natgillin/translations-raw huggingface dataset:
Blandt de stikprøver af intravenøse stofbrugere, der blev testet i 2004-2005, meldes om en udbredelse af HCV-antistoffer på over 60 % i 60 undersøgelser fra 17 lande (6 ud af 28 lande har ikke indberettet data) (
HCV antibody levels of over 60 % among the IDU samples tested in 2004–05 are reported in 60 studies from data suggest that, especially in areas where prevalence has been high, the burden of infection in IDUs is likely to be now decreasing and possibly that prevention and harm-reduction
1 49 i Polen og Det Forenede Kongerige (
policies are showing effect (144
Antallet af nydiagnosticerede tilfælde af hiv blandt intravenøse stofbrugere skønnes på nuværende tidspunkt at udgøre ca. 3 500 pr. år i EU.
Among young IDUs (under age 25) in these samples, a high prevalence (over 40 % in at least one sample) was found in seven countries and among new IDUs, for whom data are not available for many countries, in Poland and the United
meldt om undersøgelser, hvor udbredelsen var under 25 %.
Kingdom (149). Only five countries reported studies where prevalence was less than 25%. %.
Aids-forekomst og adgang til HAART
The number of newly diagnosed cases of HIV among injecting drug users is estimated to be currently around 3 500 per annum in the EU.
På grundlag af de foreliggende data og skøn over antallet af intravenøse stofbrugere og problematiske stofbrugere (se kapitel 6) kan det beregnes, at der i EU formentlig er ca. 1 million mennesker med HCV-infektion, som på et tidspunkt i deres liv har været intravenøse stofbrugere.
From the available data and estimates of the number of IDUs and problem drug users (see Chapter 6), it can be calculated that there may be around one million people living with an HCV infection in the EU who have ever in their lives been drug injectors.
Da højaktiv antiretroviral behandling (HAART), som har været tilgængelig siden 1996, effektivt standser hiv-infektions progression til aids, er data om aids-forekomsten derfor ikke længere så nyttige som indikator for overførsel af hiv.
As highly active antiretroviral treatment (HAART), available since 1996, effectively stops progression of HIV infection to AIDS, AIDS incidence data have therefore become less helpful as an indicator for HIV transmission.
Ifølge WHO-skøn er dækningsgraden af HAART høj i EU-medlemsstaterne, kandidatlandene og Norge, idet alle har indberettet en dækningsgrad på mindst 75 % (145), selv om der ikke foreligger specifikke data for intravenøse stofbrugere.
reporting at least 75 % coverage (145
Data om aids-forekomsten er fortsat vigtige, da
Time trends in notified cases of hepatitis B and C show different pictures.
Udbredelsen af markører for HBV-infektion varierer mere end markører for HCV-infektion, muligvis på grund af forskelle i omfanget af vaccination.
Of the Baltic countries, Latvia records a decrease in AIDS incidence, at 23 new cases per million in 2005, down from a peak of 26 new cases per million in 2004, while Estonia has not provided IDU-specific data in 2005 but reported an increase between 2003 and
De mest fuldstændige datasæt, der foreligger, er for antistoffet mod hepatitis core antigen (anti-HBc), hvilket indikerer en tidligere infektion.
While HIV infection in IDUs in the EU is mainly concentrated in few high-prevalence countries, viral hepatitis and, in particular, infection caused by the hepatitis C virus (HCV), is much more evenly distributed and more highly prevalent.
Data for de to seneste år er skøn korrigeret for indberetningsforsinkelser og kan derfor ændres over tid (kilde: EuroHIV). ) Se tabel INF-11, INF-12 og INF-13 i Statistical bulletin 2007.
Data for the two most recent years are estimates adjusted for reporting delays therefore subject to changes over time (source EuroHIV). )
I årsberetningen er kun stikprøver på 50 og derover medtaget.) Se figur INF-6 (del vii) i Statistical bulletin 2007.
In the annual report only samples of size 50 and larger are reported.)
Årsberetning for 2007: narkotikasituationen i Europa virkning af vaccinationsprogrammer.
Annual report 2007: the state of the drugs problem in Europe
God sundhedstilstand blandt indsatte er god folkesundhed anmeldte tilfælde af hepatitis C-infektion (
Good prison health is good public health
); denne andel er imidlertid meget forskellig fra land til land, hvilket viser, at der er forskelle i overførslen af hepatitis C. For at kunne udforme bedre forebyggelses- og skadesreduktionsstrategier på dette område vil det formentlig være vigtigt at forstå de faktorer, der har bidraget til forskellene mellem landene med hensyn til forekomsten af infektion.
