In a real-life setting, direct-acting antivirals to people who inject drugs with chronic hepatitis c in Turkey

Background: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting. Methods: We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization’s objective of eliminating viral hepatitis

Edirne’de sigara satıcılarının haritası

Amaç: Türkiye’de gençlerde tütün kullanımı artmaktadır. Tütün mücadelesinde birçok önlemler etkili bir şekilde yürürlüğe konmasına karşın perakende tütün satış noktalarına ilişkin düzenlemeler dikkatlerden kaçmış ve etkin bir şekilde denetlenmemiştir. Bu çalışmada sigara satıcılarının yoğunluğunu görsel yönleriyle göstermeyi amaçladık. Gereç ve Yöntem: Edirne şehir merkezinde perakende tütün satıcılarının coğrafi konumlanmaları, sayıları ve pazarlama ortamları ortaya kondu ve coğrafi konumları haritalandı. Sonuçlar: 520 dükkan veya mağazada 569 satış noktası saptandı. Her 270 kişiye bir satış noktası düştüğü hesaplandı. Bu satış noktası yoğunluğu ulusal ortalamanın üzerinde ve İstanbul’a göre 4 kat daha fazla idi. Tütün ürünü tezgahları özellikle çikolata, şekerleme ve sakız gibi çocukların ilgisini çeken ürünlerin yanında ve çocukların kolaylıkla görüp ulaşabileceği şekilde düzenlenmişti. Sigara satıcılarının %47’sinin bir eğitim, sağlık veya spor tesisine 100 metreden daha yakında bulunduğu hazırlanan harita üzerinde gösterildi. Çıkarımlar: Türkiye’de özellikle ergenlerde artan tütün kullanımının nedenlerinden biri de ulusal tütün tekelinin özelleştirilmesi sürecinde ortaya çıkan, perakende tütün satışında ortaya çıkan kuralsızlıklardır. Haritalama tekniklerinin kullanılması perakende pazarlama ortamının denetiminde yararlı olabilir.Objective: The youth smoking rate is on the rise in Turkey. Although many marketing bans have been effectively implemented, regulations related to retail tobacco outlets have gone unnoticed and have not been effectively supervised. In this study, we aimed to show the lack of legal regulation related to the high retail tobacco outlet density with displays. Material and Methods: In the center of Edirne, the marketing environment, numbers and geographical distribution of retail tobacco outlets were documented and mapped with geographical positions. Results: There were 569 retail tobacco points of sale in 520 stores. We calculated one tobacco retail outlet per 270 people. This retail outlet density rate is above the national average and about four times higher than the density in Istanbul. Products especially attracting children, such as chocolate, sweet candy and chewing gum, were set up near the tobacco stands and were easy for children to recognize and reach. It can be seen on the city map that 47% of retail tobacco outlets are within 100 m of education, health or sport facilities. Conclusion: We concluded that one of the reasons for the increasing prevalence of cigarette use, especially among adolescents in Turkey, is deregulation of the retail tobacco marketing industry as a result of the privatization process of the national tobacco monopoly. Using mapping techniques can be useful in terms of controlling the retail marketing environment