Prevalence of skin and soft tissue infections and its related high-risk behaviors among people who inject drugs: A systematic review and meta-analysis

ABSTRACT

Background: The high prevalence of skin and soft tissue infections (SSTIs) is a significant health concern among people who inject drugs (PWIDs). This meta-analysis estimates the prevalence of SSTIs and its related risk behaviors among PWIDs.

Methods: We searched PubMed, Science Direct, Web of Science, and Cochrane electronic databases independently in February 2018. After reviewing for duplication, full-text of selected articles were assessed for eligibility using certain Population, Intervention, Comparator, Outcomes (PICO) criteria. We used fixed and random-effects meta-analysis models to estimate the pooled prevalence, pooled odds ratio (OR) and 95% confidence intervals (CI).

Results: After a detailed assessment, a total of 20 studies containing 9,502 patients met the eligibility criteria. A pooled prevalence of 44% (95% CI, 31–56%) was estimated for SSTIs among PWIDs. Among the potential risk factors, only injecting frequency has a significant positive relationship with SSTIs among PWIDs (OR = 1.20, 95%CI = 1.03–1.37).

Conclusion: The results of the present study indicate that PWIDs have a very high burden of SSTs infection, and also emphasized the potential role of higher injecting frequency on the prevalence of SSTs among PWIDs. These results suggest that more interventions to reduce of injection frequency might be useful in decreasing of SSTs burden among PWIDs.

KEYWORDS:

• Skin infection
• soft tissue infection
• people who inject drugs
• systematic review
• meta-analysis

Acknowledgments

The authors would like to thank Dr. Javad Haroni, for his assistance during the preparation of this manuscript. There are no funding sources for this paper.

Authors’ contributions

Study concept and design HGh and BA. Analysis and interpretation of data: MN, AR and HGh. Drafting the manuscript: BA, MN, AN,MK, MSM, and MH. Critical revision.

Disclosure of potential conflicts of interest

The authors declare that there is no conflict of interests regarding the publication of this paper