To address the problem of undiagnosed HIV infection, new guidance has been published this year (WHO/UNAIDS, 2007). A more proactive approach of healthcare providers to recommending HIV testing and counselling, especially at facilities targeting most-at-risk populations, such as injecting drug users, is suggested in order to achieve increased voluntary uptake of HIV testing.
Blandt de største udfordringer i forbindelse med folkesundheden har i de seneste to årtier været genfremkomsten af overførbare sygdomme som f.eks. tuberkulose, stigningen i og den hastige udbredelse af hiv/aids og den tilsyneladende pandemi af problematisk brug af psykotrope stoffer. De mest udsatte befolkningsgrupper lider uforholdsmæssigt meget under disse forhold.
Among the greatest challenges in public health in the last two decades are: the resurgence of communicable diseases such as TB; the rise and rapid spread of HIV/AIDS; and the seemingly uncontrollable pandemic of problematic use of psychotropic drugs.
Blandt især fængselsindsatte forekommer der ofte stofproblemer, og udbredelsen af smitsomme sygdomme er forholdsvis høj.
Among prison populations, in particular, drug problems are often common and levels of infectious diseases relatively high.
Endvidere fortsættes stofbrug ofte eller påbegyndes undertiden i fængslet; og i dette miljø kan højrisikoadfærd være udbredt.
Moreover, drug use often continues or, sometimes, is initiated in prison; and in this setting, high-risk behaviours can be common.
Fængsler har derfor potentiale til at medføre øget forekomst af smitte med potentielt livstruende sygdomme, men kan også være en mulighed for at gøre en indsats for en særlig vigtig målgruppe.
Prisons, therefore, have the potential to lead to elevated levels of infection of potential life-threatening diseases but may also provide an opportunity to intervene with a particularly important target group.
I det seneste årti er der på EU-plan opstået almindelig enighed om de centrale elementer, der er nødvendige for en effektiv indsats til bekæmpelse af smitsomme sygdomme blandt intravenøse stofbrugere.
In Norway, hepatitis A and B vaccinations were stepped up after epidemic outbreaks of these liver infections showed that injecting drug use had spread to smaller municipalities.
Uanset balancen mellem disse elementer i de forskellige nationale politikker er der klart enighed om, at en koordineret og omfattende indsats inden for folkesundheden er af afgørende betydning for at begrænse spredningen af smitsomme sygdomme blandt stofbrugere.
With a few exceptions (France, the United Kingdom (England and Wales), Norway) prison health is generally an integral part of the judicial or security system rather than of the health system, thus risking isolating health in prisons from mainstream public health approaches and raising questions about the independence, quality, accessibility and level of health services provided.
Den ringe sundhedstilstand blandt indsatte kan have følger for den bredere folkesundhed, når stofbrugere løslades og genoptager kontakten til deres familie og andre i nærmiljøet.
The high prevalence of hepatitis C infection among injectors points strongly for the need to develop more effective responses to this disease, for which vaccination is not an option.
Påvisningen af alvorlige overførbare sygdomme som f.eks. hiv-infektion og tuberkulose kan derfor, hvis det ledsages af tilstrækkelige behandlings- og skadesreduktionsforanstaltninger, bidrage betydeligt til sundhedstilstanden i de nærmiljøer, som de indsatte kommer fra, og som de vender tilbage til.
A number of countries have specific programmes aimed at hepatitis C prevention and some interesting work is developing in this area, for example the ‘stop hepC’ campaign, which has run in Oslo since 2003, aims at reaching drug users before they have started injecting or while they are still new to the practice.
For at løse problemet med ikke-diagnosticeret hiv-infektion er der i år blevet offentliggjort en ny vejledning (WHO/UNAIDS, 2007).
The poor health status of prisoners can have implications for wider public health, when drug users are released and resume contact with their family and others in the community.
Der foreslås en mere proaktiv tilgang fra sundhedsvæsenets side til at anbefale hiv-test og -rådgivning, især i forbindelse med tiltag, der er rettet mod de mest udsatte grupper, f.eks. intravenøse stofbrugere, for at få flere til frivilligt at lade sig hiv-teste.
Therefore, the detection of serious communicable diseases such as HIV infection and tuberculosis, accompanied by adequate treatment and harm-reduction measures can contribute significantly to the health status of the communities from which the prisoners come and to which they will return.
Et budskab, der fremgår af EONN’s arbejde om dette emne, er, at regelmæssige frivillige lægeundersøgelser, herunder testning og rådgivning i forbindelse med hiv og anden infektion, er et særlig hensigtsmæssigt tilbud til intravenøse stofbrugere.
