Mortality among injection drug users in northern thailand: A prospective cohort study

Vu Minh Quan, Apinun Aramrattana, Tasanai Vongchak, Carl A Latkin, Deborah Donnell, Ting Yuan Liu, Kanokporn Wiboonnatakul, David D Celentano

Research output: Contribution to journalArticle

Abstract

Objectives: To measure mortality rates and assess predictors of all-cause mortality in a cohort of Thai injection drug users (IDUs) who were enrolled and followed up from 2004 through 2006. Methods: In this prospective cohort study, we enrolled 314 community-dwelling IDUs (95% being men; 42% of ethnic minority; median age, 29 years [range, 18-69 years]) and followed up them at 6-month intervals. Mortality rates were calculated based on personyears of follow-up. Marginal Cox proportional hazards models for clustered data were constructed to determine the factors associated with all-cause mortality. Findings: During 445.7 person-years of follow-up, 17 of 314 (5.4%) IDUs died. The all-cause mortality rate was 3.8 per 100 person-years (95% confidence interval [CI] = 2.2-6.1). The standardized mortality ratio was 5.8 (95% CI = 3.5-9.1). The mortality rate among HIV-positive IDUs was 13.4 per 100 person-years (95% CI = 5.4 -27.6). In a marginal Cox proportional-hazards model for clustered data, the excess mortality was associated with HIV-positivity (hazard ratio [HR] = 7.0, 95% CI = 2.8 -17.6), benzodiazepine use (HR = 3.1, 95% CI = 1.1-9.4), and excessive alcohol consumption at enrollment (HR = 3.5, 95% CI = 1.3-9.1). Conclusions: The all-cause mortality among the drug injectors is high. The increased mortality was associated with HIV infection, benzodiazepine use, and excessive alcohol consumption.

Original languageEnglish (US)
Pages (from-to)217-222
Number of pages6
JournalJournal of Addiction Medicine
Volume4
Issue number4
DOIs
StatePublished - Dec 2010

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Thailand
Drug Users
Cohort Studies
Prospective Studies
Injections
Mortality
Confidence Intervals
Benzodiazepines
Proportional Hazards Models
Alcohol Drinking
HIV
Independent Living
HIV Infections

Keywords

  • Alcohol
  • Benzodiazepine
  • Mortality
  • Opioid
  • Substance abuse
  • Thailand

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)

Cite this

Mortality among injection drug users in northern thailand : A prospective cohort study. / Quan, Vu Minh; Aramrattana, Apinun; Vongchak, Tasanai; Latkin, Carl A; Donnell, Deborah; Liu, Ting Yuan; Wiboonnatakul, Kanokporn; Celentano, David D.

In: Journal of Addiction Medicine, Vol. 4, No. 4, 12.2010, p. 217-222.

Research output: Contribution to journalArticle

Quan, Vu Minh ; Aramrattana, Apinun ; Vongchak, Tasanai ; Latkin, Carl A ; Donnell, Deborah ; Liu, Ting Yuan ; Wiboonnatakul, Kanokporn ; Celentano, David D. / Mortality among injection drug users in northern thailand : A prospective cohort study. In: Journal of Addiction Medicine. 2010 ; Vol. 4, No. 4. pp. 217-222.
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abstract = "Objectives: To measure mortality rates and assess predictors of all-cause mortality in a cohort of Thai injection drug users (IDUs) who were enrolled and followed up from 2004 through 2006. Methods: In this prospective cohort study, we enrolled 314 community-dwelling IDUs (95{\%} being men; 42{\%} of ethnic minority; median age, 29 years [range, 18-69 years]) and followed up them at 6-month intervals. Mortality rates were calculated based on personyears of follow-up. Marginal Cox proportional hazards models for clustered data were constructed to determine the factors associated with all-cause mortality. Findings: During 445.7 person-years of follow-up, 17 of 314 (5.4{\%}) IDUs died. The all-cause mortality rate was 3.8 per 100 person-years (95{\%} confidence interval [CI] = 2.2-6.1). The standardized mortality ratio was 5.8 (95{\%} CI = 3.5-9.1). The mortality rate among HIV-positive IDUs was 13.4 per 100 person-years (95{\%} CI = 5.4 -27.6). In a marginal Cox proportional-hazards model for clustered data, the excess mortality was associated with HIV-positivity (hazard ratio [HR] = 7.0, 95{\%} CI = 2.8 -17.6), benzodiazepine use (HR = 3.1, 95{\%} CI = 1.1-9.4), and excessive alcohol consumption at enrollment (HR = 3.5, 95{\%} CI = 1.3-9.1). Conclusions: The all-cause mortality among the drug injectors is high. The increased mortality was associated with HIV infection, benzodiazepine use, and excessive alcohol consumption.",
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T1 - Mortality among injection drug users in northern thailand

T2 - A prospective cohort study

AU - Quan, Vu Minh

AU - Aramrattana, Apinun

AU - Vongchak, Tasanai

AU - Latkin, Carl A

AU - Donnell, Deborah

AU - Liu, Ting Yuan

AU - Wiboonnatakul, Kanokporn

AU - Celentano, David D

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AB - Objectives: To measure mortality rates and assess predictors of all-cause mortality in a cohort of Thai injection drug users (IDUs) who were enrolled and followed up from 2004 through 2006. Methods: In this prospective cohort study, we enrolled 314 community-dwelling IDUs (95% being men; 42% of ethnic minority; median age, 29 years [range, 18-69 years]) and followed up them at 6-month intervals. Mortality rates were calculated based on personyears of follow-up. Marginal Cox proportional hazards models for clustered data were constructed to determine the factors associated with all-cause mortality. Findings: During 445.7 person-years of follow-up, 17 of 314 (5.4%) IDUs died. The all-cause mortality rate was 3.8 per 100 person-years (95% confidence interval [CI] = 2.2-6.1). The standardized mortality ratio was 5.8 (95% CI = 3.5-9.1). The mortality rate among HIV-positive IDUs was 13.4 per 100 person-years (95% CI = 5.4 -27.6). In a marginal Cox proportional-hazards model for clustered data, the excess mortality was associated with HIV-positivity (hazard ratio [HR] = 7.0, 95% CI = 2.8 -17.6), benzodiazepine use (HR = 3.1, 95% CI = 1.1-9.4), and excessive alcohol consumption at enrollment (HR = 3.5, 95% CI = 1.3-9.1). Conclusions: The all-cause mortality among the drug injectors is high. The increased mortality was associated with HIV infection, benzodiazepine use, and excessive alcohol consumption.

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KW - Benzodiazepine

KW - Mortality

KW - Opioid

KW - Substance abuse

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