BackgroundRegistration of patients with substance use disorders is of key importance to get insights and to study trends in patients characteristics and substance use patterns. The Treatment Demand Indicator (TDI) is gathering this information at European level since 2000. In Belgium, this registration started at national level in 2011 and an increasing number of facilities of different types are participating in this data collection since then.Methods/DesignThis surveillance register collects information on every treatment episode started by patients for their substance use disorder. Information is collected on socio-demographic characteristics of the patient, treatment history and substance use patterns. Patients are identified uniquely using their national identification number in order identify multiple episodes followed by a same person. A large range of treatment facilities have the possibility to participate in this registration to allow a wide coverage of the population.DiscussionThe objective of the paper is to facilitate the use of data by authorities or researchers by correctly describing all aspects of the indicator. The case definition, the variables collected and the way data should be reported are of key importance to use and interpret the data correctly. An overview of the data registered in 2014 gives also an idea of the content of the database. The article also pictures the strengths and limitations of the register and foresees some future improvements.
Background: In Belgium, people who inject drugs (PWID) are at a high risk of being infected by hepatitis C (HCV) as injecting drug use is the main mode for transmission of HCV in Europe. Estimates about the number of people living with HCV in Belgium are rare and even less is known about the prevalence of HCV among PWID. Method: Between 1 February 2019 and 26 April 2019, PWID and high-risk opiate users (HROU) were recruited in Brussels through respondent-driven sampling (RDS). They were invited to a questionnaire and underwent a rapid HCV test. Results: A total of 253 respondents participated in the study, of which 168 were PWID and 238 were HROU, with 153 respondents belonging to both categories. The overall unweighted sample average for HCV antibodies was 41.1%. The weighted population estimates were 43.7% (95% CI 30.6-56.8%) for RDS-II and 43.4% (95% CI 28.9-58.0%) for RDS-SS. Conclusions: This prevalence is lower than the prevalence estimates reported elsewhere in Europe. However, the data still suggest that serious efforts are needed to reach the goal set by the WHO to reduce HCV by 2030 with 90%.
Background: In Belgium, people who inject drugs (PWID) are at a high risk of being infected by hepatitis C (HCV) as injecting drug use is the main mode for transmission of HCV in Europe. Estimates about the number of people living with HCV in Belgium are rare and even less is known about the prevalence of HCV among PWID. Method: Between 1 February 2019 and 26 April 2019, PWID and high risk opiate users (HROU) were recruited in Brussels through respondent driven sampling (RDS). They were invited to a questionnaire and underwent a rapid HCV-test. Results: 253 respondents participated in the study, of which 168 were PWID and 238 were HROU, with 153 respondents belonging to both categories. The overall unweighted sample average for HCV antibodies was 41.1%. The weighted population estimates were 43.7% (95%CI: 30.6% - 56.8%) for RDS-II and 43.4% (95%CI: 28.9% - 58.0%) for RDS-SS. Conclusions: This prevalence is lower than the prevalence estimates reported elsewhere in Europe. However, the data still suggest that serious efforts are needed to reach the goal set by the WHO to reduce HCV by 2030 with 90%.
Background The objective of the study was to describe the frequencies of health-care utilization by people with substance use disorder (SUD), including contacts with general practitioners (GP), psychiatrists, emergency departments (ED) and hospital admissions and to compare this frequency to the general population. Methods Data from the national register of people who were in treatment for SUD between 2011 and 2014 was linked to health care data from the Belgian health insurance (N = 30,905). Four comparators were matched on age, sex and place of residence to each subject in treatment for SUD (N = 123,620). Cases were further divided in five mutually exclusive categories based on the main SUD (opiates, crack/cocaine, stimulants, cannabis and alcohol). We calculated the average number of contacts with GP, psychiatrists and ED, and hospital admissions per person over a ten year period (2008–2017), computed descriptive statistics for each of the SUD and used negative binomial regression models to compare cases and comparators. Results Over the ten-year period, people in treatment for SUD overall had on average 60 GP contacts, 3.9 psychiatrist contacts, 7.8 visits to the ED, and 16 hospital admissions. Rate ratios, comparing cases and corresponding comparators, showed that people in treatment for SUD had on average 1.9 more contacts with a GP (95 % CI 1.9-2.0), 7.4 more contacts with a psychiatrist (95 % CI 7.0-7.7), 4.2 more ED visits (95 % CI 4.2–4.3), and 6.4 more hospital admissions (95 % CI 6.3–6.5). Conclusions The use of health services for people with SUD is between almost two (GP) and seven times (psychiatrist) higher than for comparators. People in treatment for alcohol use disorders use health care services more frequently than people in treatment for other SUD. The use of health services remained stable in the five years before and after the moment people with SUD entered into treatment for SUD. The higher use of primary health care services by people with SUD might indicate that they have higher health care needs than comparators.
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