Tuberculosis screening in a novel substance abuse treatment center in Malaysia: Implications for a comprehensive approach for integrated care

Al-Darraji, Haider Abdulrazzaq Abed; Wong, Kee Cheong; Yeow, David Gan Eng; Fu, Jiaju; Loeliger, Kelsey; Paiji, Christopher; Kamarulzaman, Adeeba; Altice, Frederick L.

doi:10.1016/j.jsat.2013.08.023

Cited by 17 publications

(24 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Unlike most of the studies of male drug users in Malaysia (63, 65, 77), the prevalence of ATS use among women who use drugs is extraordinarily high and in the absence of medication-assisted treatments, remains largely unaddressed (59, 65). This difference in substance use patterns is also observed in Southeast Asia generally, where the estimated age-adjusted prevalence of ATS dependence among women is 0.31% (95% CI: 0.23–0.42), while prevalence of opioid dependence is over three times lower at 0.09% (95% CI: 0.06–0.13)(29).…”

Section: Discussionmentioning

confidence: 97%

Patterns of substance use and correlates of lifetime and active injection drug use among women in Malaysia

Wickersham

Loeliger

Marcus

et al. 2015

The American Journal of Drug and Alcohol Abuse

Self Cite

View full text Add to dashboard Cite

Background While drug use is associated with HIV risk in Southeast Asia, little is known about substance use behaviors among women, including drug injection. Objectives To describe patterns of substance use among women using alcohol and drugs in Malaysia and identify correlates of lifetime and active drug injection, a risk factor for HIV transmission. Methods A survey of 103 women who used drugs in the last 12 months assessed drug use history and frequency, including drug injection and drug use during pregnancy, self-reported HIV-status, childhood and adulthood physical and sexual abuse, and access to and utilization of harm reduction services, including needle-syringe exchange programs (NSEP) and opioid agonist maintenance therapy (OAT). Principal component analyses (PCA) were conducted to assess drug use grouping. Results Amphetamine-type substances (ATS; 82.5%), alcohol (75.7%) and heroin (71.8%) were the most commonly used drugs across the lifetime. Drug injection was reported by 32.0% (n=33) of participants with 21.4% (n=22) having injected in the last 30 days. PCA identified two groups of drug users: opioids/benzodiazepines and club drugs. Lifetime drug injection was significantly associated with lower education, homelessness, prior criminal justice involvement, opioid use, polysubstance use, childhood physical and sexual abuse, and being HIV-infected, but not with prior OAT. Conclusion Women who use drugs in Malaysia report high levels of polysubstance use and injection-related risk behaviors, including sharing of injection equipment and being injected by others. Low OAT utilization suggests the need for improved access to OAT services and other harm reduction measures that prioritize women.

show abstract

Section: Discussionmentioning

confidence: 97%

Patterns of substance use and correlates of lifetime and active injection drug use among women in Malaysia

Wickersham

Loeliger

Marcus

et al. 2015

The American Journal of Drug and Alcohol Abuse

Self Cite

View full text Add to dashboard Cite

show abstract

“…This strategy presents an opportunity for the health system to manage multiple related issues, which could result in an overall cost savings to the system and respond to calls in the literature for integrative approaches to co-treating infectious disease and substance use disorders. 46–49 …”

