Tag: ECDC

Key interventions to prevent and control infections among people who inject drugs

Posted on by Milutin

Injecting drug use remains a crucial risk factor for acquiring blood-borne viruses such as hepatitis B and C, and HIV, but also other infectious diseases, such as sexually transmitted infections (STIs) and tuberculosis (TB). While for STIs and TB, injecting drugs does not directly cause infection, factors such as living conditions or higher-risk sexual practices place some people who inject drugs at a greater risk.

In new public health guidance released today, the European Centre for Disease Prevention and Control (ECDC) and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) have joined forces to identify key interventions to address infectious diseases in this population. Reflecting on new evidence, infectious disease treatments, and public health concepts, this guidance updates the 2011 edition.

This joint guidance reinforces the need for a comprehensive and coordinated approach to addressing the persistent public health challenge of drug-related infections in EU/EEA countries. Ultimately, it aims to improve the well-being and health outcomes of individuals affected by these issues.

The guidance aims to support policy-makers and public health/social programme planners by providing an evidence base for developing national strategies, policies, and programmes for preventing and controlling infections and infectious diseases among people who inject drugs. It also provides practice considerations and aims to inform the monitoring and evaluation of prevention and control strategies, policies, and programmes.

The six key intervention areas and recommendations proposed in the guidance range from the provision of sterile injection equipment, testing, and vaccination, to the treatment of infections and drug dependence. They are:

  • Sterile injection equipment – provide sterile needles and syringes and other drug preparation equipment (cookers, filters and water for injection), including in prisons and through pharmacies.
  • Drug dependence treatment – provide opioid agonist treatment (OAT), including in prisons, for people who are dependent on opioids. OAT should be offered in conjunction with sterile injecting equipment and information, education, and counselling.
  • Vaccination – offer vaccinations against hepatitis A and B, respiratory infections and tetanus, as well as the pneumococcal and the human papillomavirus vaccines for people living with HIV who inject drugs.
  • Testing – routinely offer voluntary and confidential infectious disease testing and link all people with a positive test result to care.
  • Infectious disease treatment – offer infectious disease treatment according to national and international guidelines, ensure there is good cooperation and links between service providers dedicated to people who inject drugs and infectious disease care; involve peer mentors to strengthen adherence to treatment.
  • Drug consumption rooms – provide supervised injecting facilities to reduce injecting risk behaviour among people who inject drugs, which could as a consequence contribute to the prevention of HCV and HIV transmission.

To access the Guidance follow this link>>>.

 

Increasing linkage to care and adherence to treatment for hepatitis C among people who inject drugs

Posted on by Milutin

Hepatitis C virus (HCV) infection is a major public health threat due to disease burden and risk of complications and death. Injecting drug use is the most likely mode of HCV transmission reported in the EU/EEA and accounted for 49% of acute and 61% of chronic infections in 2018. Compared to other drug-associated blood-borne viral infections, HCV is the most prevalent one among people who inject drugs (PWID) across Europe. Prevalence of HCV antibody among PWID estimated from nationally representative samples ranged between 15% and 86% during 2018–2019. The prevalence of current infections measured by HCV-RNA (or antigen) tests ranged from 15% to 64% between 2013 and 2019 in six countries with available data. PWID are therefore considered as a priority population in prevention, testing, linkage to care and treatment, and prevention of re-infections to achieve HCV elimination.

Following advances in treatment for hepatitis C (HCV), optimizing linkage to care and adherence to treatment of people who inject drugs became of pivotal importance. An ECDC/EMCDDA stakeholders survey in 2018 indicated that two components of the cascade of care, linkage to care and adherence to treatment, were priority areas for inclusion in the updated guidance, planned for publication in 2022. The systematic review Interventions to increase linkage to care and adherence to treatment for hepatitis C among people who inject drugs: A systematic review and practical considerations from an expert panel consultation was commissioned with the aim to evaluate the effectiveness of interventions on HCV linkage to care and adherence to treatment among people who inject drugs.

Available evidence suggests that integrated, people-centered approaches may improve engagement throughout the continuum of HCV care among people who inject drugs. For progressing HCV elimination efforts, interventions should be implemented in colocation with harm reduction and counselling activities and in combination with additional services, including opioid substitution treatment, directly observed therapy, peer support and/or contingency management.

Highlights of the review include:

  • Integrated care and cooperation between service providers optimize the HCV care continuum among people who inject drugs.
  • Results suggest that people who inject drugs with HCV infection can be effectively linked and treated with direct-acting antivirals regimens in settings outside of hospital.
  • Interventions that facilitate HCV care must be implemented at settings where people who inject drugs are already accessing services.
  • The experts’ reflections complement the findings of the literature review and inform public health practice by considering the heterogeneity of health systems and national regulatory frameworks.
  • Higher quality studies investigating interventions addressing the entire care cascade from testing to cure and prevention of reinfections among highly vulnerable populations are urgently needed.

To read the full article, follow this link>>>.

