Search

Background Ethnicity can influence susceptibility to infection, as COVID-19 has shown. Few countries have systematically investigated ethnic variations in infection. Methods We linked the Scotland 2001 Census, including ethnic group, to national databases of hospitalizations/deaths and serological diagnoses of bloodborne viruses for 2001–2013. We calculated age-adjusted rate ratios (RRs) in 12 ethnic groups for all infections combined, 15 infection categories, and human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C (HCV) viruses. Results We analysed over 1.65 million infection-related hospitalisations/deaths. Compared with White Scottish, RRs for all infections combined were 0.8 or lower for Other White British, Other White and Chinese males and females, and 1.2–1.4 for Pakistani and African males and females. Adjustment for socioeconomic status or birthplace had little effect. RRs for specific infection categories followed similar patterns with striking exceptions. For HIV, RRs were 136 in African females and 14 in males; for HBV, 125 in Chinese females and 59 in males, 55 in African females and 24 in males; and for HCV, 2.3–3.1 in Pakistanis and Africans. Conclusions Ethnic differences were found in overall rates and many infection categories, suggesting multiple causative pathways. We recommend census linkage as a powerful method for studying the disproportionate impact of COVID-19. [ABSTRACT FROM AUTHOR]

Background: To address high levels of drug-related harms among people who inject drugs (PWID) in Glasgow, a novel contingency management intervention was developed to engage high-risk PWID with four harm reduction measures (known as the WAND initiative: W ound care, A ssessment of injecting, N aloxone, and D ried blood-spot test). Our aims were to assess if WAND engaged and re-engaged high-risk PWID., Methods: Baseline data of WAND participants (n = 831) from 1st Sept-2020 to 30th Aug-2021 were analysed. For those who took part in the first six months, extent of re-engagement was determined and, among those re-engaged, intervention coverage was compared between baseline and final engagement., Results: Among those who first engaged in WAND from Sept 2020-Feb 2021 (n = 546), 40 % re-engaged by Aug 2021. Compared to those who engaged once (n = 321), those who re-engaged (n = 215) within one year had higher baseline prevalence of injecting risk behaviours such as injecting daily (56 % vs 64 %, p = 0.032), injecting away from home (42 % vs 52 %, p = 0.0179), injecting cocaine (56 % vs 75 %, p < 0.001), having an SSTI (40 % vs 60 %, p < 0.001), and been prescribed naloxone (57 % vs 72 %, p < 0.001). For those who re-engaged six months to one year after initial engagement (n = 107), there was a significant increase in having a BBV test in the last six months (61 % to 81 %, p = 0.003) and carrying naloxone (22 % to 32 %, p = 0.011)., Conclusion: WAND was able to engage and re-engage large numbers of high-risk PWID with multiple harm reduction initiatives. These findings suggest contingency management could be a useful tool for harm reduction services., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: In Scotland, a general practice-based case-finding initiative, to diagnose and refer hepatitis C virus (HCV) chronically infected former injecting drug users (IDUs), was evaluated., Methods: Testing was offered in eight Glasgow general practices in areas of high deprivation and high HCV and IDU prevalence to attendees aged 30-54 years with a history of IDU. Test uptake and diagnosis rates were compared with those in eight demographically similar control practices., Results: Of 422 eligible intervention practice attendees, 218 (52%) were offered an HCV test and, of these, 121 (56%) accepted. Poor venous access in 13 individuals prevented testing. Of 105 tested, 70% (74/105) were antibody positive of which 58% (43/74) were RNA positive by PCR. Of 43 chronically infected individuals identified in intervention practices, 22 (51%) had attended specialist care within 30 months of the study, while 9 (21%) had defaulted. In control practices, 8 (22%) of 36 individuals tested were antibody positive. Test uptake and case yield were approximately 3 and 10 times higher in intervention compared with control practices, respectively., Conclusions: Targeted case-finding in primary care demonstrated higher test uptake and diagnosis rates; however, to optimize diagnosis and referral of chronically infected individuals, alternative means of testing (e.g. dried blood spots) and retention in specialist care (e.g. outreach services) must be explored.