Publications

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    • Drogues, Statistiques
    • 2012
    • Article
    • Anglais

    BACKGROUND:
    To determine the seroprevalence of hepatitis B (HBV), hepatitis C (HCV) and HIV infections in problem drug users (PDU) in Luxembourg. To measure the validity of self-reported test results provided by study participants as well as obtained through the national drug-monitoring system (RELIS).
    METHODS:
    In a cross-sectional multisite study, data were collected by voluntary, anonymous and assisted questionnaires and serological detection of antibodies and antigens. Out of 1169 contacts, 397 participants were recruited within in and out-of-treatment settings (84.2% injecting drug users; IDU).
    RESULTS:
    The prevalence of antibodies to HIV was 8/272 (2.9%; 95% CI 0.9% to 4.9%), to HCV 245/343 (71.4%; 66.6% to 76.2%), and 67/310 (21.6%; 17.1% to 26.2%) to total HBV antibodies and surface antigen (for IDU 5/202, 218/268 and 59/239, respectively). Specificity of study self-reports was very high for HBV and perfect for HCV and HIV. Sensitivity was 0.224, 0.798 and 0.800, respectively. Kappa scores provided degrees of agreement between serological tests and study self-reports of 0.89 for HIV, 0.65 for HCV and 0.25 for HBV. In contrast to simultaneous cross-sectional self-reports, secondary self-reported data (RELIS) showed high agreement for HIV and HBV infections and provided a good proxy for estimation of HCV seroprevalence.
    CONCLUSION:
    HIV testing routines in PDU should be completed at least by HBV and HCV detection given the poor validity of cross-sectional self-reports on hepatitis infections. HIV and hepatitis prevalence estimations in PDU gain by relying on multisite/setting data collection. Research should further investigate the validity of HIV and hepatitis self-reports from routine drug-monitoring systems versus cross-sectional surveys.

    Souce: Pubmed

    • Date de parution:
    • Editeur: BMJ
    • Statistiques, Drogues
    • 2014
    • Article
    • Anglais

    BACKGROUND:
    To investigate social and economic inequalities in fatal overdose cases related to opioid and cocaine use, recorded in Luxembourg between 1994 and 2011.
    METHODS:
    Cross-examination of national data from law enforcement and drug use surveillance sources and of forensic evidence in a nested case-control study design. Overdose cases were individually matched with four controls, when available, according to sex, year of birth, drug administration route and duration of drug use. 272 cases vs 1056 controls were analysed. Conditional logistic regression analysis was performed to assess the respective impact of a series of socioeconomic variables.
    RESULTS:
    Being professionally active [OR=0.66 (95% CI 0.45-0.99)], reporting salary as main legal income source [OR=0.42 (95% CI 0.26-0.67)] and education attainment higher than primary school [OR=0.50 (95% CI 0.34-0.73)] revealed to be protective factors, whereas the professional status of the father or legal guardian of victims was not significantly associated to fatal overdoses.
    CONCLUSIONS:
    Socioeconomic inequalities in drug users impact on the occurrence of fatal overdoses. Compared to their peers, users of illicit drugs with lower socioeconomic profiles show increased odds of dying from overdose. However, actual and self-referred socioeconomic characteristics of drug users, such as educational attainment and employment, may have a greater predictive value of overdose mortality than the parental socioeconomic status. Education, vocational training and socio-professional reintegration should be part of drug-related mortality prevention policies.

    Souce: Pubmed

    • Date de parution:
    • Editeur: Elsevier
    • Drogues, Statistiques
    • 2014
    • Article
    • Anglais

    BACKGROUND/AIM:
    We analysed gender differences in national fatal overdose (FOD) cases related to opiates and cocaine use between 1985 and 2011 (n = 340).
    METHODS:
    Cross-examination of national data from law enforcement and drug use surveillance sources and of forensic evidence. Bivariate and logistic regression analysis of male/female differences according to sociodemographics, forensic evidence and drug use trajectories.
    RESULTS:
    The burden of deaths caused by FOD on the general national mortality was higher for men (PMR/100=0.55) compared with women (PMR/100=0.34). Compared with their male peers, women were younger at the time of death (t=3.274; p=0.001) and showed shorter drug use careers (t=2.228; p=0.028). Heroin use was recorded more frequently in first drug offences of female victims (AOR=6.59; 95% CI 2.97-14.63) and according to forensic evidence, psychotropic prescription drugs were detected to a higher degree in females (AOR=2.019; 95% CI 1.065-3.827).
    CONCLUSION:
    The time window between the onset of illicit drug use and its fatal outcome revealed to be shorter for women versus men included in our study. Early intervention in female drug users, routine involvement of first-line healthcare providers and increased attention to use of poly- and psychotropic prescription drugs might contribute to prevent premature drug-related death and reduce gender differences.

    Souce: Pubmed

    • Date de parution:
    • Editeur: Karger
    • Santé mentale, Maladies, Statistiques
    • 2008
    • Ouvrage
    • Anglais

    [Atlas de la santé en Europe]
    This updated statistical atlas presents key health figures for the WHO European Region. They cover basic data on populations, births, deaths, life expectancy and diseases, lifestyle and environmental indicators, such as drinking, smoking and traffic accidents, and types and levels of health care.
    Each indicator is presented as a map to show overall regional variations, a bar chart to indicate country rankings and a time chart to show trends over time in three main country groupings.
    Using the WHO Regional Office for Europe’s unique Health for All database, combined with the best alternative sources of data around the Region, this atlas offers the most comprehensive overview of health in Europe. In a handy size, this atlas is designed to be an easily accessible resource at all times, in the office or on the road.

