime homelessness (AOR=2.52); and being incarcerated two or more times (AOR=1.99). The SD model facilitates identifying non-linearities and feedback loop structures not included in the statistical model and high leverage points such as harm reduction and HCV treatment that could ameliorate the spread of HCV.ConclusionsThe results may indicate an overall positive impact of harm reduction efforts in reducing HCV prevalence among young PWID in NYC while injection risks and structural factors remain areas of key concern. An SD approach contributes to a better understanding of how these risk factors interact and what policies could be effective in reducing HCV infections.

scholarly journals Drug use practices among people who inject drugs in a context of drug market changes: Challenges for optimal coverage of harm reduction programs

2017 ◽  
Vol 45 ◽  
pp. 18-24 ◽  
Author(s):  
Élise Roy ◽  
Nelson Arruda ◽  
Pascale Leclerc ◽  
Carole Morissette ◽  
Caty Blanchette ◽  
...  
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
People Who Inject Drugs ◽  
Drug Market ◽  
Market Changes

scholarly journals Extended urbanisation and the spatialities of infectious disease: Demographic change, infrastructure and governance

Urban Studies ◽  
2020 ◽  
pp. 004209802091087 ◽  
Author(s):  
Creighton Connolly ◽  
Roger Keil ◽  
S. Harris Ali
Keyword(s):  
Infectious Disease ◽  
Infectious Diseases ◽  
Political Ecology ◽  
Demographic Change ◽  
Disease Spread ◽  
Future Research ◽  
Suburban Areas ◽  
Urban Edge ◽  
Increased Risk ◽  
Health And Disease

This paper argues that contemporary processes of extended urbanisation, which include suburbanisation, post-suburbanisation and peri-urbanisation, may result in increased vulnerability to infectious disease spread. Through a review of existing literature at the nexus of urbanisation and infectious disease, we consider how this (potential) increased vulnerability to infectious diseases in peri- or suburban areas is in fact dialectically related to socio-material transformations on the metropolitan edge. In particular, we highlight three key factors influencing the spread of infectious disease that have been identified in the literature: demographic change, infrastructure and governance. These have been chosen given both the prominence of these themes and their role in shaping the spread of disease on the urban edge. Further, we suggest how a landscape political ecology framework can be useful for examining the role of socio-ecological transformations in generating increased risk of infectious disease in peri- and suburban areas. To illustrate our arguments we will draw upon examples from various re-emerging infectious disease events and outbreaks around the world to reveal how extended urbanisation in the broadest sense has amplified the conditions necessary for the spread of infectious diseases. We thus call for future research on the spatialities of health and disease to pay attention to how variegated patterns of extended urbanisation may influence possible outbreaks and the mechanisms through which such risks can be alleviated.

Incidence of bacterial infections in chronic kidney disease patients admitted in nephrology unit of Kathmandu Medical College Teaching Hospital

2018 ◽  
Vol 7 (1) ◽  
pp. 26-29
Author(s):  
Laxman Adhikari
Keyword(s):  
Infectious Disease ◽  
Chronic Kidney Disease ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Kidney Disease ◽  
Tract Infection ◽  
Infectious Diseases ◽  
Bacterial Infections ◽  
College Teaching ◽  
Medical College

Background: Infectious diseases are one of the leading causes of morbidity and mortality in chronic kidney disease patients, second only to cardiovascular causes. As the incidence of chronic kidney disease is increasing, the number of deaths due to infectious disease is also increasing. Infectious disease includes infection, bacteremia and sepsis in chronic kidney disease patients.Objective: To assess the incidence of bacterial infections in chronic kidney disease patients.Methodology: A prospective cross-sectional study was done among all chronic kidney disease patients admitted over 6 months in Nephrology Unit of Department of Medicine, Kathmandu Medical College Teaching Hospital.Results: 58 patients were admitted with infectious diseases, out of which 6 patients (10.34%) died during treatment while 1 patient (1.78%) left against medical advice. Infection in patients undergoing dialysis (5D) was much more compared to stage 4 or 5chronic kidney disease patients (58.62% vs. 13.79% vs. 17.24% respectively). 19 patients (32.76%) had pneumonia, 16 patients (27.56%) had Urinary Tract Infection while 12 patients (20.70%) had sepsis. Although sepsis was less prevalent compared to pneumonia/ Urinary Tract Infection, deaths due to sepsis was very high.Conclusion: The incidence of bacterial infections in chronic kidney disease patients is still high despite all the improvements in infection control and dialysis practices, and still lots is left to be done to reduce the morbidity and mortality caused by infections in chronic kidney disease patients.

scholarly journals Impact of drug consumption rooms on risk practices and access to care in people who inject drugs in France: the COSINUS prospective cohort study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023683
Author(s):  
Marc Auriacombe ◽  
Perrine Roux ◽  
Laélia Briand Madrid ◽  
Sébastien Kirchherr ◽  
Charlotte Kervran ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hepatitis C ◽  
Drug Use ◽  
Harm Reduction ◽  
Access To Care ◽  
Social Services ◽  
People Who Inject Drugs ◽  
Drug Consumption ◽  
Risk Practices ◽  
The Impact