Section: Discussionmentioning

confidence: 99%

Tuberculosis and excess alcohol use in the United States, 1997–2012

Volkmann¹,

Moonan²,

Miramontes³

et al. 2015

int j tuberc lung dis

View full text Add to dashboard Cite

SUMMARY BACKGROUND Excess alcohol use among tuberculosis (TB) patients complicates TB control strategies. OBJECTIVES To characterize the role of excess alcohol use in TB control, we describe the epidemiology of excess alcohol use and TB in the United States among those aged ≥15 years. DESIGN Using data reported to the National Tuberculosis Surveillance System, 1997–2012, we examined associations between excess alcohol use and TB treatment outcomes and markers for increased transmission (involvement in a local genotype cluster of cases) using multivariate logistic regression. We used Cox proportional hazards regression analysis to examine the relationship between excess alcohol use and the rate of conversion from positive to negative in sputum culture results. RESULTS Excess alcohol use was documented for 31 207 (15.1%) of 207 307 patients. Prevalence of excess alcohol use was greater among male patients (20.6%) and US-born patients (24.6%). Excess alcohol use was associated with a positive sputum smear result (aOR 1.23, 95%CI 1.18–1.28) and death during treatment (vs. completion of treatment) (aOR 1.16, 95%CI 1.10–1.22). The rate of culture conversion was higher among patients without excess alcohol use (adjusted hazard ratio 1.20, 95%CI 1.18–1.23). CONCLUSIONS Excess alcohol use was common among patients with TB, and was associated with TB transmission, lower rates of sputum culture conversion, and greater mortality.

show abstract

“…A study in Malaysia demonstrated that TB screening and care in drug rehabilitation centres and facilities offering OST was a very effective targeting strategy. 150 …”

Section: Drug Policy and Infectious Diseasesmentioning

confidence: 99%

Public health and international drug policy

et al. 2016

Self Cite

View full text Add to dashboard Cite

Executive summary In September 2015, the member states of the United Nations endorsed sustainable development goals (SDG) for 2030 that aspire to human rights-centered approaches to ensuring the health and well-being of all people. The SDGs embody both the UN Charter values of rights and justice for all and the responsibility of states to rely on the best scientific evidence as they seek to better humankind. In April 2016, these same states will consider control of illicit drugs, an area of social policy that has been fraught with controversy, seen as inconsistent with human rights norms, and for which scientific evidence and public health approaches have arguably played too limited a role. The previous UN General Assembly Special Session (UNGASS) on drugs in 1998 – convened under the theme “a drug-free world, we can do it!” – endorsed drug control policies based on the goal of prohibiting all use, possession, production, and trafficking of illicit drugs. This goal is enshrined in national law in many countries. In pronouncing drugs a “grave threat to the health and well-being of all mankind,” the 1998 UNGASS echoed the foundational 1961 convention of the international drug control regime, which justified eliminating the “evil” of drugs in the name of “the health and welfare of mankind.” But neither of these international agreements refers to the ways in which pursuing drug prohibition itself might affect public health. The “war on drugs” and “zero-tolerance” policies that grew out of the prohibitionist consensus are now being challenged on multiple fronts, including their health, human rights, and development impact. The Johns Hopkins – Lancet Commission on Drug Policy and Health has sought to examine the emerging scientific evidence on public health issues arising from drug control policy and to inform and encourage a central focus on public health evidence and outcomes in drug policy debates, such as the important deliberations of the 2016 UNGASS on drugs. The Johns Hopkins-Lancet Commission is concerned that drug policies are often colored by ideas about drug use and drug dependence that are not scientifically grounded. The 1998 UNGASS declaration, for example, like the UN drug conventions and many national drug laws, does not distinguish between drug use and drug abuse. A 2015 report by the UN High Commissioner for Human Rights, by contrast, found it important to emphasize that “[d]rug use is neither a medical condition nor does it necessarily lead to drug dependence.” The idea that all drug use is dangerous and evil has led to enforcement-heavy policies and has made it difficult to see potentially dangerous drugs in the same light as potentially dangerous foods, tobacco, alcohol for which the goal of social policy is to reduce potential harms. Health impact of drug policy based on enforcement of prohibition The pursuit of drug prohibition has generated a parallel economy run by criminal networks. Both these networks, which resort to violence to protect their markets, and the police and sometimes military ...

show abstract

Tuberculosis screening in a novel substance abuse treatment center in Malaysia: Implications for a comprehensive approach for integrated care

Cited by 17 publications

References 34 publications

Patterns of substance use and correlates of lifetime and active injection drug use among women in Malaysia

Patterns of substance use and correlates of lifetime and active injection drug use among women in Malaysia

Tuberculosis and excess alcohol use in the United States, 1997–2012

Public health and international drug policy

Contact Info

Product

Resources

About