Author
Bradley Mathers
Other affiliations: University of New South Wales, National Drug and Alcohol Research Centre, Kirby Institute ...read more
Bio: Bradley Mathers is an academic researcher from World Health Organization. The author has contributed to research in topics: Acquired immunodeficiency syndrome (AIDS) & Population. The author has an hindex of 18, co-authored 33 publications receiving 5372 citations. Previous affiliations of Bradley Mathers include University of New South Wales & National Drug and Alcohol Research Centre.
Papers
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TL;DR: The high prevalence of HIV among many populations of injecting drug users represents a substantial global health challenge and existing data are far from adequate, in both quality and quantity.
1,192 citations
TL;DR: More IDUs have anti-HCV than HIV infection, and viral hepatitis poses a key challenge to public health, which will inform efforts to prevent and treat HCV and HBV in IDUs.
1,189 citations
TL;DR: Mortality among opioid-dependent users varies across countries and populations; treatment is clearly protective against mortality even in non-randomized observational studies; study characteristics predict mortality levels.
Abstract: Aims To review the literature on mortality among dependent or regular users of opioids across regions, according to specific causes, and related to a number of demographic and clinical variables. Methods Multiple search strategies included searches of Medline, EMBASE and PsycINFO, consistent with the methodology recommended by the Meta‐analysis of Observational Studies in Epidemiology (MOOSE) group; grey literature searches; and contact of experts for any additional unpublished data from studies meeting inclusion criteria. Random‐effects meta‐analyses were conducted for crude mortality rates (CMRs) and standardized mortality ratios (SMRs), with stratified analyses where possible. Meta‐regressions examined potentially important sources of heterogeneity across studies. Results Fifty‐eight prospective studies reported mortality rates from opioid‐dependent samples. Very high heterogeneity across studies was observed; pooled all‐cause CMR was 2.09 per 100 person‐years (PY; 95% CI; 1.93, 2.26), and the pooled SMR was 14.66 (95% CI: 12.82, 16.50). Males had higher CMRs and lower SMRs than females. Out‐of‐treatment periods had higher mortality risk than in‐treatment periods (pooled RR 2.38 (CI: 1.79, 3.17)). Causes of death varied across studies, but overdose was the most common cause. Multivariable regressions found the following predictors of mortality rates: country of origin; the proportion of sample injecting; the extent to which populations were recruited from an entire country (versus subnational); and year of publication. Conclusions Mortality among opioid‐dependent users varies across countries and populations. Treatment is clearly protective against mortality even in non‐randomized observational studies. Study characteristics predict mortality levels; these should be taken into account in future studies.
726 citations
TL;DR: Worldwide coverage of HIV prevention, treatment, and care services in IDU populations is very low, and there is an urgent need to improve coverage of these services in this at-risk population.
666 citations
TL;DR: Evidence on the effectiveness of individual-level approaches to prevention of HIV infection is summarized, global and regional coverage of opioid substitution treatment, needle and syringe programmes, and antiretroviral treatment is reviewed, and the effect of increased coverage and a combination of these three approaches on HIV transmission and prevalence in injecting drug users is modeled.
422 citations
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TL;DR: The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) as discussed by the authors was used to estimate the incidence, prevalence, and years lived with disability for diseases and injuries at the global, regional, and national scale over the period of 1990 to 2015.
5,050 citations
TL;DR: The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) as discussed by the authors was used to estimate the burden of disease attributable to mental and substance use disorders in terms of disability-adjusted life years (DALYs), years of life lost to premature mortality (YLLs), and years lived with disability (YLDs).
4,753 citations
TL;DR: In the Global Burden of Disease Study 2013 (GBD 2013) as mentioned in this paper, the authors estimated the quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013.
4,510 citations
Simon I. Hay, Amanuel Alemu Abajobir1, Kalkidan Hassen Abate2, Cristiana Abbafati3 +800 more•Institutions (32)
TL;DR: At a global level, DALYs and HALE continue to show improvements and the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning.
3,029 citations
TL;DR: The optimal management of patients with acute and chronic HCV infections in 2018 and onwards is described, as well as developments in diagnostic procedures and improvements in therapy and prevention.
2,491 citations