IntroductionThe high prevalence of hepatitis C and the persistence of HIV and hepatitis C virus (HCV) risk practices in people who inject drugs (PWID) in France underlines the need for innovative prevention interventions. The main objective of this article is to describe the design of the COSINUS cohort study and outline the issues it will explore to evaluate the impact of drug consumption rooms (DCR) on PWID outcomes. Secondary objectives are to assess how DCR (a) influence other drug-related practices, such as the transition from intravenous to less risky modes of use, (b) reduce drug use frequency/quantity, (c) increase access to treatment for addiction and comorbidities (infectious, psychiatric and other), (d) improve social conditions and (e) reduce levels of violence experienced and drug-related offences. COSINUS will also give us the opportunity to investigate the impact of other harm reduction tools in France and their combined effect with DCR on reducing HIV-HCV risk practices. Furthermore, we will be better able to identify PWID needs.Methods and analysisEnrollment in this prospective multi-site cohort study started in June 2016. Overall, 680 PWID in four different cities (Bordeaux, Marseilles, Paris and Strasbourg) will be enrolled and followed up for 12 months through face-to-face structured interviews administered by trained staff to all eligible participants at baseline (M0), 3 month (M3), 6 month (M6) and 12 month (M12) follow-up visits. These interviews gather data on socio-demographic characteristics, past and current drug and alcohol consumption, drug-use related practices, access to care and social services, experience of violence (as victims), offences, other psychosocial issues and perception and needs about harm reduction interventions and services. Longitudinal data analysis will use a mixed logistic model to assess the impact of individual and structural factors, including DCR attendance and exposure to other harm reduction services, on the main outcome (HIV-HCV risk practices).Ethics and disseminationThis study was reviewed and approved by the institutional review board of the French Institute of Medical Research and Health (opinion number: 14–166). The findings of this cohort study will help to assess the impact of DCR on HIV-HCV risk practices and other psycho-social outcomes and trajectories. Moreover, they will enable health authorities to shape health and harm reduction policies according to PWID needs. Finally, they will also help to improve current harm reduction and therapeutic interventions and to create novel ones.

Injection site infections and injuries in men who inject image- and performance-enhancing drugs: prevalence, risks factors, and healthcare seeking

2014 ◽  
Vol 143 (1) ◽  
pp. 132-140 ◽  
Author(s):  
V. D. HOPE ◽  
J. McVEIGH ◽  
A. MARONGIU ◽  
M. EVANS-BROWN ◽  
J. SMITH ◽  
...  
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
Injection Site ◽  
People Who Inject Drugs ◽  
Open Wound ◽  
Factors Associated ◽  
Risks Factors ◽  
And Performance ◽  
Performance Enhancing Drugs ◽  
Performance Enhancing

SUMMARYPeople who inject drugs are vulnerable to infections and injuries at injection sites, but these have rarely been studied in those injecting image- and performance-enhancing drugs (IPEDs). This study examined the factors associated with reported symptoms of injection site infections and injuries in IPED injectors. Of the 366 male IPED injectors surveyed, 42% reported ever having redness, swelling and tenderness (36% in the preceding year), and 6·8% had ever had an abscess or open wound at an injection site. Having these symptoms was associated with a range of factors related to drug use and healthcare utilization. One sixth (17%) of those reporting redness, tenderness and swelling had ever sought treatment, as had the majority (76%) of those reporting an abscess, sore or open wound. Most common sources of advice were emergency clinics and General Practitioners. Interventions are needed to support access to appropriate injecting equipment and provide targeted harm reduction advice.

scholarly journals Immunotherapy and vaccination against infectious diseases

2020 ◽  
Author(s):  
Meinolf Ebbers ◽  
Christoph J. Hemmer ◽  
Brigitte Müller-Hilke ◽  
Emil C. Reisinger
Keyword(s):  
Infectious Disease ◽  
Infectious Diseases ◽  
Bacterial Infections ◽  
Treatment Options ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Therapeutic Antibodies ◽  
Immunomodulatory Drugs ◽  
Multidrug Resistant Bacteria ◽  
New Treatment

SummaryDue to the overuse of antibiotics, infections, in particular those caused by multidrug-resistant bacteria, are becoming more and more frequent. Despite the worldwide introduction of antibiotic therapy, vaccines and constant improvements in hygiene, the burden of multidrug-resistant bacterial infections is increasing and is expected to rise in the future. The development of monoclonal therapeutic antibodies and specific immunomodulatory drugs represent new treatment options in the fight against infectious diseases. This article provides a brief overview of recent advances in immunomodulatory therapy and other strategies in the treatment of infectious disease.

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