1
|
Yin W, Panakadan S, Shwe YY, Peters K, Sharma M, Murphy E. Enhance harm reduction programmes in responding to the changing trend of drug use and HIV transmission in Asia and the pacific. AIDS 2021; 35:2229-2232. [PMID: 34602593 DOI: 10.1097/qad.0000000000003011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Wenyuan Yin
- Regional Office for Asia and the Pacific, Joint United Nations Programme on HIV/AIDS (UNAIDS)
| | - Salil Panakadan
- Regional Office for Asia and the Pacific, Joint United Nations Programme on HIV/AIDS (UNAIDS)
| | - Ye Yu Shwe
- Regional Office for Asia and the Pacific, Joint United Nations Programme on HIV/AIDS (UNAIDS)
| | - Karen Peters
- Regional Office for Southeast Asia and the Pacific, United Nations Office for Drugs and Crime (UNODC), Bangkok, Thailand
| | - Mukta Sharma
- Regional Office for South-east Asia, World Health Organization (WHO), New Delhi, Delhi, India
| | - Eamonn Murphy
- Regional Office for Asia and the Pacific, Joint United Nations Programme on HIV/AIDS (UNAIDS)
| |
Collapse
|
2
|
Rajabi A, Sharafi H, Alavian SM. Harm reduction program and hepatitis C prevalence in people who inject drugs (PWID) in Iran: an updated systematic review and cumulative meta-analysis. Harm Reduct J 2021; 18:12. [PMID: 33482831 PMCID: PMC7825164 DOI: 10.1186/s12954-020-00441-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 11/16/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Prevalence of hepatitis C virus (HCV) infection among people who inject drugs (PWID) in Iran is high. Since 2005, the Iranian government has implemented a harm reduction program to control HCV. We aimed to describe the prevalence of HCV antibody (Ab) in Iranian PWID before and after the implementation of harm reduction with cumulative meta-analysis. METHODS Following PRISMA guidelines, we conducted a systematic review and meta-analysis of studies published on the seroprevalence of HCV among PWID. We systematically reviewed the literature to identify eligible studies up to December 2018 in international and national databases. Pooled prevalence and 95% confidence intervals were calculated using Der Simonian and Laird method, taking into account conceptual heterogeneity. Subgroup analyses were performed by harm reduction implementation and studies' characteristics to assess the sources of heterogeneity. We used Cochran-Armitage test for the linear trend of the prevalence of HCV Ab among PWID. RESULTS We reviewed 5966 papers and reports and extracted data from 62 eligible records. The pooled HCV Ab prevalence among PWID in Iran was 46.5% (95% confidence interval [95% CI] 41.1-52.0%). Overall, the Cochran-Armitage test for trend indicated a significant decreasing trend of HCV Ab prevalence (P = 0.04). The cumulative meta-analysis showed a slight decline in the prevalence of HCV Ab between the years 2005 and 2018. CONCLUSIONS The HCV Ab prevalence among PWID in Iran is high, with a considerable geographical variation. The prevalence of HCV Ab among PWID in Iran slightly decreased after 2005 which could be, at least to some extent, related to the implementation of extensive harm reduction programs in the country.
Collapse
Affiliation(s)
- Abdolhalim Rajabi
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, Iran
- Environmental Health Research Center, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Seyed Moayed Alavian
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, Iran.
- Middle East Liver Diseases (MELD) Center, Tehran, Iran.