For those who are drug-dependent, treatment programmes in prison can provide an opportunity that may benefit not only the individual’s health, but may also reduce the likelihood of future offending.
For at øge kendskabet til sundhedstilstanden blandt indsatte og de specifikke tiltag støtter Europa-Kommissionens folkesundhedsprogram Health in Prisons-projektet, der gennemføres af WHO’s regionalkontor for Europa, med henblik på at oprette en database til indsamling af relevante indikatorer for sundhedstilstanden blandt indsatte og andre sundhedsdeterminanter.
In order to increase our knowledge of the prison health situation and of the specific responses, the public health programme of the European Commission supports the Health in Prisons Project, World Health Organisation Regional Office for Europe, to establish a database for the collection of relevant prison health indicators and other health determinants.
EONN deltager i den fælles udvikling af databasen sammen med WHO Europe og European Network on Drugs and Infections Prevention in Prison (ENDIPP) (1).
The EMCDDA is involved in the joint development of the database together with WHO Europe and the European Network on Drugs and Infections Prevention in Prison (Endipp) (1).
I 2004-2005 meldte seks lande om en udbredelse på over 40 %.
Drug treatment and harm-reduction services also need to develop responses to the risks posed by the sexual behaviour of their clients.
Vaccination spiller en vigtig rolle med hensyn til at forebygge hepatitis A og B. Nogle lande tilbyder vaccination mod hepatitis B på befolkningsplan, mens andre målretter indsatsen mod personer, der anses for at være særligt udsatte.
In addition to drug injecting, drug users may also be exposed to an elevated risk of HIV infection due to their sexual behaviour — either because of impaired decision- making, the association of some drugs with high-risk sexual behaviours, or through their involvement in sex work or sex for drug exchanges.
I Norge blev antallet af hepatitis A- og B-vaccinationer øget, efter at epidemiske udbrud af disse leverinfektioner viste, at intravenøs stofbrug havde bredt sig til mindre kommuner.
Women drug users may be particularly vulnerable, though concerns also exist about the interaction between drug use and high-risk sexual behaviour among some groups of men who have sex with men.
Tidstendenserne i anmeldte tilfælde af hepatitis B og C viser forskellige billeder.
In addition to HIV, drug users may also be at higher risk of acquiring other sexually transmitted diseases (STDs), and drug treatment services may be able to play an important role in diagnosing undetected STDs.
Med hensyn til hepatitis B synes andelen af intravenøse stofbrugere blandt alle anmeldte tilfælde generelt at være faldet, hvilket muligvis afspejler den stigende
For example, a recent Maltese study reported undetected human papilloma virus infections among women screened at an outpatient treatment unit.
Den store udbredelse af hepatitis C-infektion blandt intravenøse stofbrugere understreger stærkt behovet for
Needle and syringe programmes reduce risks; voluntary counselling and testing of infectious diseases; vaccination and treatment of infectious diseases.
Kapitel 8: Narkotikarelaterede smitsomme sygdomme og narkotikarelaterede dødsfald
Chapter 8: Drug-related infectious diseases and drug-related deaths injecting-related risks of infectious diseases, testing and counselling services, and referral to treatment.
Arten og omfanget af udlevering af sterilt sprøjteudstyr varierer fra land til land.
programmes (NSPs) were identified as a priority measure for addressing the spread of infectious disease among drug injectors in three out of four EU countries and Norway (151).
Generelt udleveres sprøjterne på et fast sted via specialiserede narkotikatjenester, og i alle lande undtagen 3 suppleres dette tilbud af mobile tjenester, som kan nå ud til grupper af intravenøse stofbrugere i marginaliserede miljøer. Salgsautomater supplerer nåle- og
Provision of clean needles and syringes is reported by all countries except Cyprus, where this measure has, in 2006, been recommended by an expert group to curb a possible increase in injecting-related infections.
), men der foreligger at udvikle mere effektive tiltag over for denne sygdom, hvor vaccination ikke er en mulighed.
The distribution of other sterile equipment such as alcohol pads and dry wipes, water, filters and cookers together with clean syringes is becoming a general approach among service providers.
En række lande har specifikke programmer, der tager sigte på at forebygge hepatitis C, og der er ved at udvikle sig interessante tiltag på dette område, f.eks. tager »stop hepC«-kampagnen, som har været i gang i Oslo siden 2003, sigte på at nå ud til stofbrugere, inden de eventuelt begynder at injicere stoffer, eller mens de stadig er i begyndelsesfasen.
