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We have analyzed the relationship between the prevalence of diabetes mellitus (type 2) and socio-economic status of patients. The cross-sectional study included 79,855 patients registered in Belgium capitation-fee primary health care centers. The adjusted prevalence for age and gender was 6.3%, significantly higher than the estimated 4.7% in the general population. The gap is mainly explained by the lower socio-economic status of the patients we take care of. Inside our population we found a 1.8 times higher risk to be affected by diabetes mellitus for patients with lower socio-economic status (95% confidence interval: 1.6-1.9). This higher risk is found for all age groups except for the elderly. Studies should be designed to investigate how that social inequality for health also concern quality of care and therapeutical outcomes.

In industrialized countries, transmission of hepatitis C occurs primarily through injecting drug use. Transmission of hepatitis C in injecting drug users is mainly associated with the sharing of contaminated syringes/needles, although evidence for risk of hepatitis C infection through sharing of other injecting paraphernalia is increasing. In this paper, the independent effects of sharing paraphernalia other than syringes/needles have been estimated. The prevalence and force of infection were modelled using three serological data sets from drug users in three centres in Belgium as a function of the sharing behaviour. It was found that sharing of materials other than syringes/needles indeed seemed to contribute substantially to the spread of hepatitis C among injecting drug users.

Aims: To estimate viral seroprevalences for HCV, HBV and HIV among belgian intravenous (IVDU) and non intravenous (non-IVDU) drug users; to assess risk factors for HCV infection in IVDU; to assess feasibility of chronic hepatitis C follow-up in this population., Design: Cross-sectional study. Demographic and behavioural characteristics were obtained by a standardized questionnaire. Serum samples were tested for HCV, HBV and HIV., Subjects and Setting: 329 patients (244 IVDU and 85 non-IVDU) attending ten general practitioners in 1995., Results: HCV seroprevalence was 78.3%; it was 35.7% for HBV and 0.9% for HIV in IVDU, vs 2.4%, 8.3% and 0%, respectively, in non-IVDU. In logistic regression analysis, independent risk factors for HCV infection were: 1/sharing of syringes and/or of "cottons" used as filters (adjusted prevalence odds ratio [POR] = 31.7; 95% confidence interval [CI] = 9.8-102.5), 2/duration of injecting upper than one month (adjusted POR = 8.6; CI = 3.0-24.7) and 3/age (adjusted POR = 1.2 by year of difference; CI = 1.0-1.3). A biochemical follow-up was obtained in 70% of HCV seropositive users; 79.5% of them had chronic hepatitis C (mean value of ALT = 3.5 times upper normal value, range 1.1-23.0). Among these, 24.7% went through liver biopsy during the three years follow-up period of the study., Conclusions: HCV seroprevalence is very high among belgian IVDU. Prevention strategies have to focus on neophytes injectors. They must be urgently revisited for what concern needles/syringes exchange programs: "cottons" must be included. Follow-up and treatment of chronic hepatitis C seem to be poorly effective among drug users.