| |
Collapse
|
3
|
Mahmud S, Mumtaz GR, Chemaitelly H, Al Kanaani Z, Kouyoumjian SP, Hermez JG, Abu‐Raddad LJ. The status of hepatitis C virus infection among people who inject drugs in the Middle East and North Africa. Addiction 2020; 115:1244-1262. [PMID: 32009283 PMCID: PMC7318323 DOI: 10.1111/add.14944] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 08/14/2019] [Accepted: 12/16/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS People who inject drugs (PWID) are a key population at high risk of hepatitis C virus (HCV) infection. The aim of this study was to delineate the epidemiology of HCV in PWID in the Middle East and North Africa (MENA). METHODS Syntheses of data were conducted on the standardized and systematically assembled databases of the MENA HCV Epidemiology Synthesis Project, 1989-2018. Random-effects meta-analyses and meta-regressions were performed. Meta-regression variables included country, study site, year of data collection and year of publication [to assess trends in HCV antibody prevalence over time], sample size and sampling methodology. Numbers of chronically infected PWID across MENA were estimated. The Shannon Diversity Index was calculated to assess genotype diversity. RESULTS Based on 118 HCV antibody prevalence measures, the pooled mean prevalence in PWID for all MENA was 49.3% [95% confidence interval (CI) = 44.4-54.1%]. The country-specific pooled mean ranged from 21.7% (95% CI = 4.9-38.6%) in Tunisia to 94.2% (95% CI = 90.8-96.7%) in Libya. An estimated 221 704 PWID were chronically infected, with the largest numbers found in Iran at 68 526 and in Pakistan at 46 554. There was no statistically significant evidence for a decline in HCV antibody prevalence over time. Genotype diversity was moderate (Shannon Diversity Index of 1.01 out of 1.95; 52.1%). The pooled mean percentage for each HCV genotype was highest in genotype 3 (42.7%) and in genotype 1 (35.9%). CONCLUSION Half of people who inject drugs in the Middle East and North Africa appear to have ever been infected with hepatitis C virus, but there are large variations in antibody prevalence among countries. In addition to > 200 000 chronically infected current people who inject drugs, there is an unknown number of people who no longer inject drugs who may have acquired hepatitis C virus during past injecting drug use. Harm reduction services must be expanded, and innovative strategies need to be employed to ensure accessibility to hepatitis C virus testing and treatment.
Collapse
Affiliation(s)
- Sarwat Mahmud
- Infectious Disease Epidemiology Group, Weill Cornell Medicine‐QatarCornell University, Qatar Foundation, Education CityDohaQatar
| | - Ghina R. Mumtaz
- Infectious Disease Epidemiology Group, Weill Cornell Medicine‐QatarCornell University, Qatar Foundation, Education CityDohaQatar,Department of Epidemiology and Population Health, Faculty of Health SciencesAmerican University of BeirutBeirutLebanon
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine‐QatarCornell University, Qatar Foundation, Education CityDohaQatar
| | - Zaina Al Kanaani
- Infectious Disease Epidemiology Group, Weill Cornell Medicine‐QatarCornell University, Qatar Foundation, Education CityDohaQatar
| | - Silva P. Kouyoumjian
- Infectious Disease Epidemiology Group, Weill Cornell Medicine‐QatarCornell University, Qatar Foundation, Education CityDohaQatar
| | - Joumana G. Hermez
- Department of Communicable Diseases, HIV/Hepatitis/STIs Unit, World Health Organization,Regional Office for the Eastern MediterraneanCairoEgypt
| | - Laith J. Abu‐Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine‐QatarCornell University, Qatar Foundation, Education CityDohaQatar,Department of Healthcare Policy and Research, Weill Cornell MedicineCornell UniversityNew YorkNY, USA,College of Health and Life SciencesHamad bin Khalifa UniversityDohaQatar
| |
Collapse
|
4
|
Moradi G, Hajarizadeh B, Rahmani K, Mohamadi-Bolbanabad A, Darvishi S, Zareie B, Zavareh FA, Sharafi H, Alavian SM, Ramazani R, Eftekhar M, Radfar SR, Piroozi B, Gouya MM. Drug use and risk behaviour profile, and the prevalence of HIV, hepatitis C and hepatitis B among people with methamphetamine use in Iran. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 73:129-134. [PMID: 31654935 DOI: 10.1016/j.drugpo.2019.09.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/24/2019] [Accepted: 09/26/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Stimulants substances use, particularly methamphetamine use, is increasing globally, including in Iran. This study assessed the drug use and risk behaviour profile, and prevalence of HIV, hepatitis C virus (HCV), and hepatitis B virus (HBV) among a large population using methamphetamine as their primary drug in Iran. METHODS This cross-sectional study was conducted in eight provinces of Iran. Individuals using methamphetamine for ≥3 months during the past three years, with no life-time history of injecting opioid drugs were enrolled. Drug use and risk behaviour data were collected through interviews. Blood samples were tested for HIV antibodies (HIV Ab), HCV antibodies (HCV Ab), and HBV surface antigen (HBs Ag). RESULT Among 567 participated, 84% were men and mean age was 36 years. Smoking with pipe was the most common method of methamphetamine use (53%), while 13% had a history of injecting methamphetamine, among whom 30% shared needles or syringes. Among those having sex during intoxication phase (n = 270), 48% never used condom. The prevalence of HIV Ab, HCV Ab and HBs Ag was 6.7% (95%CI: 4.7-9.1), 19.4% (95%CI: 16.2-22.9) and 1.4% (95%CI: 0.6-2.7), respectively. Age ≥ 30 years (adjusted OR [aOR]: 2.10, 95%CI: 1.18-3.76), lower education (high school vs. tertiary education, aOR: 13.95, 95%CI: 1.90-102.60), and injecting methamphetamine (aOR: 1.92, 95%CI 1.10-3.35) were significantly associated with HCV exposure. No factor was found associated with HIV infection. Among those reporting no potential injecting or sexual risk factors, 19.8% and 6.8% have HCV Ab positive and HIV Ab positive, respectively. CONCLUSION High prevalence of injecting and sexual risk behaviours, HIV infection and HCV exposure were found among individuals using methamphetamine as their primary drug, demonstrating them as an emerging population at risk of HIV and HCV in Iran. Targeted screening and harm reduction programs for this population are required.
