Theme: Epidemiology & Public Health Research Year: 2017
Background
People who use injectable drugs (PWUID) are a population at high risk of hepatitis C (HCV) and HIV infection worldwide. Access to opioid substitution therapy (OST) is a key challenge for controlling the spread of both diseases. In Senegal, the ANRS 12243 UDSEN study (2012 – 2014) has estimated the size of PWUID living in Dakar at 1324, with a prevalence of HIV and HCV reaching 5,2% and 23,3%, respectively. In this context, the CEPIAD (Dakar Center for addiction management) has opened in 2014 and 192 PWUID are currently offered OST combined with medical and psycho-social follow-up. Within the center, the CoDISEN cohort study provides data on the efficacy of an integrated approach of care for PWUID.
Methods
CoDISEN is a prospective, monocentric, cohort with a six-monthly follow-up for a total duration of 3 years. Main inclusion criteria are age above 18, active use of injecting drugs or on OST and residency in Dakar> 3 months. At baseline, all patients are offered a complete medical and biological check-up with psycho-social evaluation and addiction appraisal. A sub-study on anthropologic determinants of drug use is also ongoing. The number of patients to be included will be 500.
Results
As of the 4th of May 2017, 88 patients have been included, of whom 83 are on OST. Age median is 47 years and 4,3 % are women. The number of positive HBs Antigen, HCV or HIV antibodies is 9, 8 and 4, respectively. HBV vaccination has been offered to 22 patients without HBV markers.
Conclusion
The CoDISEN will provide a unique set of data of the impact of an integrated approach for the management of PWUID. This innovative research program should help shaping future public health policies regarding the prevention of HIV and HCV in this high risk group living in Sub-Saharan Africa.