El riesgo de hepatitis B y C en adolescentes jóvenes que se inyectan drogas: un desafío futuro para la salud pública / Risk of Viral Hepatitis B and C Among Young Adolescents Who Inject Drugs: A Future Public Health Challenge

Varada Madge, E. Vinayakan, Rishi Garg, Sunil Mehra

Resumen


Los adolescentes son una población vulnerable .Debido a la falta de información médica sobre inyectarse drogas y hepatitis viral, es probable que muchos adolescentes se involucren en inyecciones no seguras y en prácticas sexuales que podrían ser riesgosas para su salud.

Objetivo: el presente artículo explora los perfiles de riesgo que hacen que los adolescentes sean vulnerables al virus de la hepatitis B (VHB) y al de la hepatitis C (VHC) .Se informa sobre los resultados de un estudio titulado " Prevención y manejo temprano de la hepatitis B y C en grupos de alto riesgo en Amritsar e Imphal, India ", que se realizó entre octubre de 2014 y enero de 2018 .Más información sobre estos dos estados se puede encontrar en la b sección de antecedentes.

Materiales y métodos : en esta intervención, se inscribieron 1700 usuarios de drogas inyectables (UDI); 24 de la muestra total fueron adolescentes.Utilizamos una herramienta de evaluación de riesgos para controlar por estado de salud y el compromiso con prácticas de reducción de daños.Dado que el número era pequeño, se usó una distribución de frecuencia simple (número y porcentaje) para analizar los datos y para dilucidar los resultados generales.

Resultados: Encontramos que 25 de los 29 adolescentes mantenían relaciones sexuales y que la mayoría no usaban métodos de protección tipo condones.Siete se estaban inyectando más de 30 inyecciones al día y ocho adolescentes mencionaron compartr agujas. Durante esta intervención, tres adolescentes fueron diagnosticados con VHC y puestos bajo tratamiento durante el período del proyecto. Cuatro adolescentes mostraban síntomas de ITS y habían sido tratados por lo mismo durante el año anterior.

Conclusión: nuestros hallazgos sugieren la necesidad de dirigirse a poblaciones más jóvenes para la intervención . Necesitan educación contínua sobre prácticas de reducción de daños y seguimiento médico para reducir el riesgo de transmisión de VHB y VHC.

Abstract

Adolescents are a vulnerable population. Given the lack of health information on injecting drugs and viral hepatitis, it is likely that many adolescents engage in unsafe injection and in sexual practices that could be risky for their health.

Aim: The present paper explores the risk profiles that make adolescents vulnerable to Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV). It reports on the results of a study entitled “Prevention and Early Management of Hepatitis B and C among high risk group in Amritsar and Imphal, India”, that was conducted from October 2014 till January 2018. More information on these two states can be found in the background section.

Material and methods: In this intervention, we enrolled 1700 injection drug users (IDU); 24 of the total sample were adolescents. A risk assessment tool was used to monitor their health status and adherence to harm reduction practices. Since the number was small, simple frequency distribution (number and per cent) was used to analyse the data and to elucidate the overall results.

Results: We found that 25 of 29 adolescents were sexually active and most of them did not use protective methods, such as condoms. Seven were injecting more than 30 shots per day and eight adolescents mentioned that they shared needles. Three adolescents in this intervention, were diagnosed with HCV and were linked to treatment during the project period. Four adolescents showed symptoms of STI and had been treated for the same in the prior year.

Conclusion: Our findings suggest a need to target younger populations for intervention. They need ongoing education on harm reduction practices and medical follow-up to reduce the risk of transmission of HBV and HCV.

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Referencias


Nelson PK et al. Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews. Lancet. 2011; 378(9791): 571–583

The Global Strategy for Women’s, Children’s and Adolescent’s Health: Survive, Thrive and Transform, 2016-2030, Available at: http://www.who.int/life-course/partners/global-strategy/globalstrategyreport2016-2030-lowres.pdf, accessed online on March 2018.

Injecting Drug Users Among Under 18s: A Snapshot of Available Data. Harm Reduction International Reports. 2013. Available at: https://www.hri.global/files/2014/08/06/injecting_among_under_18s_snapshot_WEB.pdfaccessed online on January 2018.

Injecting Drug Users Among Under 18s: A Snapshot of Available Data. Harm Reduction International Reports. 2013. Available at: https://www.hri.global/files/2014/08/06/injecting_among_under_18s_snapshot_WEB.pdf, accessed online on January 2018

Anju Dhawan, Raman Deep Pattanayak, Anita Chopra, Vinod Kumar Tikoo, and Rajesh Kumar (2016), “Injection drug use among children and adolescents in India: Ringing the alarm bells”, Indian Journal of Psychiatry, vol 58, number 4, pp: 387–393.

Des Jarlais DC, et al. Variability in the Incidence of Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus Infection among Young Injecting Drug Users in New York City. Am. J. Epidemiol. 2003; 157(5): 467-471 doi: 10.1093/aje/kwf222. Available online: http://aje.oxfordjournals.org/content/157/5/467.full#T2 Accessed: 2 October 2013

Sunil Suhas Solomon, Shruti H Mehta, Aylur K Srikrishnan, Suniti Solomon, Allison M McFall, Oliver Laeyendecker, David D Celentano, Syed H Iqbal, Santhanam Anand, Canjeevaram K Vasudevan, Shanmugam Saravanan, Gregory M Lucas, Muniratnam S Kumar, Mark S Sulkowski, Thomas C Quinn (2015), “Burden of hepatitis C virus disease and access to hepatitis C virus services in people who inject drugs in India: A cross-sectional study”, Lancet Infectious Diseases, vol 15, pp:36-45

Michelle Kermode, Amenla Nuken, Gajendra Kumar Medhi, Brogen Singh Akoijam, H. Umesh Sharma, and Jagadish Mahanta (2016), “High burden of hepatitis C & HIV co-infection among people who inject drugs in Manipur, Northeast India”, Indian Journal of Medical Research”, vol 143, number 3, pp: 348-356.

HIV and young people who inject drugs: Technical brief, Available at: http://www.who.int/hiv/pub/toolkits/hiv-young-idu/en/, accessed online on April 2018

HIV and Young People Who Inject Drugs. Technical Brief. 2015. Available at: http://www.unaids.org/sites/default/files/media_asset/2015_young_people_drugs_en.pdf, accessed online on April 2018.

Hepatitis B Virus: Epidemiology and Transmission Risk, Emergency Medical Injuries Guidelines, Available at- http://www.hpsc.ie/a-z/EMIToolkit/appendices/app21-27.pdf, accessed online on January 2018

HIV and young people who inject drugs http://www.unaids.org/sites/default/files/media_asset/2015_young_people_drugs_en.pdf, accessed online on January 2018.

Anju Dhawan, Raman Deep Pattanayak, Anita Chopra, Vinod Kumar Tikoo, Rajesh Kumar (2016), “Injecting Drug Use Among Children And Adolescents in India: Ringing The Alarm Bells”, Indian Journal of Psychiatry, vol 58, issue 4, pp: 387-393

Mennis Jeremy and Mason Michael (2010), “Social and geographic contexts of adolescent substance use: The moderating effects of age and gender”, Elsevier, vol 34, pp: 150-157.

What are the complications of Chronic Heroin Use, National Institute on Drug Abuse, Available at https://www.drugabuse.gov/publications/research-reports/heroin/what-are-medical-complications-chronic-heroin-use, accessed online on January 2018


 

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