Collapse
Affiliation(s)
- Ghobad Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | - Khaled Rahmani
- Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Amjad Mohamadi-Bolbanabad
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Sonia Darvishi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Bushra Zareie
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Fatemeh Azimian Zavareh
- Iranian Center for Communicable Diseases Control, Ministry of Health & Medical Education, Tehran, Iran
| | - Heidar Sharafi
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Seyed Moayed Alavian
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Rashid Ramazani
- Iranian Center for Communicable Diseases Control, Ministry of Health & Medical Education, Tehran, Iran
| | - Mehrdad Eftekhar
- Mental Health research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Ramin Radfar
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Bakhtiar Piroozi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohammad-Mehdi Gouya
- Iranian Center for Communicable Diseases Control, Ministry of Health & Medical Education, Tehran, Iran.
| |
Collapse
|
5
|
Mental health and cognitive function responses to quetiapine in patients with methamphetamine abuse under methadone maintenance treatment. J Affect Disord 2019; 251:235-241. [PMID: 30928863 DOI: 10.1016/j.jad.2019.03.078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/24/2019] [Accepted: 03/25/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Patients with methamphetamine (MA) abuse under methadone maintenance treatment (MMT) are susceptible to several complications including cognitive disturbance and mental health disorder. This trial was designed to determine the impacts of quetiapine administration on cognitive function and mental health scale in patients with MA abuse under MMT. METHODS This study was carried out in 60 MA abusers under MMT. Patients were randomly allocated to receive either 100 mg quetiapine (n = 30) or control (n = 30) daily for 8 weeks. Cognitive function and mental health scale were taken at baseline and post-treatment to evaluate relevant variables. RESULTS Quetiapine significantly decreased depression (b -3.94; 95% CI, -7.73, -0.16; P = 0.04) and sleep disorder (b -2.18; 95% CI, -2.89, -1.47; P < 0.001). Also, quetiapine administration resulted in a significant reduction in Iowa Gambling Task (b -2.70; 95% CI, -4.69, -0.71; P = 0.009), and significant increases in Verbal Fluency Test (b 3.04; 95% CI, 1.24, 4.85; P = 0.001), Reverse Digit Span (b 2.80; 95% CI, 2.13, 3.47; P = 0.001) compared with the placebo. CONCLUSION Overall, taking 100 mg quetiapine daily for 8 weeks by patients MA abuse in MMT had favorable effects on some of cognitive functions and mental health parameters.
