Improved benchmark-multiplier method to estimate the prevalence of ever-injecting drug use in Belgium, 2000-10.
Improved benchmark-multiplier method to estimate the prevalence of ever-injecting drug use in Belgium, 2000-10.
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DOI：
10.1186/0778-7367-71-10
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发表时间：
2013-05-03
期刊：
影响因子：
--
通讯作者：
Sasse A
中科院分区：
文献类型：
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作者：
Bollaerts K;Aerts M;Sasse A
对吸毒人口规模的准确估计对于循证决策至关重要。然而，吸毒者构成了一个“隐藏”人口，因此需要使用间接方法来估计人口规模。采用基准乘数法，利用来自全国艾滋病毒/艾滋病登记册和注射吸毒者血清行为研究的数据，估计比利时18-64岁的曾经注射吸毒者的人口规模。然而，由于缺乏风险因素信息和对艾滋病毒阳性/艾滋病病例缺乏后续行动，限制了比利时艾滋病毒/艾滋病登记册作为基准的作用。为了克服这些局限性，需要进行统计校正。特别是，使用链式方程估算法来校正缺失的风险因素信息，而随机死亡率模型则用于说明艾滋病毒阳性/艾滋病阴性病例的死亡率。采用蒙特卡罗模拟获得置信区间，适当反映随机误差引起的不确定性以及与上述两种统计校正相关的不确定性。2010年，曾注射吸毒者的患病率（/1000）估计为3.5，95%置信区间[2.5;4.8]。2000-2010年期间没有观察到明显的时间趋势。为了能够使用比利时艾滋病毒/艾滋病登记册作为基准来估计注射吸毒者的人口规模，需要进行统计校正，否则将产生严重偏差的估计。通过制定改进的方法，比利时再次能够提供曾经注射吸毒者的人口估计数，这对于评估治疗覆盖率和预测保健需求和费用至关重要。
Accurate estimates of the size of the drug-using populations are essential for evidence-based policy making. However, drug users form a ‘hidden’ population, necessitating the use of indirect methods to estimate population sizes. The benchmark-multiplier method was applied to estimate the population size of ever injecting drug users (ever-IDUs), aged 18–64 years, in Belgium using data from the national HIV/AIDS register and from a sero-behavioral study among injecting drug users. However, missing risk factor information and absence of follow-up of the HIV+/AIDS– cases, limits the usefulness of the Belgian HIV/AIDS register as benchmark. To overcome these limitations, statistical corrections were required. In particular, Imputation by Chained Equations was used to correct for the missing risk factor information whereas stochastic mortality modelling was applied to account for the mortality among the HIV+/AIDS– cases. Monte Carlo simulation was used to obtain confidence intervals, properly reflecting the uncertainty due to random error as well as the uncertainty associated with the two statistical corrections mentioned above. In 2010, the prevalence (/1000) of ever-IDUs was estimated to be 3.5 with 95% confidence interval [2.5;4.8]. No significant time trends were observed for the period 2000–2010. To be able to estimate the ever-IDU population size using the Belgian HIV/AIDS register as benchmark, statistical corrections were required without which seriously biased estimates would result. By developing the improved methodology, Belgium is again able to provide ever-IDU population estimates, which are essential to assess the coverage of treatment and to forecast health care needs and costs.