title: Healthcare seeking and hospital admissions by people who inject drugs in response to symptoms of injection site infections or injuries in three urban areas of England.
abstract: People who inject drugs (PWID) are vulnerable to infections and injuries at injection sites. The factors associated with reporting symptoms of these, seeking related advice, and hospital admission are examined. PWID were recruited in Birmingham, Bristol and Leeds using respondent-driven sampling (N = 855). During the preceding year, 48% reported having redness, swelling and tenderness (RST), 19% an abscess, and 10% an open wound at an injection site. Overall, 54% reported ⩾1 symptoms, with 45% of these seeking medical advice (main sources emergency departments and General Practitioners). Advice was often sought ⩾5 days after the symptom first appeared (44% of those seeking advice about an abscess, 45% about an open wound, and 35% for RST); the majority received antibiotics. Overall, 9·5% reported hospital admission during the preceding year. Ever being diagnosed with septicaemia and endocarditis were reported by 8·8% and 2·9%, respectively. Interventions are needed to reduce morbidity, healthcare burden and delays in accessing treatment.
authors.affiliation: Centre for Infectious Disease Surveillance and Control,Public Health England,London,UK.
authors.forename: V D
authors.initials: VD
authors.lastname: Hope
authors.affiliation: Centre for Infectious Disease Surveillance and Control,Public Health England,London,UK.
authors.forename: F
authors.initials: F
authors.lastname: Ncube
authors.affiliation: Centre for Research on Drugs & Health Behaviour,London School of Hygiene & Tropical Medicine,London,UK.
authors.forename: J V
authors.initials: JV
authors.lastname: Parry
authors.affiliation: School of Social and Community Medicine,University of Bristol,Bristol,UK.
authors.forename: M
authors.initials: M
authors.lastname: Hickman
mesh_terms: D000293:Adolescent; D000328:Adult; D004739:England / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015819:Substance Abuse, Intravenous / Q000150:complications*; D014505:Urban Population; D014946:Wound Infection / Q000453:epidemiology*; D055815:Young Adult