Collapse
|
6
|
Comparison of Continuous Performance Test Results of Former Morphine and Methamphetamine Users During the Early Abstinence Phase. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2018. [DOI: 10.5812/ijpbs.57233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
7
|
Mahmud S, Kouyoumjian SP, Al Kanaani Z, Chemaitelly H, Abu-Raddad LJ. Individual-level key associations and modes of exposure for hepatitis C virus infection in the Middle East and North Africa: a systematic synthesis. Ann Epidemiol 2018; 28:452-461. [PMID: 29661680 DOI: 10.1016/j.annepidem.2018.03.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 03/01/2018] [Accepted: 03/16/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE To identify, map, and synthesize the individual-level key associations and modes of exposure for hepatitis C virus (HCV) infection in the Middle East and North Africa (MENA), the most affected region by HCV. METHODS Source of data was the MENA HCV Epidemiology Synthesis Project database, populated through systematic literature searches. Risk factors determined to be statistically significant after adjustment for confounders were extracted and categorized into key associations or modes of exposure. RESULTS In total, 329 risk factors were identified from 109 articles in 14 of 24 MENA countries. Among key associations, age was most frequently reported (n = 39; 34.2%), followed by other infections/diseases (n = 20; 17.5%), and incarceration (n = 17; 14.9%). Among modes of exposure, health care-related exposures were most frequently reported (n = 127; 59.5%), followed by injecting drug use exposures (n = 45; 20.9%), community-related exposures (n = 34; 15.8%), and sexual-related exposures (n = 8; 3.7%). Blood transfusion, hemodialysis, surgical and other medical procedures, dental work, and medical injections were identified as key health care-related exposures. CONCLUSIONS Health care appears to be the primary driver of prevalent (and possibly incident) infections in MENA, followed by injecting drug use. HCV screening should target the identified modes of exposure. Commitment to prevention should be an integral component of HCV response to achieve HCV elimination by 2030, with focus on strengthening infection control in health care facilities, improving injection safety and blood screening, and expanding harm reduction services for people who inject drugs.
Collapse
Affiliation(s)
- Sarwat Mahmud
- Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation -Education City, Doha, Qatar
| | - Silva P Kouyoumjian
- Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation -Education City, Doha, Qatar
| | - Zaina Al Kanaani
- Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation -Education City, Doha, Qatar
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation -Education City, Doha, Qatar
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation -Education City, Doha, Qatar; Department of Healthcare Policy & Research, Weill Cornell Medicine, Cornell University, New York.
| |
Collapse
|
8
|
Methamphetamine Dependence, Psychological Well-being, Criminality and High Risk Sexual Behaviors in Female-Only Methadone Services in Tehran and Karaj, Iran. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2018. [DOI: 10.5812/ijpbs.61859] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
9
|
Mahmud S, Akbarzadeh V, Abu-Raddad LJ. The epidemiology of hepatitis C virus in Iran: Systematic review and meta-analyses. Sci Rep 2018; 8:150. [PMID: 29317673 PMCID: PMC5760657 DOI: 10.1038/s41598-017-18296-9] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 12/07/2017] [Indexed: 12/12/2022] Open
Abstract
The aim of this study was to characterize hepatitis C virus (HCV) epidemiology in Iran and estimate the pooled mean HCV antibody prevalence in different risk populations. We systematically reviewed and synthesized reports of HCV incidence and/or prevalence, as informed by the Cochrane Collaboration Handbook, and reported our findings following the PRISMA guidelines. DerSimonian-Laird random effects meta-analyses were implemented to estimate HCV prevalence in various risk populations. We identified five HCV incidence and 472 HCV prevalence measures. Our meta-analyses estimated HCV prevalence at 0.3% among the general population, 6.2% among intermediate risk populations, 32.1% among high risk populations, and 4.6% among special clinical populations. Our meta-analyses for subpopulations estimated HCV prevalence at 52.2% among people who inject drugs (PWID), 20.0% among populations at high risk of healthcare-related exposures, and 7.5% among populations with liver-related conditions. Genotype 1 was the most frequent circulating strain at 58.2%, followed by genotype 3 at 39.0%. HCV prevalence in the general population was lower than that found in other Middle East and North Africa countries and globally. However, HCV prevalence was high in PWID and populations at high risk of healthcare-related exposures. Ongoing transmission appears to be driven by drug injection and specific healthcare procedures.
Collapse
Affiliation(s)
- Sarwat Mahmud
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Vajiheh Akbarzadeh
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- Department of Healthcare Policy and Research, Weill Cornell Medical College, Cornell University, New York, New York, USA
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
- Department of Healthcare Policy and Research, Weill Cornell Medical College, Cornell University, New York, New York, USA.