 

Collection of models of good practice

Posted on by Milutin

The European Centre for Disease Prevention and Control (ECDC) and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) Guidance Prevention and control of infectious diseases among people who inject drugs identifies good practice for prevention and control of infectious diseases among people who inject drugs. This guidance aims to support policy makers in Europe to plan adequate, evidence-based, pragmatic, and rationally designed public health responses for the prevention and control of infections among people who inject drugs. It aims at public health programme planners and decision makers working in the fields of infectious diseases, general public health, addiction and mental healthcare, social services, and drug control at national and regional levels.

Published n 2011, the Guidance is currently being updated. In addition to ongoing systematic reviews of peer-reviewed literature, a collection of models of good practice has been initiated by the two agencies, that should add practice-based evidence derived from interventions implemented in real-life, European settings.

The two EU agencies are inviting applications to report models of good practice targeting PWID population aiming to:

  • improve community-based testing
  • increase linkage to care
  • increase adherence to treatment of infection interventions
  • prevention or reduction of infections through successful health promotion approaches

The infections of interest are hepatitis B (HBV), hepatitis C (HCV), HIV and tuberculosis (TB).

Should you or your organisation be interested in reporting a model of good practice that fits the scope of this call, please express your interest following this link>>>.

Hep C robust prevalence estimates

Posted on by Milutin

The European Centre for Disease Prevention and Control published their new Toolkit to support the generation of robust estimates of hepatitis C prevalence. This toolkit supports EU Member States in generating robust prevalence estimates for hepatitis C.

The overarching aim of this toolkit is to gain a better understanding of the HCV epidemiology in the EU/EEA.

European surveillance data show on-going transmission of viral hepatitis across the European Union and European Economic Area (EU/EEA). The available notification data however, do not provide a clear epidemiological picture of hepatitis C in Europe. Prevalence data from population surveys are a key source of information to complement the surveillance data for hepatitis C due to the limitations of surveillance for hepatitis: the infection is often asymptomatic and notifications are strongly influenced by local testing practices.

This toolkit offers:

  • An algorithm to assist EU/EEA Member States in their decision-making around selecting the type of HCV prevalence survey that should be undertaken
  • The technical protocol for conducting hepatitis C prevalence surveys in the general population
  • Modelled estimates of the national burden of viral hepatitis C in EU/EEA countries

To read and download the Protocol, follow this link>>>

Correlation Focal points and expert group meeting

Posted on by Milutin

The Correlation – European Harm Reduction Network held its Focal point and expert group meeting from 2 to 4 October 2019 in Helsinki. The meeting gathered 60 participants from 31 countries and territories. Among them, DPNSEE network members are focal points for Albania, Bosnia Herzegovina, Bulgaria (not present at the meeting), Greece, Montenegro, North Macedonia, Romania and Serbia.

The agenda included a wide range of interesting issues including New projects on European level, Results of the first round of monitoring harm reduction, Challenges in Harm Reduction and also Correlation state of affairs and Methadone shortage in Romania. Complementing this agenda, participants were given the opportunity to join a series of workshops on Advocacy, Peer Involvement and Intervention Planning, Monitoring and Evaluation. Building upon this pool of expertise, the event offered the possibility to present developments in the different EU countries in regard to drug policy and harm reduction and to disseminate relevant work and activities.

Since the launch of the monitoring tool for harm reduction organizations, Correlation Focal Points have been working on collecting the required data and information. The tool had more than 100 questions and 35 countries from Europe participated. Some results are strange. For instance, the only 3 countries in Europe which expressed civil society’s good cooperation with governments were Albania, Bosnia Herzegovina and Romania! During the meeting, participants shared their experiences and provided feedback on the tool and the process.

Ms Dagmar Hedrich, Head of the Health consequences and responses sector, Lead scientist for harm reduction at EMCDDA, presented the data collected by the agency. DPNSEE Vice President and Executive Director asked what can we do with outdated data coming from some EMCDDA focal points and how could they include data from candidate and non-EU countries? The reply we got was that EMCDDA’s institutional obligation is to report on 28 EU countries and 2 who pay for their services (Norway and Turkey) and that budget cuts and no funds prevent them to cover more. An interesting view Ms Hedrich proposed is that the civil society organisations can perform social autopsy of overdose deaths of people who were using their services. The implementation researches are one of important potentials of CSOs – qualitative information they can provide. A good model they use is that EMCDDA prepares short reports with key messages, tailored for policy makers, followed by webpages or web based portals which give a full information.

The presentation from the European Centre for Disease Prevention and Control (ECDC) was focused on monitoring in general and on Hepatitis in particular. It emphasized that there is a big problem with low number of those diagnosed for HEP, huge numbers in prisons and lack of accurate data.

On Friday 4, the seminar Wellbeing economy – A way to sustainability in the HIV and AIDS response? was held as an official side event during Finland’s Presidency of the Council of the EU in cooperation with HIV Finland.