CoDISEN: Cohort Study on People Who Inject Drugs in Senegal
Study Details
Study Description
Brief Summary
The main purpose of the CoDISEN cohort study is to propose a model of prevention and care for HIV and viral hepatitis adapted to the needs of people who inject drugs (PWID) in Dakar, Senegal.
Condition or Disease | Intervention/Treatment | Phase |
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Detailed Description
THE UNODC estimated the number of consumers of injectable drugs at 1,02 millions in 2012 in Africa among which 12,1 % lived with HIV. Prevalences of HIV, chronic hepatitis C and B among people who inject drugs remain little documented in Sub-Saharan Africa. The transmission of HCV in Africa is mainly hospital-borne, bound to a precarious transfusional and therapeutic safety. However, the transmission by intravenous drug use emerges as a new stake in public health in urban areas. The report of a strong HIV prevalence in the population of PWID in the sub-region ( for example, In 2007, in the Cape Verde, prevalence of the HIV was 14 % in emprisoned PWID against 0,8 % in the general population) contributed to assert the reality of the use of intravenous drugs in the region and the vulnerability of this population. Senegal, a country with an concentrated HIV epidemic [0,5 % prevalence in 2012, WHO source] is the first country of western Africa to have measured prevalence of HIV (5,2 %), HBV (7,9 %) and HCV (23,3 %) in PWID (Study ANRS 12243). In view of these results, the Senegalese authorities introduced from October, 2011 in Dakar, activities of harm reduction by means of a mobile team of social workers and mediators allowing individual and collective activities of prevention, needle exchange program, references for care and follow-up, as well as a opioid substitution program in a methadone center (CEPIAD) located in Dakar, first of its kind in Western Africa. The objective of the present research project thus is to estimate the impact of a strategy of " test and treat " of HIV and harm reduction initiatives on the prevalence and incidence of HIV, HBV and HCV infections in an population of injectable drug consumers followed in the methadone center ( CEPIAD) of Dakar, Senegal
Study Design
Outcome Measures
Primary Outcome Measures
- incidence of HIV [24 months]
number of participants infected with HIV at inclusion and acquiring HIV during follow-up
Secondary Outcome Measures
- incidence of hepatitis C infection (HCV) [24 months]
number of participants infected with HCV at inclusion and acquiring HCV during follow-up
- incidence of hepatitis B infection (HBV) [24 months]
number of participants infected with HBV at inclusion and acquiring HBV during follow-up
- incidence of relevant coinfections and comorbidities [24 months]
number of patients developping sexually transmitted infections, tuberculosis and other conditions -% Test realized / test planned
- Retention rate and its determinants [24 months]
Number of participants retained in the cohort follow-up + analysis of determinants of retention
- mortality rate and determinants [24 months]
Number of participants dead during follow-up + analysis of determinants of death evolution of CD4 and HIV viral load in participants with HIV and treated with ARVs, HBV viral load , and HCV viral load in participants with viral hepatitis B and C Incidence of clinical events and biological of interest
- Access to treatment of HCV, HBV infections and other coditions requiring specific therapeutical management [24 months]
Number of patients treated for HIV, HBV, HCV and other medical conditions according to national or international guidelines recommendations
- Effectiveness of tuberculosis regimens [24 months]
Number of cured patients / number of patients initiating treatment
Eligibility Criteria
Criteria
Inclusion Criteria:
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being aged greater than or equal to 18 years or emancipated minor,
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Being or have been an injecting drug user and followed at the CEPIAD (methadone program)
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Living in the Dakar region for at least three months,
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Consenting to the study after individual information.
Exclusion Criteria:
- Mental impairment making it difficult or impossible to consent to the study.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | CEPIAD | Dakar | Senegal |
Sponsors and Collaborators
- French National Agency for Research on AIDS and Viral Hepatitis
Investigators
- Principal Investigator: Pierre-Marie Girard, M.D., PhD, Inserm - Sorbonne Université
- Principal Investigator: Moussa Seydi, M.D., CRCF - CHNU Fann
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- ANRS 12334 CoDISEN