| |
Collapse
|
10
|
Tavitian-Exley I, Maheu-Giroux M, Platt L, Heimer R, Uusküla A, Levina O, Vickerman P, Boily MC. Differences in risk behaviours and HIV status between primary amphetamines and opioid injectors in Estonia and Russia. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 53:96-105. [PMID: 29306786 DOI: 10.1016/j.drugpo.2017.11.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 11/14/2017] [Accepted: 11/20/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND OBJECTIVE People who inject drugs (PWID) account for over half of new HIV infections in Eastern Europe and central Asia, where opioids continue to be the dominant illicit drugs injected. Stimulants including amphetamines (ATS) have been associated with HIV infection risk in several settings. We sought to examine whether primary ATS injection was associated with greater HIV risk, compared to opioid injection in two European locales with significant HIV epidemics. METHODS PWID in Kohtla-Järve and St. Petersburg were recruited using respondent-driven sampling in 2012-2013. Survey data on demographic characteristics, service use, injecting and sexual risk behaviours and HIV-status (and HCV in Kohtla-Järve) were compared between primary opioid and ATS injectors using logistic regression models. RESULTS Of 591 injectors recruited in Kohtla-Järve and 811 in St. Petersburg, 195 (33%) and 27 (4%) primarily injected ATS in each city. In both cities, ATS injectors were younger than opioid injectors, initiated injection later, injected less frequently and were more likely to have been paid for sex. In both cities, PWID had high levels of multiple sex partners. In Kohtla-Järve, ATS-injectors had lower odds of back-loading and greater odds of polydrug use than opioid-injectors. In St. Petersburg, where over half of PWID reported unsafe sharing practices, ATS-injectors were less likely to report these practices. ATS-injection was negatively associated with being HIV positive in Kohtla-Järve (aOR = 0.6; 95%CI: 0.5-0.8) and St. Petersburg (aOR = 0.3; 95%CI: 0.1-0.7). ATS-injection was negatively associated with HCV-reactivity in Kohtla-Järve (aOR = 0.5; 95%CI: 0.3-0.6). CONCLUSIONS In both locations, primary ATS injection was associated with lower injecting risk behaviours, lower odds of HIV and being paid for sex compared to opioid injection. Interventions targeting the characteristics and needs of ATS injectors are needed to increase contact with services and reduce sexual and injecting risk. Harm reduction services, including sexual risk reduction, need to be expanded for all PWID in St. Petersburg.
Collapse
Affiliation(s)
- Isabel Tavitian-Exley
- Department of Infectious Disease Epidemiology, Imperial College London, United Kingdom.
| | - Mathieu Maheu-Giroux
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Canada
| | - Lucy Platt
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Robert Heimer
- Epidemiology of Microbial Diseases, School of Public Health, Yale University, United States
| | - Anneli Uusküla
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Olga Levina
- NGO Stellit, St Petersburg, Russian Federation
| | - Peter Vickerman
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Marie-Claude Boily
- Department of Infectious Disease Epidemiology, Imperial College London, United Kingdom.
| |
Collapse
|
11
|
High prevalence of depressive symptoms and impulsivity as well as their relationship during subacute methamphetamine withdrawal in chronic abusers. J Clin Neurosci 2017; 39:1-3. [DOI: 10.1016/j.jocn.2017.02.062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 02/15/2017] [Indexed: 11/18/2022]
|
12
|
Noori R, Daneshmand R, Farhoudian A, Ghaderi S, Aryanfard S, Moradi A. Amphetamine-Type Stimulants in a Group of Adults in Tehran, Iran: A Rapid Situation Assessment in Twenty-Two Districts. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2016. [DOI: 10.17795/ijpbs-7704] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
13
|
Mouton M, Harvey BH, Cockeran M, Brink CB. The long-term effects of methamphetamine exposure during pre-adolescence on depressive-like behaviour in a genetic animal model of depression. Metab Brain Dis 2016; 31:63-74. [PMID: 26581673 DOI: 10.1007/s11011-015-9765-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 11/11/2015] [Indexed: 01/01/2023]
Abstract
Methamphetamine (METH) is a psychostimulant and drug of abuse, commonly used early in life, including in childhood and adolescence. Adverse effects include psychosis, anxiety and mood disorders, as well as increased risk of developing a mental disorder later in life. The current study investigated the long-term effects of chronic METH exposure during pre-adolescence in stress-sensitive Flinders Sensitive Line (FSL) rats (genetic model of depression) and control Flinders Resistant Line (FRL) rats. METH or vehicle control was administered twice daily from post-natal day 19 (PostND19) to PostND34, followed by behavioural testing at either PostND35 (early effects) or long-lasting after withdrawal at PostND60 (early adulthood). Animals were evaluated for depressive-like behaviour, locomotor activity, social interaction and object recognition memory. METH reduced depressive-like behaviour in both FSL and FRL rats at PostND35, but enhanced this behaviour at PostND60. METH also reduced locomotor activity on PostND35 in both FSL and FRL rats, but without effect at PostND60. Furthermore, METH significantly lowered social interaction behaviour (staying together) in both FRL and FSL rats at PostND35 and PostND60, whereas self-grooming time was significantly reduced only at PostND35. METH treatment enhanced exploration of the familiar vs. novel object in the novel object recognition test (nORT) in FSL and FRL rats on PostND35 and PostND60, indicative of reduced cognitive performance. Thus, early-life METH exposure induce social and cognitive deficits. Lastly, early-life exposure to METH may result in acute antidepressant-like effects immediately after chronic exposure, whereas long-term effects after withdrawal are depressogenic. Data also supports a role for genetic predisposition as with FSL rats.
