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Randomized Controlled Trial
. 2015 Jun;105(6):1136-41.
doi: 10.2105/AJPH.2014.302473. Epub 2015 Apr 16.

High Mortality Among Non-HIV-Infected People Who Inject Drugs in Bangkok, Thailand, 2005-2012

Suphak Vanichseni  1 , Michael Martin, Pravan Suntharasamai, Udomsak Sangkum, Philip A Mock, Roman J Gvetadze, Marcel E Curlin, Manoj Leethochawalit, Sithisat Chiamwongpaet, Benjamaporn Chaipung, Janet M McNicholl, Lynn A Paxton, Somyot Kittimunkong, Kachit Choopanya
Affiliations
Randomized Controlled Trial

High Mortality Among Non-HIV-Infected People Who Inject Drugs in Bangkok, Thailand, 2005-2012

Suphak Vanichseni et al. Am J Public Health. 2015 Jun.

Abstract

Objectives: We examined the causes of hospitalization and death of people who inject drugs participating in the Bangkok Tenofovir Study, an HIV preexposure prophylaxis trial.

Methods: The Bangkok Tenofovir Study was a randomized, double-blind, placebo-controlled trial conducted during 2005 to 2012 among 2413 people who inject drugs. We reviewed medical records to define the causes of hospitalization and death, examined participant characteristics and risk behaviors to determine predictors of death, and compared the participant mortality rate with the rate of the general population of Bangkok, Thailand.

Results: Participants were followed an average of 4 years; 107 died: 22 (20.6%) from overdose, 13 (12.2%) from traffic accidents, and 12 (11.2%) from sepsis. In multivariable analysis, older age (40-59 years; P = .001), injecting drugs (P = .03), and injecting midazolam (P < .001) were associated with death. The standardized mortality ratio was 2.9.

Conclusions: People who injected drugs were nearly 3 times as likely to die as were those in the general population of Bangkok and injecting midazolam was independently associated with death. Drug overdose and traffic accidents were the most common causes of death, and their prevention should be public health priorities.

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Figures

FIGURE 1—
FIGURE 1—
Kaplan–Meier product-limit survival estimate for injection drug users (n = 2413): Bangkok Tenofovir Study; Bangkok, Thailand; 2005–2012.
See this image and copyright information in PMC

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