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Auteur J. M. KALDOR
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Estimating the cost-effectiveness of needle-syringe programs in Australia / J. A. KWON ; J. ANDERSON ; C. C. KERR ; H. H. THEIN ; L. ZHANG ; J. IVERSEN ; G. J. DORE ; J. M. KALDOR ; M. G. LAW ; L. MAHER ; D. P. WILSON in AIDS, Vol.26, n°17 (November 2012)
Titre : Estimating the cost-effectiveness of needle-syringe programs in Australia Type de document : Périodique Auteurs : J. A. KWON ; J. ANDERSON ; C. C. KERR ; H. H. THEIN ; L. ZHANG ; J. IVERSEN ; G. J. DORE ; J. M. KALDOR ; M. G. LAW ; L. MAHER ; D. P. WILSON Année de publication : 2012 Article en page(s) : 2201-2210 Langues : Anglais (eng) Mots-clés : Thésaurus Géographique
PROGRAMME ; ECHANGE DE SERINGUES ; COUT ; EFFICACITE ; EVALUATION ; VIH ; HEPATITE ; MODELE STATISTIQUE ; USAGER ; REDUCTION DES RISQUES
Discipline : PRE Prévention / Prevention Résumé : OBJECTIVE: To evaluate the impact and cost-effectiveness of needle-syringe programs (NSPs) with respect to HIV and hepatitis C virus (HCV) infections among Australian injecting drug users (IDUs).
DESIGN/METHODS: A health economic analysis was conducted incorporating a mathematical model of HIV and HCV transmission among IDUs. An empirical relationship between syringe availability and receptive syringe sharing (RSS) was assessed. We compared the epidemiological outcomes and costs of NSP coverage (status quo RSS of 15-17%) with scenarios that had no NSPs (RSS of 25-50%). Outcomes included numbers of HIV and HCV infections averted, lifetime health sector costs, and cost per quality-adjusted life year (QALY) gained. Discounting was applied at 3% (sensitivity: 0%, 5%) per annum.
RESULTS: We estimated that NSPs reduced incidence of HIV by 34-70% (192-873 cases) and HCV by 15-43% (19 000-77 000 cases) during 2000-2010, leading to 20 000-66 000 QALYs gained. Economic analysis showed that NSP coverage saved A$70-220 million in healthcare costs during 2000-2010 and will save an additional A$340-950 million in future healthcare costs. With NSPs costing A$245 million, the programs are very cost-effective at A$416-8750 per QALY gained. Financial investment in NSPs over 2000-2010 is estimated to be entirely recovered in healthcare cost savings by 2032 with a total future return on investment of $1.3-5.5 for every $1 invested.
CONCLUSION: Australia's early introduction and high coverage of NSPs has significantly reduced the prevalence of HIV and HCV among IDUs. NSPs are a cost-effective public health strategy and will result in substantial net cost savings in the future.
Domaine : Drogues illicites / Illicit drugs Refs biblio. : 41 Affiliation : The Kirby Institute, The University of New South Wales, Sydney, Australia Permalink :
in AIDS > Vol.26, n°17 (November 2012) . - 2201-2210[article]Extreme cause-specific mortality in a cohort of adult prisoners--1988 to 2002: a data-linkage study / A. KARIMINIA
Titre : Extreme cause-specific mortality in a cohort of adult prisoners--1988 to 2002: a data-linkage study Titre traduit : (Mortalité liée à une cause spécifique extrême dans une cohorte de prisonniers adultes de 1998 à 2002 : étude sur les transmissions des données) Type de document : Périodique Auteurs : A. KARIMINIA ; T. G. BUTLER ; S. P. CORBEN ; M. H. LEVY ; L. GRANT ; J. M. KALDOR ; M. G. LAW Année de publication : 2007 Importance : 317-318 Présentation : fig. ; tabl. Note générale : International Journal of Epidemiology, 2007, 36, (2), 317-318 Langues : Anglais (eng) Mots-clés : Thésaurus TOXIBASE
MORTALITE ; PRISON ; ENQUETE ; SUICIDE ; EVOLUTION ; ETUDE RETROSPECTIVE ; SURDOSE
OBJECTIVES: Describe the standardized mortality ratio (SMR) and its trend in adults who have served time in prison. Design: A retrospective cohort study of 85,203 adults imprisoned in New South Wales (NSW), Australia, between 1 January 1988 and 31 December 2002. METHODS: We obtained information on deaths by record linkage with the Australian National Death Index (NDI). Mortality rates were estimated using the person-time method. SMRs were calculated using sex, age, and calendar-specific death rates from the NSW population. Time trends in SMRs were assessed using the test for linear trends. RESULTS: The median overall follow-up of the cohort was 7.7 years. We identified 5137 deaths (4714 men, 423 women) among the cohort of which the vast majority (4834, 94%) occurred following release from custody. All-cause SMR was 3.7 (95% CI: 3.6-3.8) in men and 7.8 (95% CI: 7.1-8.5) in women. SMRs were substantially raised for deaths due to mental and behavioural disorders (men: 13.2, 95% CI: 12.3-14.0; women: 62.8, 95% CI: 52.7-74.9) and drug-related deaths (men: 12.8, 95% CI: 12.2-13.5; women: 50.3, 95% CI: 43.7-57.8). The SMR for death by homicide was 10.2 (95% CI: 8.9-11.7) in men and 26.3 (95% CI: 17.8-39.0) in women. Aboriginal men were 4.8 times, and Aboriginal women 12.6 times, more likely to die than the general NSW population. Over the study period on average all-cause SMR decreased significantly in men (p = 0.003) and women (p = 0.05) largely due to the decline in SMRs for drug-related deaths and suicide. CONCLUSION: In the largest study so far reported, mortality of male and female offenders was far greater than expected for all major causes, especially deaths caused by drug overdose. Despite some indication of a reduction in excess mortality in recent years, there remains an overwhelming need for enhanced responses to mental health and drug problems for people who have been in prison. (Author' s abstract)