Collapse
Affiliation(s)
- Moné Mouton
- Centre of Excellence for Pharmaceutical Sciences, Faculty of Health Sciences, Division of Pharmacology, North-West University, Internal box 16, Potchefstroom campus, Potchefstroom, 2520, Republic of South Africa
| | - Brian H Harvey
- Centre of Excellence for Pharmaceutical Sciences, Faculty of Health Sciences, Division of Pharmacology, North-West University, Internal box 16, Potchefstroom campus, Potchefstroom, 2520, Republic of South Africa
| | - Marike Cockeran
- Research Entity for Medicine Usage in South Africa, Faculty of Health Sciences, North-West University, Potchefstroom, 2520, South Africa
| | - Christiaan B Brink
- Centre of Excellence for Pharmaceutical Sciences, Faculty of Health Sciences, Division of Pharmacology, North-West University, Internal box 16, Potchefstroom campus, Potchefstroom, 2520, Republic of South Africa.
| |
Collapse
|
14
|
Alam-mehrjerdi Z, Mokri A, Dolan K. Methamphetamine use and treatment in Iran: A systematic review from the most populated Persian Gulf country. Asian J Psychiatr 2015; 16:17-25. [PMID: 26123235 DOI: 10.1016/j.ajp.2015.05.036] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 05/11/2015] [Accepted: 05/19/2015] [Indexed: 11/26/2022]
Abstract
AIM Methamphetamine use is a new health concern in Iran, the most populated Persian Gulf country. However, there is no well-documented literature. The current study objectives were to systematically review all published English and Persian studies of the prevalence of methamphetamine use, the general physical and psychiatric-related harms and the availability of methamphetamine treatment and harm reduction services for adult users in Iran. MATERIALS AND METHODS A comprehensive search of the international peer-reviewed and gray literature was undertaken. Multiple electronic and scientific English and Persian databases were systematically searched from January 2002 to September 2014. Additionally, English and Persian gray literature on methamphetamine use was sought using online gray literature databases, library databases and general online searches over the same period of time. RESULTS Nineteen thousand and two hundred and eight studies, reports and conference papers were identified but only 42 studies were relevant to the study objectives. They were mainly published in 2010-2014. The search results confirmed the seizures of methamphetamine (six studies), the prevalence of methamphetamine use among the general population (three studies), drug users (four studies), women (nine studies) and opiate users in opiate treatment programs (five studies). In addition, methamphetamine use had resulted in blood-borne viral infections (one study), psychosis and intoxication (ten studies). Different reasons had facilitated methamphetamine use. However, the Matrix Model, community therapy and harm reduction services (four studies) had been provided for methamphetamine users in some cities. CONCLUSION The current situation of methamphetamine use necessitates more research on the epidemiology and health-related implications. These studies should help in identifying priorities for designing and implementing prevention and educational programs. More active models of engagement with Persian methamphetamine users and the provision of services that meet their specific treatment needs are required.
