Increased risk of non-fatal overdose associated with non-prescribed benzodiazepine use in Scotland, UK.

BACKGROUND: Drug-related deaths (DRDs) in Scotland increased for seven years in a row between 2014 and 2020, consolidating Scotland's place at the top of the United Kingdom and European drug-related mortality charts. One of the defining features of this recent and rapid rise has been the role of benzodiazepines, which are now involved in the majority of all DRDs. These deaths are linked to use of non-prescribed, benzodiazepine-type novel psychoactive substances (NPS) which have been identified by the United Nations as a global threat to public health. This study aimed to estimate the prevalence and determinants of non-prescribed benzodiazepine use and its association with recent non-fatal overdose among a national sample of people who inject drugs (PWID). METHODS: Data from the 2019-20 Needle Exchange Surveillance Initiative (NESI) was analysed using logistic regression. NESI is a voluntary, anonymous, biennial, cross-sectional, bio-behavioural survey of PWID attending community-based services providing injecting equipment in mainland Scotland. RESULTS: Prevalence of non-prescribed benzodiazepine use in the past six months was 52% and significantly associated with age (aOR 0.97, 0.96-0.98), frequent incarceration (aOR 1.29, 1.07-1.57), recent public injecting (aOR 3.25, 2.33-4.55), a recent methadone prescription (aOR 1.87, 1.51-2.33), and a history of benzodiazepine prescription (aOR 1.92, 1.47-2.52). In addition, non-prescribed benzodiazepine use was significantly associated with non-fatal overdose in the past year among PWID (aOR 2.47, 1.90-3.21). CONCLUSION: This study found a high prevalence of non-prescribed benzodiazepine use among a national sample of PWID in Scotland. Prevalence was highest among populations known to be at increased risk of drug-related death and use was strongly associated with overdose. These novel findings highlight the scale of the non-prescribed benzodiazepine issue Scotland faces, and the urgency required to expand its harm reduction infrastructure to address this unique element of its overdose crisis.

Population-based repeat cross-sectional seroprevalence survey of SARS-CoV-2 IgG antibodies in Pimpri Chinchwad Municipal Corporation Area, Maharashtra, India.

Context: Population-based seroepidemiological studies are recommended to measure the extent of spread of coronavirus disease of 2019 (COVID-19) infection in an area. The present seroprevalence survey was planned with the aim to estimate the cumulative burden of the COVID-19 disease in the Pimpri Chinchwad corporation area. Aims: To estimate the cumulative burden of the COVID-19 disease in the Pimpri Chinchwad corporation area. Settings and Design: The study was carried out in Pimpri Chinchwad Municipal Corporation (PCMC) city area. It was a descriptive cross-sectional survey. Materials and Methods: A population-based seroprevalence study for immunoglobulin G (IgG) antibodies for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was carried out among 10082 residents in the age group of 6 years and above selected by cluster random sampling. Thirty-five clusters were in slums, 45 clusters in tenements and 120 clusters from housing societies. The fieldwork for the collection of samples was carried out from 16 June to 17 June 2021. For antibody testing, a kit from Abbott (SARS-CoV-2 IgG) was used which employs chemiluminescent microparticle immunoassay (CMIA) technology. Statistical Analysis Used: Frequency analysis was done for sociodemographic variables, the cumulative incidence of COVID-19, age-stratified infection rate, risk factors and COVID symptomatic versus asymptomatic cases. Chi-square test of association was applied to test the association between seropositivity and sociodemographic and clinical profile of participants. Results: The overall seropositivity for IgG antibodies was 81.34%. Those living in the Gaothan area (tenements) had a positivity rate of 84.5%. The age group between 45 and 60 years had a seropositivity of 91%. Conclusions: The study indicates that a considerable proportion of the population had encountered the novel coronavirus approaching herd immunity.

Equity-focused health impact assessment of Portuguese tobacco control legislation.

The World Health Organization recommend the Equity-Focused Health Impact Assessment (HIA) as a means to assess the impact of social and economic policies on the health of populations, and acknowledges their contribution to health inequality. We describe the application of the Equity-focused Impact Assessment methodology on the Portuguese law on Smoking Prevention and Tobacco Control (Law No. 37/2007). A rapid assessment was carried out to issue recommendations which could be incorporated into the law during a revision in 2014. Quantitative (consumption and health status indicators; equity analysis) and qualitative (Focus Group) approaches were taken to evaluate the impact of the law and formulate recommendations. Young people, men and women of low socioeconomic status, and pregnant women were identified as requiring specific and appropriate interventions to prevent smoking and support smoking cessation.

A large community outbreak of Legionnaires disease in Vila Franca de Xira, Portugal, October to November 2014.

An outbreak of Legionnaires' disease with 334 confirmed cases was identified on 7 November 2014 in Vila Franca de Xira, Portugal and declared controlled by 21 November. Epidemiological, environmental and microbiological analysis identified industrial wet cooling systems to be the probable source of infection. Preliminary results from sequence-based typing of clinical specimens and environmental isolates confirmed this link. A series of meteorological phenomena are likely to have contributed to the scale of this outbreak.