RESUMO
Addiction to illicit substances or medicines is influenced by cultural, religious, ethnic factors as well as local availability. The purpose of this study was to evaluate the profile of drug users and characteristics of the psychoactive substances used in French overseas territories, using data from the OPPIDUM survey. OPPIDUM is an annual, nationwide, multicentric, cross-sectional study based on specialized care centres that included subjects presenting a drug addiction or under opiate maintenance treatment. The current study includes data from the 2012 and 2013 surveys and focuses on patients included by drug addiction centres located in French overseas departments and territories: French Pacific Ocean (French Polynesia, New Caledonia), French Americas (Guadeloupe, Saint Martin, French Guiana) and Reunion Island. Data from metropolitan France (2013 survey) were included as reference. Two hundred and forty-five patients were included. The sex ratio was 3.7 for the Pacific Ocean, 3.5 for the French Americas and 3.3 for Reunion Island. Cannabis was consumed in all the territories, from 50.8% in Reunion Island to 81.7% in Pacific Ocean. Cocaine was most frequently consumed in the French Americas (61%), mainly in the 'freebase' form (91%), whereas 6.5% of cocaine users in metropolitan France did so. Problematic use of medicines was most frequent in Reunion Island. Heroin seems rarely used in all overseas territories. This study highlights the complexity of substances used in French overseas territories, which often differ from that in mainland France. The relative difference between different areas provides valuable information for future investigations and possible interventions.
Assuntos
Cocaína/administração & dosagem , Heroína/administração & dosagem , Drogas Ilícitas , Psicotrópicos/administração & dosagem , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Adulto , Cocaína/efeitos adversos , Feminino , França/epidemiologia , Guiana Francesa/epidemiologia , Guadalupe/epidemiologia , Heroína/efeitos adversos , Humanos , Masculino , Martinica/epidemiologia , Nova Caledônia/epidemiologia , Polinésia/epidemiologia , Psicotrópicos/efeitos adversos , Reunião/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Inquéritos e Questionários , Adulto JovemRESUMO
This study explored the access to the French national renal transplantation waiting list and the waiting time before transplantation for the patients with ESRD on dialysis living in the FOT. Overseas health authorities gave data on ESRD incidence and prevalence. Data on patients registered between 1997 and 2000 were extracted from the French national waiting list (390 patients from the FOT and 9378 from continental France). Registered prevalence of ESRD in FOT (726 to 1418 per million population (pmp)) were higher than continental France (580 pmp). The yearly incidence of registration on the national French waiting list was 36 pmp. The same figure was observed in the FAT (French Guyana and Caribbean's islands: 36.8 to 43 pmp), very low in New Caledonia and Tahiti (7.7 and 18.1 pmp), and very high in the Reunion Island, where a renal transplantation unit is available (77.5 pmp). Median waiting times before transplantation varied significantly, FAT: 35.4 months, Reunion Island: 9.9 months, Pacific Territories: 8.8 months and the Metropolitan territory: 12.2 months. After adjustment on risk factors known to be associated with the waiting times before transplantation, we still observed a longer waiting time for patients from FAT (RR = 1,4, p < 0.05) and a lower waiting time for patients from Reunion Island (RR = 0.6, p < 0.001) compared to waiting time observed in patients from continental France. Consequently, transplantation teams in FAT must be developed.
Assuntos
Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Transplante de Rim/estatística & dados numéricos , França/epidemiologia , Guiana Francesa/epidemiologia , Guadalupe/epidemiologia , Humanos , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/cirurgia , Martinica/epidemiologia , Nova Caledônia/epidemiologia , Polinésia/epidemiologia , Reunião/epidemiologia , Listas de EsperaAssuntos
Diabetes Mellitus Tipo 2/epidemiologia , Glicemia/análise , Djibuti/epidemiologia , Guadalupe/epidemiologia , Humanos , Programas de Rastreamento , Micronésia/epidemiologia , Nova Caledônia/epidemiologia , Polinésia/epidemiologia , Prevalência , Reunião/epidemiologia , Índias Ocidentais/epidemiologiaRESUMO
The prevalence of diabetes mellitus among patients treated for end-stage renal failure by dialysis in France was studied in two stages (UREMIDIAB Study). The first stage consisted of a questionnaire which was mailed to all dialysis centres in mainland France. The response rate was 80.8%, resulting in a study population of 12,903 patients. Of these patients 884 were declared diabetic (6.9%). Later 295 of them were interviewed by seven specially-trained physicians who checked the medical records together with the nephrologist in charge. Plasma C-peptide was measured in almost all of the patients. Effectively, 1.4% were found to have Type 1 diabetes and 5.5%, Type 2. Diabetic nephropathy was found to be the only primary renal diagnosis among 93.9% of Type 1 diabetic patients and 36.8% of Type 2. Of the latter 51.6% had a non-diabetic cause of renal failure. In the second stage a survey was later conducted in 13 of 14 dialysis centres located in the remote overseas French territories. Among 934 patients 1.04% were Type 1 diabetic and 19.67% Type 2 (22.9% altogether). Type 2 diabetic patients treated overseas were essentially non-Caucasians (92.6%). The sex ratio was 0.54 in the overseas territories vs 1.4 in the mainland. We conclude that the prevalence of diabetes among people on dialysis is low in mainland France. But there are striking differences in the prevalence of Type 2 diabetes among dialysis patients in mainland France and its overseas territories. These differences are not related to access to dialysis facilities.