    • Date de parution:
    • Editeur: Organisation Mondiale de la Santé (OMS) [World Health Organization (WHO)]
    • Politique nationale, Statistiques
    • 2009
    • Communiqué
    • Français, Anglais

    Cette enquête a été réalisée à la demande du ministère de la Santé auprès de 484 personnes (333 Luxembourgeois et 151 étrangers) de plus de 17 ans. Elle révèle que le taux de satisfaction des patients est particulièrement élevé lorsqu’on les interroge sur la transparence, la visibilité et l’accès aux soins de santé.
    En comparant le système de santé luxembourgeois et celui d’autres pays, qui sont dotés soit d’un système similaire, soit d’un système très éloigné (les États-Unis), l’enquête permet de situer le système luxembourgeois à l’échelle internationale et d‘en faire ressortir les particularités et les carences éventuelles.

    • Date de parution:
    • Editeur: Ministère de la Santé
    • Statistiques, Drogues
    • 2012
    • Article
    • Anglais

    BACKGROUND:
    To estimate the prevalence of problem drug use (PDU) and injecting drug use (IDU) in Luxembourg and analyze trends between 1997 and 2009. To assess the feasibility of prevalence estimations based on drug use surveillance systems.
    METHODS:
    Serial multi-method PDU/IDU prevalence estimations based upon capture-recapture, Poisson regression, multiplier and back-calculation methods. Comparative analysis of methods and assessment of their robustness to variations of external factors.
    RESULTS:
    National PDU and IDU prevalence rates were estimated at 6.16/1,000 (95% CI 4.62/1,000 to 7.81/1,000) and 5.68/1,000 (95% CI 4.53/1,000 to 6.85/1,000) inhabitants aged 15-64 years, respectively. Absolute prevalence and prevalence rates of PDU increased between 1997 and 2000 and declined from 2003 onwards, whereas IDU absolute prevalence and prevalence rates witnessed an increasing trend between 1997 and 2007.
    CONCLUSIONS:
    Drug use surveillance systems can be valuable instruments for the estimation and trend analysis of drug misuse prevalence given multiple methods are applied that rely on serial and representative data from different sources and different settings, control multiple counts and build upon standardized and sustained data collection routines. The described institutional contact indicator revealed to be a useful tool in the context of PDU/IDU prevalence estimations and thus contributes to enhancing evidence-based drug policy planning.

    Souce: Pubmed

    • Date de parution:
    • Editeur: Karger
    • Drogues, Statistiques
    • 2015
    • Article
    • Anglais

    BACKGROUND:
    To determine the existence of a social gradient in fatal overdose cases related to non-prescribed opioids and cocaine use, recorded in Luxembourg between 1994 and 2011.
    METHODS:
    Overdose cases were individually matched with four controls in a nested case-control study design, according to sex, year of birth, drug administration route and duration of drug use. The study sample, composed of 272 cases and 1,056 controls, was stratified according to a Social Inequality Accumulation Score (SIAS), based on educational attainment, employment, income, financial situation of subjects and the professional status of their father or legal guardian. Least squares linear regression analysis on overdose mortality rates and ridit scores were applied to determine the Relative Index of Inequality (RII) of the study sample.
    RESULTS:
    A negative linear relationship between the overdose mortality rate and the relative socioeconomic position was observed. We found a difference in mortality of 29.22 overdose deaths per 100 drug users in the lowest socioeconomic group compared to the most advantaged group. In terms of the Relative Inequality Index, the overdose mortality rate of opioid and cocaine users with lowest socioeconomic profiles was 9.88 times as high as that of their peers from the highest socioeconomic group (95% CI 6.49-13.26).
    CONCLUSIONS:
    Our findings suggest the existence of a marked social gradient in opioids and cocaine related overdose fatalities. Harm reduction services should integrate socially supportive offers, not only because of their general aim of social (re)integration but crucially in order to meet their most important objective, that is to reduce drug-related mortality.

    Souce: Pubmed

    • Date de parution:
    • Editeur: Plos One
    • Maladies, Statistiques
    • 2011
    • Ouvrage
    • Anglais

    [livre blanc EHRA: La situation actuelle en matière d'électrophysiologie cardiaque pour le Luxembourg]

    The White Book contains information about the current status of cardiac electrophysiology in many European countries.

    The EHRA’s White Book has become a reference for those seeking information about invasive rhythm procedures in Europe and the Mediterranean area countries. No other publication provides such a comprehensive collection of data from this region of the globe. The process of gathering the data for the White Book is complex and necessarily involves different sources among which the national scientific societies play a major role. The principle followed is to obtain the best possible evidence. Despite this, the disparity of the data sources produces some heterogeneity and some of them are based upon raw estimation from the national scientific societies.

    However, the principle that some data is better than no data was followed in this book, and when data come just from estimation, this is clearly indicated in the book.

    • Date de parution:
    • Editeur: European Society of Cardiology (ESC)
  • Dernière modification le 12-10-2015