Frequency, factors and costs associated with injection site infections: Findings from a national multi-site survey of injecting drug users in England
Frequency, factors and costs associated with injection site infections: Findings from a national multi-site survey of injecting drug users in England
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DOI：
10.1186/1471-2334-8-120
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发表时间：
2008-09-18
影响因子：
3.7
通讯作者：
Ncube, Fortune
中科院分区：
文献类型：
--
作者：
Hope, Vivian;Kimber, Jo;Ncube, Fortune
背景资料：在北美，注射吸毒者注射部位感染与严重的发病率和保健服务费用有关。本研究探讨了注射部位感染的频率，因素和相关的成本在英格兰的IDUs。方法：Unlinked匿名调查在2003/05年招募IDUs从社区设置在7个地点在英格兰各地。使用问卷收集自我报告的注射实践、注射部位感染症状（脓肿或开放性伤口）和卫生服务利用数据，参与者还提供干血斑样本（检测血液传播病毒感染标志物）。通过将问卷调查数据与国家数据库和科学文献中的信息相结合，获得了成本估计。结果：在1,058名参与者中，有36%的人在去年报告了注射部位感染。那些报告注射部位感染的人更可能是女性，年龄超过24岁，并且有：去年注射到腿部，腹股沟和手部;在过去四周内注射14天或以上;清洁针头/注射器重复使用;注射快克可卡因;丙型肝炎抗体;以前接受过处方的替代药物。三分之二的注射部位感染者报告寻求医疗建议;一半人参加了急诊科，其中四分之三报告住院。相关医疗保健成本的简单保守估计范围从每年1550万英镑到高达磅万英镑;不过，如果做出不那么保守的单位成本假设，总额可能会高得多（磅万英镑）。这些费用中的绝大多数是由于住院和不确定性是由于很少的数据住院时间stays.Conclusion：注射部位感染的症状是常见的注射吸毒者在英格兰。卫生服务的潜在成本是巨大的，但这些成本需要更准确的确定。需要制定和评估更有针对性的干预措施，以支持更安全的注射。自我报告症状的有效性，以及症状，感染严重程度和就医行为之间的关系需要进一步研究。
Background: Injection site infections among injecting drug users (IDUs) have been associated with serious morbidity and health service costs in North America. This study explores the frequency, factors and costs associated with injection site infections among IDUs in England.Methods: Unlinked-anonymous survey during 2003/05 recruiting IDUs from community settings at seven locations across England. Self-reported injecting practice, symptoms of injection site infections ( abscess or open wound) and health service utilisation data were collected using a questionnaire, participants also provided dried blood spot samples ( tested for markers blood borne virus infections). Cost estimates were obtained by combining questionnaire data with information from national databases and the scientific literature.Results: 36% of the 1,058 participants reported an injection site infection in the last year. Those reporting an injection site infection were more likely to be female and aged over 24, and to have: injected into legs, groin, and hands in last year; injected on 14 or more days during the last four weeks; cleaned needles/syringes for reuse; injected crack-cocaine; antibodies to hepatitis C; and previously received prescribed substitute drug. Two-thirds of those with an injection site infection reported seeking medical advice; half attended an emergency department and three-quarters of these reported hospital admission. Simple conservative estimates of associated healthcare costs range from 15.5 pound million per year to as high as 30 pound million; though if less conservative unit costs assumptions are made the total may be much higher (47 pound million). The vast majority of these costs are due to hospital admissions and the uncertainty is due to little data on length of hospital stays.Conclusion: Symptoms of injection site infections are common among IDUs in England. The potential costs to the health service are substantial, but these costs need more accurate determination. Better-targeted interventions to support safer injection need to be developed and evaluated. The validity of self-reported symptoms, and the relationship between symptoms, infection severity, and health seeking behaviour require further research.