Note de contenu : fig. ; tabl. Domaine : Drogues illicites / Illicit drugs Refs biblio. : 30 Affiliation : Centre for Health Research in Criminal Justice, Sydney, Australia. firstname.lastname@example.org
Centre for Health Research in Criminal Justice, Sydney, Australia. email@example.com
Numéro Toxibase : 1302153 Centre Emetteur : 13 OFDT Cote : A03349 Permalink : Factors associated with mortality in a cohort of Australian prisoners / A. KARIMINIA
Titre : Factors associated with mortality in a cohort of Australian prisoners Titre traduit : (Facteurs associés à la mortalité dans une cohorte de prisonniers australiens) Type de document : Périodique Auteurs : A. KARIMINIA ; M. G. LAW ; T. G. BUTLER ; S. P. CORBEN ; M. H. LEVY ; J. M. KALDOR ; L. GRANT Année de publication : 2007 Importance : 417-428 Présentation : tabl. Note générale : European Journal of Epidemiology, 2007, 22, (7), 417-428 Langues : Anglais (eng) Mots-clés : Thésaurus TOXIBASE
MORTALITE ; PRISON ; COHORTE ; SURDOSE ; EVOLUTION ; SUICIDE ; ENQUETE
Discipline : EPI Epidémiologie / Epidemiology Résumé : We examined factors associated with increased mortality in a cohort of 85,203 adults with a history of imprisonment in New South Wales, Australia, between 1988 and 2002. Information on death was collected through linkage to the Australian National Death Index. The influence of demographic and criminological factors on the standardised mortality ratio (SMR) for all-cause mortality, and deaths due to drug overdose and suicide was examined using negative binomial regression models. The number of deaths identified was 5,137 (4,714 men, 423 women, 303 in custody). The overall SMR was 3.7 (3.63.8) in men and 7.8 (7.18.5) in women. SMRs raised for deaths due to drug overdose (men: 12.8, women: 50.3) and suicide (men: 4.8, women: 12.2). The high SMR was associated with hospitalisation for mental illness, multiple imprisonments, and early stage of follow-up independently of causes of death. Being released from prison increased the SMRs for all-cause and drug-related mortality, but not suicide. For women, significant trends for decreasing risk with increasing age were noted. Minority groups, in particular men, had a lower risk of death than white people. In men a sex or drug offence was associated with a lower risk and a property or violence offence was related to higher mortality. Our results reinforce how disadvantaged prisoners are, measured by mortality as the most fundamental scale of human wellbeing. Certain demographic and imprisonment characteristics are indicators of high mortality among this population. The underlying causes of some of these characteristics such as mental illness or multiple imprisonments are potentially treatable and preventable. Prison health services need to develop interventions targeting high-risk groups to avoid this situation. (Author' s abstract) Domaine : Drogues illicites / Illicit drugs Refs biblio. : 44 Affiliation : Centre for Health Research in Criminal Justice, Justice Health, Sydney, NSW, Australia Numéro Toxibase : 1302154 Centre Emetteur : 13 OFDT Cote : A03350 Permalink : HIV prevalence among IDUs in Australia: a methodological review / J. M. KALDOR
Titre : HIV prevalence among IDUs in Australia: a methodological review Titre traduit : (Prévalence du VIH chez les toxicomanes par voie intraveineuse en Australie: revue des études) Type de document : Périodique Auteurs : J. M. KALDOR ; J. ELFORD ; A. WODAK ; J. N. CROFTS ; KIDD S. Année de publication : 1993 ISBN/ISSN/EAN : 0959-5236 Note générale : Drug and Alcohol Review, 1993, 12, 175-184 Langues : Anglais (eng) Mots-clés : Thésaurus TOXIBASE
VIH ; VOIE INTRAVEINEUSE ; SEROPOSITIVITE
Discipline : EPI Epidémiologie / Epidemiology Résumé : FRANÇAIS :
Une analyse des quatorze études portant sur la prévalence de l'infection à VIH en Australie, montre que celle-ci est basse chez les toxicomanes intraveineux (0 à 5%) sauf chez les hommes, toxicomanes intraveineux homosexuels (20 à 24%). Toutefois chacune des méthodes utilisées a des limites. Une uniformité méthodologique est nécessaire pour améliorer la vue d'ensemble de l'occurence de l'infection.