While the distribution of sterile injecting material through NSPs is generally no longer regarded as a controversial issue, not all countries prioritise these programmes, and some consider pharmacy sales as largely sufficient.
meget få data om omsætningen, og der mangler forskning i effektiviteten af denne form for tilbud.
However, a growing number of countries have nationwide networks of NSPs.
Luxembourg har nu sluttet sig til Spanien og Tyskland blandt de få lande, der tilbyder nåle- og sprøjtebytning i fængsler; i Tyskland er tilbuddet dog begrænset til et enkelt fængsel i Berlin.
Countries reporting good national coverage of NSPs include: Luxembourg and Malta, two small countries; Italy, where NSPs are commonly or often implemented in about 70 % of all local health districts; the Czech Republic, where they are available in all 77 districts and in the capital city of Prague; and Finland, where legislation obliges municipalities to provide relevant services to prevent infectious diseases, including NSPs.
De mange apoteker i nærmiljøet betyder, at sprøjtebytteordninger, der foregår via apoteker, i vidt omfang kan forbedre den geografiske adgang til sprøjter og derfor supplere udleveringen fra specialiserede tjenester.
Portugal estimates that its pharmacy-based and outreach NSPs cover about 50 % of the territory, and in Denmark, 10 of the 13 counties run NSPs.
F.eks. i Skotland blev der udleveret 1,7 millioner sprøjter via et netværk af 116 deltagende apoteker i 2004, og i Portugal deltog over 1 300 apoteker i ordningen og udleverede 1,4 millioner sprøjter (153).
All Austrian cities with a significant injecting drug scene have at least one needle and syringe outlet, and in Bulgaria, services are available in 10 cities with relatively high levels of problem drug use.
Der er meldt om formelt organiserede apoteksbaserede sprøjtebytte- eller udleveringsordninger i otte europæiske lande (Belgien, Danmark, Spanien, Frankrig, Nederlandene, Portugal, Slovenien, Det Forenede Kongerige).
In Estonia, it was estimated in 2005 that 37 % of IDUs were in contact with NSPs, while the coverage of the target groups in Slovakia and Romania was estimated to be considerably lower (20 % and 10–15 %, respectively).
Narkotikabehandlings- og skadesreduktionstjenester bør også udvikle tiltag over for risiciene i forbindelse med deres klienters seksuelle adfærd.
The nature and range of provision of sterile injecting material vary between countries.
Foruden intravenøs stofbrug kan stofbrugere også have en forøget risiko for hiv-infektion som følge af deres seksuelle adfærd — enten på grund af nedsat dømmekraft, forbindelsen mellem nogle stoffer og seksuel højrisikoadfærd eller via deres involvering i sexarbejde eller udveksling af sex for stoffer.
In general, syringe provision outlets are located in specialised drugs agencies, and in all but three countries this type of provision is complemented by mobile services that can reach out to groups of drug injectors in marginalised neighbourhoods.
Kvindelige stofbrugere er særligt udsatte, selv om der også er bekymringer over samspillet mellem stofbrug og seksuel højrisikoadfærd blandt nogle grupper af mænd, som har sex med mænd.
Syringe vending machines complement the available NSP services in 10 countries (152), but data on turnover are scarce and research about the effectiveness of this type of provision is lacking.
Foruden hiv kan stofbrugere også have større risiko for at pådrage sig andre seksuelt overførte sygdomme, og narkotikabehandlingstjenester kan i givet fald spille en vigtig rolle med hensyn til at diagnosticere uopdagede seksuelt overførte sygdomme.
Luxembourg has now joined Spain and Germany among the few countries offering needle and syringe exchange in prisons; although provision in Germany is limited to one prison in Berlin.
F.eks. blev der i en nylig maltesisk undersøgelse meldt om uopdagede infektioner med human papilloma virus blandt kvinder, der var blevet screenet på et ambulatorium.
Between 2003 and 2005, increases in the total number of syringes exchanged or distributed through specialised NSPs were reported by several countries (Bulgaria, the Czech Republic, Estonia, Hungary, Austria, Slovakia,
I lande, hvor stofbrugere især køber deres sprøjteudstyr på apoteker, kunne disse spille en større rolle i forbindelse med andre sundhedsfremmende foranstaltninger rettet mod stofbrugere, bl.a. formidling af information om seksuelle risici og risici som følge af intravenøs stofbrug for smitsomme sygdomme, test og rådgivningstjenester samt henvisning til behandling.
The widespread availability of community-based pharmacies means that syringe exchange schemes operated through pharmacies can considerably improve the geographical availability of syringes and, therefore, complement provision by specialist agencies.
