{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:00:42Z","timestamp":1790308842604,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Injection drug use is an emerging challenge in Fiji and the Pacific region, where injection\u2010related infections may contribute substantially to morbidity, mortality and healthcare burden. However, data on the epidemiology and outcomes of these infections remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an observational cross\u2010sectional study among people who inject drugs admitted to hospital with infections over a 6\u2010month period. Data on infection type, injecting practices, substance use history, and relevant clinical and demographic variables were collected using a structured questionnaire and medical record review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 128 participants, 76% were males. The majority were of iTaukei ethnicity (95%). Most were in the 18\u201325\u2010year\u2010old age range. The predominant infection was HIV (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200997, 76%) and 42 (33%) patients had a positive blood culture.\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      <\/jats:styled-content>\n                      was the most common bacterial pathogen identified. Median length of stay was 10\u2009days (interquartile range 6\u201314\u2009days) with 31% in\u2010hospital mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusions<\/jats:title>\n                    <jats:p>This study highlights the high burden of acute infections and associated morbidity and mortality among people who inject drugs in Fiji, compounded by social vulnerabilities and limited access to harm reduction services. The findings underscore the urgent need for integrated patient\u2010centred interventions, including hospital management, community harm reduction and strengthened surveillance to improve health outcomes in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dar.70234","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T23:44:13Z","timestamp":1787183053000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Hidden Epidemic: Epidemiology of Acute Infections in People Who Inject Drugs in Fiji"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4187-2027","authenticated-orcid":false,"given":"Manisha","family":"Naidu","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Lautoka Hospital  Lautoka Fiji"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1348-0173","authenticated-orcid":false,"given":"Yogeshni","family":"Chandra","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Lautoka Hospital  Lautoka Fiji"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(17)30375-3"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.13772"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0242165"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa008"},{"key":"e_1_2_10_6_1","unstructured":"N.Naivalurua \u201c55% of New HIV Cases Caused by Injecting Drug Use Fijivillage.com: Fiji Village \u201d(2025) [Updated 23\/12\/25; cited 2026 8\/6\/26]."},{"key":"e_1_2_10_7_1","unstructured":"L.Maher A.Hariri B.Mathers et\u00a0al. \u201cThis is the Health Crisis of Our Time: A Rapid Assessment of Injecting Drug Use and HIV in Suva Fiji \u201d(2025). Kirby Institute UNSW Sydney."},{"key":"#cr-split#-e_1_2_10_8_1.1","unstructured":"S.Pomana \"Tonga's Meth Crisis:Fighting a Superhighway of Illicit Trade Online: Talanoaotonga \"(2025) [updated 23\/12\/25"},{"key":"#cr-split#-e_1_2_10_8_1.2","unstructured":"Cited 2026 08\/06\/26] https:\/\/talanoaotonga.to\/tongas\u2010meth\u2010crisis\u2010fighting\u2010a\u2010superhighway\u2010of\u2010illicit\u2010trade\/."},{"key":"e_1_2_10_9_1","unstructured":"\u201cConcerns at the Severe Impact of Increased Meth Use in Samoa \u201d(2023). Pacific Beat: Australian Broadcasting Corporation."},{"key":"e_1_2_10_10_1","unstructured":"\u201cNational HIV Crisis Declared in Papua New Guinea \u201d[Press Release]. UNAIDSAP 26\/06\/25 (2025)."},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1010539510390663"},{"key":"e_1_2_10_12_1","unstructured":"Health AIo Welfare \u201cExperiences of Alcohol and Other Drugs Among People Who Inject Drugs \u201d(2025). Canberra: AIHW."},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108057"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2016.11.029"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa074"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.12.108282"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2014.08.003"},{"key":"e_1_2_10_18_1","unstructured":"\u201cFiji Population 2026: World Population Review \u201d(2026) https:\/\/worldpopulationreview.com\/countries\/fiji."},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.13525"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.7861\/clinmed.2022-0364"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2025.1635053"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002116"},{"issue":"8","key":"e_1_2_10_23_1","article-title":"Infective Endocarditis in Patients With a History of Intravenous Drug Abuse","volume":"17","author":"Bursy M.","year":"2025","journal-title":"Cureus"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.13471"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/SVIN.122.000806"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaa432"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(24)00481-9"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmni.2025.101623"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.13-5-511"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2022.100438"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-4558-2"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.5220"}],"container-title":["Drug and Alcohol Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dar.70234","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dar.70234","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dar.70234","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T03:34:10Z","timestamp":1790307250000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dar.70234"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,19]]},"references-count":32,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/dar.70234"],"URL":"https:\/\/doi.org\/10.1111\/dar.70234","archive":["Portico"],"relation":{},"ISSN":["0959-5236","1465-3362"],"issn-type":[{"value":"0959-5236","type":"print"},{"value":"1465-3362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,19]]},"assertion":[{"value":"2026-02-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70234"}}