Rüütel Kristi, Karnite Anda, Talu Ave, Abel-Ollo Katri, Kirvelaite Gunta, Kliiman Kai, Loit Helle-Mai, Uusküla Anneli
National Institute for Health Development, 42 Hiiu Street, Tallinn, Estonia.
Department of Public Health and Epidemiology, Riga Stradins University, Kronvalda Boulevard 9, Riga, Latvia.
Int J Drug Policy. 2014 Jan;25(1):175-8. doi: 10.1016/j.drugpo.2013.10.002. Epub 2013 Oct 16.
Illegal drug use and HIV are independent risk factors for tuberculosis (TB) among injecting drug users (IDU). Estonia and Latvia have experienced high rates of TB as well as IDU and HIV outbreaks. There is a lack of knowledge about TB among IDUs in these countries. The purpose of the current study was to estimate the prevalence and risk factors of Mycobacterium tuberculosis (MTB) infection among IDUs in Estonia and Latvia.
Participants for this cross-sectional study were recruited from syringe exchange programmes using respondent-driven sampling. For assessing infection with MTB interferon-gamma release assay (IGRA) was used.
The study included 375 participants from Estonia and 313 from Latvia. The prevalence of IGRA-positivity among IDUs was 7.7% in Estonia and 25.6% in Latvia. HIV-prevalence was 62% in Estonia and 23% in Latvia. In both countries, IGRA-positivity rates did not differ between HIV-positive and HIV-negative participants. IGRA-positivity was independently associated with a prior diagnosis of TB in Estonia and with imprisonment (ever within a lifetime) and preceding contact with a TB patient in Latvia.
Our findings indicate there is an urgent need for a more vigorous approach in providing IDUs with TB screening services.
在注射吸毒者（IDU）中，非法药物使用和艾滋病毒是结核病（TB）的独立危险因素。爱沙尼亚和拉脱维亚经历了高结核病发病率以及注射吸毒者和艾滋病毒疫情的爆发。这些国家的注射吸毒者对结核病缺乏了解。本研究的目的是估计爱沙尼亚和拉脱维亚注射吸毒者中结核分枝杆菌（MTB）感染的患病率和危险因素。
本横断面研究的参与者通过应答者驱动抽样从注射器交换项目中招募。使用干扰素-γ释放试验（IGRA）评估MTB感染情况。
该研究包括来自爱沙尼亚的375名参与者和来自拉脱维亚的313名参与者。爱沙尼亚注射吸毒者中IGRA阳性率为7.7%，拉脱维亚为25.6%。爱沙尼亚艾滋病毒患病率为62%，拉脱维亚为23%。在这两个国家，艾滋病毒阳性和阴性参与者之间的IGRA阳性率没有差异。在爱沙尼亚，IGRA阳性与先前的结核病诊断独立相关，在拉脱维亚与监禁（一生中曾有过）和之前与结核病患者接触独立相关。
我们的研究结果表明，迫切需要采取更积极的方法为注射吸毒者提供结核病筛查服务。