Den geografiske dækning af nåle- og sprøjteprogrammer og udleveringen af injektionsudstyr via disse varierer meget mellem landene. Flere og flere lande har imidlertid landsdækkende nåle- og sprøjteprogrammer.
For example, in Scotland, 1.7 million syringes were distributed through a network of 116 participating pharmacies in 2004, and in Portugal more than 1 300 pharmacies took part in the scheme and distributed 1.4 million syringes (153).
Portugal har anslået, at dets apoteksbaserede og opsøgende nåle- og sprøjteprogrammer dækker ca. 50 % af området, og i Danmark er der nåle- og
In countries where pharmacies represent a common source for drug users to obtain their injecting equipment, they could play a more important role in delivering other health-promoting measures to drug users, including the dissemination of information about sexual and
Det er almindeligt udbredt i EU, at nåle- og sprøjtebytte- eller udleveringsordninger er integreret i tjenester, der tilbydes af narkotikaorganer, og at der både tilbydes risikorådgivning og rådgivningstjenester samt henvisning af stofbrugere til behandling.
Specialised agencies that provide needle and syringe programmes can have other important public health roles, for example, assessing and raising the awareness for risk behaviour among clients, motivating them to get tested and vaccinated, as well as providing a conduit to primary healthcare and drug treatment.
Der udleveres rene nåle og sprøjter i alle lande undtagen Cypern, hvor denne foranstaltning i 2006 er blevet anbefalet af en ekspertgruppe for at bremse en mulig stigning i smitte i forbindelse med intravenøs stofbrug.
While the extent to which these agencies deliver these services is unclear, the need for this type of service development is underlined by the findings of a national audit recently conducted in England.
Det er ved at blive almindeligt blandt tjenesteudbyderne, at de udleverer andet sterilt udstyr, f.eks. alkoholservietter og tørservietter, vand, filtre og kogekar, sammen med rene sprøjter.
This audit report found that levels of awareness of infectious diseases among clients were relatively low, and that agencies could be more proactive in offering counselling, testing and vaccination.
Årsberetning for 2007: narkotikasituationen i Europa antallet af personer, der bruger stoffer, der er forbundet med overdosis (især opioider).
Annual report 2007: the state of the drugs problem in Europe
Andre faktorer, der også er vigtige, er andelen af intravenøse stofbrugere, udbredelsen af blandingsbrug, adgangen til og strategien blandt behandlingstjenester og nødhjælpstjenester.
In general, drug-related deaths occur shortly after the consumption of the substance(s). Other terms used to describe these deaths include ‘overdoses’, ‘poisonings’,
sprøjteprogrammer i 10 af de 13 amter.
1 400 deaths in 2003 (EuroHIV, 2006) (159), although this is possibly an underestimate.
Alle østrigske byer med mange intravenøse stofbrugere har mindst ét nåle- og sprøjteudleveringssted, og i Bulgarien er der adgang til tjenester i ti byer med en forholdsvis stor udbredelse af problematisk stofbrug.
It has been estimated that, in at least some European cities, 10–20 % of mortality among young adults could be attributed to opioid use, directly or indirectly (Bargagli et al., 2006) (see below).
I Estland blev det anslået i 2005, at 37 % af de intravenøse stofbrugere var i kontakt med nåle- og sprøjteprogrammer, mens dækningen af målgrupperne i Slovakiet og Rumænien blev anslået til at være betydeligt lavere (henholdsvis 20 og 10-15 %).
‘drug-induced deaths’ and ‘acute drug deaths’ (155). The number of drug-related deaths in a community will depend on the number of people using drugs associated with overdose (particularly opioids).
En række lande (Bulgarien, Den Tjekkiske Republik, Estland, Ungarn, Østrig, Slovakiet, Finland) meldte om stigninger i det samlede antal sprøjter, der blev byttet eller udleveret via specialiserede nåle- og sprøjteprogrammer mellem 2003 og
Determining the overall level of mortality resulting from problem drug use at a national or European level will require advances in data collection and analysis. An attempt at such an exercise on a national scale is reported in the Dutch national report.
Selv om sammenligneligheden af europæiske data er blevet bedre i de senere år, betyder forskelle mellem landene med hensyn til kvaliteten af indberetningen stadig, at direkte sammenligninger bør foretages med forsigtighed.
Although the comparability of European data has improved in recent years, differences in the quality of reporting between countries still mean that direct comparisons should be made with caution.
Omfanget af narkotikarelaterede dødsfald kan udtrykkes på grundlag af antallet af indberettede tilfælde, befolkningstal eller forholdsmæssig dødelighed.
The extent of drug-related deaths can be expressed in terms of the number of cases reported, by population rates or by proportional mortality.