Collapse
Affiliation(s)
- Zahra Alam-mehrjerdi
- Program of International Research and Training, National Drug and Alcohol Research Centre, Faculty of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
| | - Azarakhsh Mokri
- Department of Psychiatry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Kate Dolan
- Program of International Research and Training, National Drug and Alcohol Research Centre, Faculty of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| |
Collapse
|
15
|
Alam-mehrjerdi Z, Noori R, Dolan K. Opioid use, treatment and harm reduction services: the first report from the Persian Gulf region. JOURNAL OF SUBSTANCE USE 2014. [DOI: 10.3109/14659891.2014.966344] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
16
|
Mumtaz GR, Weiss HA, Thomas SL, Riome S, Setayesh H, Riedner G, Semini I, Tawil O, Akala FA, Wilson D, Abu-Raddad LJ. HIV among people who inject drugs in the Middle East and North Africa: systematic review and data synthesis. PLoS Med 2014; 11:e1001663. [PMID: 24937136 PMCID: PMC4061009 DOI: 10.1371/journal.pmed.1001663] [Citation(s) in RCA: 124] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Accepted: 05/08/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND It is perceived that little is known about the epidemiology of HIV infection among people who inject drugs (PWID) in the Middle East and North Africa (MENA). The primary objective of this study was to assess the status of the HIV epidemic among PWID in MENA by describing HIV prevalence and incidence. Secondary objectives were to describe the risk behavior environment and the HIV epidemic potential among PWID, and to estimate the prevalence of injecting drug use in MENA. METHODS AND FINDINGS This was a systematic review following the PRISMA guidelines and covering 23 MENA countries. PubMed, Embase, regional and international databases, as well as country-level reports were searched up to December 16, 2013. Primary studies reporting (1) the prevalence/incidence of HIV, other sexually transmitted infections, or hepatitis C virus (HCV) among PWIDs; or (2) the prevalence of injecting or sexual risk behaviors, or HIV knowledge among PWID; or (3) the number/proportion of PWID in MENA countries, were eligible for inclusion. The quality, quantity, and geographic coverage of the data were assessed at country level. Risk of bias in predefined quality domains was described to assess the quality of available HIV prevalence measures. After multiple level screening, 192 eligible reports were included in the review. There were 197 HIV prevalence measures on a total of 58,241 PWID extracted from reports, and an additional 226 HIV prevalence measures extracted from the databases. We estimated that there are 626,000 PWID in MENA (range: 335,000-1,635,000, prevalence of 0.24 per 100 adults). We found evidence of HIV epidemics among PWID in at least one-third of MENA countries, most of which are emerging concentrated epidemics and with HIV prevalence overall in the range of 10%-15%. Some of the epidemics have however already reached considerable levels including some of the highest HIV prevalence among PWID globally (87.1% in Tripoli, Libya). The relatively high prevalence of sharing needles/syringes (18%-28% in the last injection), the low levels of condom use (20%-54% ever condom use), the high levels of having sex with sex workers and of men having sex with men (15%-30% and 2%-10% in the last year, respectively), and of selling sex (5%-29% in the last year), indicate a high injecting and sexual risk environment. The prevalence of HCV (31%-64%) and of sexually transmitted infections suggest high levels of risk behavior indicative of the potential for more and larger HIV epidemics. CONCLUSIONS Our study identified a large volume of HIV-related biological and behavioral data among PWID in the MENA region. The coverage and quality of the data varied between countries. There is robust evidence for HIV epidemics among PWID in multiple countries, most of which have emerged within the last decade and continue to grow. The lack of sufficient evidence in some MENA countries does not preclude the possibility of hidden epidemics among PWID in these settings. With the HIV epidemic among PWID in overall a relatively early phase, there is a window of opportunity for prevention that should not be missed through the provision of comprehensive programs, including scale-up of harm reduction services and expansion of surveillance systems.
Collapse
Affiliation(s)
- Ghina R. Mumtaz
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Helen A. Weiss
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sara L. Thomas
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Suzanne Riome
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Hamidreza Setayesh
- Joint United Nations Programme on HIV/AIDS Regional Support Team, Middle East and North Africa, Cairo, Egypt
| | - Gabriele Riedner
- Regional Office of the Eastern Mediterranean, World Health Organization, Cairo, Egypt
| | - Iris Semini
- Joint United Nations Programme on HIV/AIDS Regional Support Team, Middle East and North Africa, Cairo, Egypt
| | - Oussama Tawil
- Joint United Nations Programme on HIV/AIDS Regional Support Team, Middle East and North Africa, Cairo, Egypt
| | - Francisca Ayodeji Akala
- Human Development Sector, Middle East and North Africa Region, World Bank, Washington (D.C.), United States of America
| | - David Wilson
- Global HIV/AIDS Program, World Bank, Washington (D.C.), United States of America
| | - Laith J. Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- Department of Healthcare Policy and Research, Weill Cornell Medical College, Cornell University, New York, New York, United States of America
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| |
Collapse
|