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    • "International Journal of Drug Policy (Maguet & Majeed, 2010, UNODC, 2010; Rehman et al., 2007 "
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    ABSTRACT: Theoretical work posits that drug-related risk behaviour increases during armed conflict; however, few studies have been conducted in conflict settings. The objective of this analysis is to determine whether conflict or local displacement impact risk behaviours among people who inject drugs (PWID) in Kabul, Afghanistan. Consenting PWID aged ≥18 years completed interviews at 3, 6, 9, 12, 18, and 24 months of follow-up. Quarters with peak conflict or local displacement exposure were defined and associations with injecting drug use and sexual risk behaviours analysed with generalized estimating equations. Of 483 PWID enrolled, 385 completed ≥1 follow-up visit (483.8 person-years) between 2007 and 2009. All participants were male, with 35% initiating injecting as a refugee. Sharing syringes (Odds Ratio (OR))=8.53, 95% Confidence Interval (CI): 2.58-28.2) and sexually transmitted infection (STI) symptoms (OR=1.72, 95% CI: 1.00-2.96) increased significantly during peak conflict quarters, while odds of STI symptoms (OR=0.06, 95% CI: 0.02-0.20) and arrest (OR=0.61, 95% CI: 0.40-0.93) were significantly lower during periods of displacement. Syringe sharing significantly increased during peak conflict periods amongst PWID in Kabul. Programming should include instruction for coping with conflict and prepare clients for harm reduction needs during conflict. Copyright © 2015 Elsevier B.V. All rights reserved.
    The International journal on drug policy 07/2015; DOI:10.1016/j.drugpo.2015.07.014 · 2.54 Impact Factor
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    • "It could be high: HCV is common in injecting drug users (36.6%) [4]; regional conflict in the last two decades has meant approximately eight million Afghan migrated to neighbouring countries, particularly Iran and Pakistan, where HIV is relatively common among injecting drug users [5]. With 5.7 million Afghan returning home during 2002-2006 the risk of an HIV epidemic is high [6]. In addition, illiteracy, poverty, and subjugation of women combined with political and social instability are likely to fuel an HIV epidemic in the country [7]. "
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    ABSTRACT: Health staff in Afghanistan may be at high risk of needle stick injury and occupational infection with blood borne pathogens, but we have not found any published or unpublished data. Our aim was to measure the percentage of healthcare staff reporting sharps injuries in the preceding 12 months, and to explore what they knew about universal precautions. In five randomly selected government hospitals in Kabul a total of 950 staff participated in the study. Data were analyzed with Epi Info 3. Seventy three percent of staff (72.6%, 491/676) reported sharps injury in the preceding 12 months, with remarkably similar levels between hospitals and staff cadres in the 676 (71.1%) people responding. Most at risk were gynaecologist/obstetricians (96.1%) followed by surgeons (91.1%), nurses (80.2%), dentists (75.4%), midwives (62.0%), technicians (50.0%), and internist/paediatricians (47.5%). Of the injuries reported, the commonest were from hollow-bore needles (46.3%, n = 361/780), usually during recapping. Almost a quarter (27.9%) of respondents had not been vaccinated against hepatitis B. Basic knowledge about universal precautions were found insufficient across all hospitals and cadres. Occupational health policies for universal precautions need to be implemented in Afghani hospitals. Staff vaccination against hepatitis B is recommended.
    BMC Infectious Diseases 01/2010; 10(1):19. DOI:10.1186/1471-2334-10-19 · 2.61 Impact Factor
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    ABSTRACT: This cross-sectional study aimed to describe the level of knowledge, perception/ attitude, and practices related to HIV among 1,054 freshmen students in four Afghan universities differences between genders. A probability, two stage sampling method was used. Data were collected by a self administered structured questionnaire. SPSS software was used for data analysis. Descriptive and inferential statistics were performed. Most of respondents were male (72.1%), their average age was 20.1 +/- 2 years, and most were unmarried (93.4%). The majority (90.8%) were aware of HIV but only 28.3% had a good level of knowledge. Around one-third (35.6%) had a positive level of attitude toward HIV. Approximately 30% had at least one risk practice; therefore, they were counted as high-risk behavior group members. Females were statistically more knowledgeable than males, and high-risk behaviors were significantly more prevalent among males; p = 0.01 and p = 0.001, respectively. However, general awareness, and attitude were not statistically different between genders. A considerable proportion of students (14.6%), as compared to peer-countries, were sexually active. A very high level of sharing injecting needles (4.5%) and shaving sets (20.8%) were also reported among informants.
    The Southeast Asian journal of tropical medicine and public health 06/2008; 39(3):404-18. · 0.72 Impact Factor
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