A review was carried out of Australian studies which have measured the prevalence of HIV infection among injecting drug users (IDUs). The main findings from the studies were that HIV prevalence in IDUs has been low in Australia, apart from in male IDUs who also has homosexual contact. HIV prevalence ranged from 20 to 24% in male IDUs reporting homosexual contact and from 0 to 5% in other IDUs. The studies, while reflecting a range of research methodologies, are subject to a number of limitations. Adoption of standardized, continuing seroprevalence surveys on IDUs would provide a better means of monitoring the occurence of HIV infection in this group, which has been a key determinant of the course of the HIV epidemic in a number of Western countries. (Extract from authors'abstract)
Domaine : Drogues illicites / Illicit drugs Refs biblio. : 33 Affiliation : Nat. Ctr. HIV Epidemiol. Clin. Res., 376 Victoria St, Sydney NSW 2010
Numéro Toxibase : 801170 Centre Emetteur : 08 CAS Strasbourg Permalink : Incidence and risk factors for hepatitis C seroconversion in injecting drug users in Australia / L. MAHER
Titre : Incidence and risk factors for hepatitis C seroconversion in injecting drug users in Australia Titre traduit : (Incidence et facteurs de risque d'une séroconversion au virus de l'hépatite C parmi des usagers de drogues par injection en Australie.) Type de document : Périodique Auteurs : L. MAHER ; B. JALALUDIN ; K. G. CHANT ; R. JAYASURIYA ; T. SLADDEN ; J. M. KALDOR ; P. L. SARGENT Année de publication : 2006 Importance : 1499-1308 Présentation : fig. ; tabl. Note générale : Addiction, 2006, 101, (10), 1499-1308 Langues : Anglais (eng) Mots-clés : Thésaurus TOXIBASE
HEPATITE ; INJECTION ; INCIDENCE ; FACTEUR DE RISQUE
Discipline : MAL Maladies infectieuses / Infectious diseases Résumé : Aims: To determine the incidence of hepatitis C virus (HCV) infection and identify risk factors for seroconversion. Design: Prospective cohort study. Participants were recruited through direct approaches, street-based outreach, methadone and sexual health clinics and needle and syringe programmes. Setting: Urban, regional and rural settings in New South Wales, Australia. Participants: Injecting drug users (IDUs) (n = 584) were screened and tested for exposure to HCV. Between 1999 and 2002 antibody HCV negative IDUs (n = 368) were enrolled and followed-up every 36 months until seroconversion or study completion. Measurements: Interviewer-administered baseline and follow-up questionnaires consisted of 131 items and included demographics, drug use and risk behaviour. Approximately 10 cc of whole blood was drawn at each visit. Specimens were stored at -70C and serology performed using one or two third-generation enzyme-linked immunosorbent assays and polymerase chain reaction testing. Findings: Sixty-eight seroconversions were observed and incidence was 30.8 per 100 person-years, with incidence in IDUs injecting Domaine : Drogues illicites / Illicit drugs Refs biblio. : 36 Affiliation : National Centre in HIV Epidemiology and Clinical Research, Level 2, St Vincent's Medical Centre, 376 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia.
Numéro Toxibase : 208882 Centre Emetteur : 02 Coordonnateur Permalink : Infection with HIV and hepatitis C virus among injecting drug users in a prevention setting : retrospective cohort study / I. VAN BEEKPermalinkPublic opinion towards supervised injecting centres and the Sydney Medically Supervised Injecting Centre (MSIC) / H. H. THEINPermalink