Opioid substitution therapy in manipur and nagaland, north-east india operational research in action 英文参考文献.docVIP

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Opioid substitution therapy in manipur and nagaland, north-east india operational research in action 英文参考文献.doc

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Opioid substitution therapy in manipur and nagaland, north-east india operational research in action 英文参考文献

Armstrongetal.HarmReductionJournal2010,7:29 /content/7/1/29 RESEARCH OpenAccess Opioidsubstitutiontherapyinmanipurand nagaland,north-eastindia:operational researchinaction GregoryArmstrong1*,MichelleKermode1,CharanSharma2,BiangtungLangkham3,NickCrofts1 Abstract Background:Thereisgoodevidencefortheeffectivenessofopioidsubstitutiontherapy(OST)forinjectingdrug users(IDUs)inmiddleandhigh-incomecountriesbutlittleevidenceregardingtheprovisionofOSTbynon- governmentorganisations(NGOs)inresource-poorsettings.ThispaperreportsonoutcomesofanNGO-basedOST programprovidingsub-lingualbuprenorphinetoopiatedependentIDUsintwonorth-eastIndianstates(Manipur andNagaland),aregionwhereconflict,under-developmentandinjectingofheroinandSpasmoproxyvon(SP)are ongoingproblems.Theobjectivesofthestudywere:1)tocalculateOSTtreatmentretention,2)toassessthe impactonHIVriskbehavioursandqualityoflife,and3)toidentifyclientcharacteristicsassociatedwithcessation oftreatmentduetorelapse. Methods:Thisstudyinvolvesanalysisofdatathatwereroutinelyandprospectivelycollectedfromallclients enrolledinanOSTprograminManipurandNagalandbetweenMay2006andDecember2007(n=2569,1853in Manipurand716inNagaland)usingstandardisedquestionnaires,andisbestclassifiedasoperationalresearch.The datawererecordedatintakeintotheprogram,afterthreemonths,andatcessation.Outcomemeasuresincluded HIVriskbehavioursandqualityoflifeindicators.Predictorsofrelapseweremodelledusingbinarylogistic regression. Results:OfallclientsenrolledinOSTduringthemonthofMay2006(n=713),72.8%remainedontreatmentafter threemonths,and63.3%aftersixmonths.Statisticallysignificant(p=0.05)improvementswereobservedin relationtoneedlesharing,unsafesex,incidentsofdetention,andarangeofqualityoflifemeasures.Greater spendingondrugsatintake(OR1.20),frequentlymissingdoses(OR8.82),andhavingheroinratherthanSPasthe mostproblematicdrug(OR1.95)werefactorsthatincreasedthelikelihoodofrelapse,andlongerdurationin treatment(OR0.76)andregularfamilyinvolvementintreatment(OR0.20)reducedthelikel