scholarly journals Potential Utility of Routine Programmatic Data in Monitoring National and State-Level HIV Epidemic in Nigeria: Data Triangulation Analysis

2019 ◽  
Author(s):  
Debem Henry ◽  
Aminu Yakubu ◽  
Mukhtar Ahmed ◽  
Gwamna Jerry ◽  
Dalhatu Ibrahim
Keyword(s):  
Pearson Correlation ◽  
National Level ◽  
State Level ◽  
Population Based ◽  
Hiv Prevalence ◽  
Reproductive Age ◽  
World Health ◽  
Linear Regression Models ◽  
Epidemic Control ◽  
Hiv Epidemic

AbstractNigeria relies on data from periodic resource-intensive surveys such as antenatal HIV seroprevalence sentinel surveys (ANC-HSS) and population-based National AIDS and Reproductive Health Surveys (NARHS) for its HIV control efforts. Nigeria has not explored the use of readily available routine programmatic data (RPD) to easily inform and monitor epidemic control efforts at local settings in near real time. This study aimed to determine the utility of RPDs (Prevention of Mother-To-Child Transmission [PMTCT] and HIV Testing and Counseling [HTC]) as a proxy for monitoring HIV epidemic in Nigeria. Using World Health Organization 12 step triangulation procedures, we compared state-level seropositivity data from PMTCT and HTC programs to HIV prevalence data from NARHS and ANC-HSS reports in relevant pairs from 2010 to 2014 in Nigeria. The study population was pregnant women and general population. We abstracted relevant data from PEPFAR Nigeria data source and published national survey reports. We compared visual (scatterplots and maps) patterns and trends, and performed Pearson correlation and univariate linear regression models of the estimates for best matched/contiguous years for which data were available. Correlation between PMTCT2014 and ANC-HSS2014 was positive and significant (R=0.7,p<0.001). ANC-HSS2014 and HTC2014 were slightly correlated (R=0.4,p<0.05). Significant correlation was observed between ANC-HSS2010 and PMTCT2013 (R=0.8,p<0.001) and between ANC-HSS2010 and HTC2013 (R=0.6, p<0.001). All RPD sources and ANC-HSS indicated a decreasing trend in national HIV prevalence in Nigeria. PMTCT2014 data showed strong capability of predicting HIV prevalence in ANC-HSS2014 in regression model (B=2.09,p<0.0001). Use of routine PMTCT data in monitoring HIV prevalence among women of reproductive age could be more valid and reliable in local settings than the use of HTC data. Use of RPD to monitor national and sub-national-level HIV epidemic in between national surveys in Nigeria could maximize program resources, and promote a more responsive and efficient actions toward epidemic control.

scholarly journals Refocusing the Vietnam HIV surveillance to the most burden areas for epidemic control

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Diep T. Vu ◽  
Duc H. Bui ◽  
Giang T. Le ◽  
Duong C. Thanh ◽  
Nghia V. Khuu ◽  
...  
Keyword(s):  
Panel Discussion ◽  
Health Sector ◽  
Hiv Prevalence ◽  
World Health ◽  
Sample Sizes ◽  
Ministry Of Health ◽  
Strategic Direction ◽  
Hiv Epidemic ◽  
Geographical Regions ◽  
Size Estimates

ObjectiveTo describe an exercise to identify priority provinces to be focused in the Vietnam National HIV Sentinel Surveillance (HSS).IntroductionThe Vietnam National HSS was established in 1994. In the late 1990s and early 2000s, when the epidemic was increasing rapidly, the HSS helped with the intensive close monitoring of the HIV epidemic. In its first 10 years, the HSS was rapidly expanded from 6 to 40 provinces and in some years, it was conducted semi-annually. After two decades, the HIV epidemic situation has changed. In most provinces, HIV prevalence has reported to have declined. Compared to the peak period, the HIV prevalence among key populations (KP) in the past decade decreased from 40-60% to 20% or lower. In many provinces, HIV prevalence was less than 10% among people who inject drugs (PWID) and less than 3% among female sex workers (FSW), and among men who have sex with men (MSM) (Table 1). At the same time, the HIV programme has since been scaled up widely with various interventions and expanded to most of the 63 provinces. In 2014, the government of Vietnam and international stakeholders conducted a joint review of the health sector response to the HIV epidemic and concluded that for better monitoring of the epidemic, a more focused and higher quality surveillance system was needed(1). In 2015, surveillance stakeholders conducted a detailed review of the HSS to discuss prioritization of the surveillance activities.MethodsThe prioritization exercise followed a principle that the HSS should be conducted in locations where there is a large population of KP with a high HIV prevalence and it is feasible to implement. Criteria for prioritizing provinces for inclusion were: 1) a high estimated KP size; 2) high HIV prevalence, measured as a 5 year (2011-2015) average prevalence (P); 3) few years with low HIV prevalence, defined as P <5% among PWID, <3% among FSW and MSM; 4) few years with insufficient HSS sample size, defined as n<150 for PWID, n<250 for FSW and MSM. Steps to prioritize provinces were:- Reviewed provincial data on KP estimates; HIV prevalence and achieved HSS sample sizes in 5 years, 2011-2015.- Developed a ranking algorithm taking into account KP size estimates, HIV prevalence and achieved sample sizes.- For each survey on PWID, FSW, MSM, took top ranked provinces for which sum of KP size estimates of these provinces exceeded 50% of the national KP size estimates.- Held a consultation workshop among domestic and international surveillance stakeholders to discuss the prioritization exercise. Issues of regional representation of the HSS in the North, South, Central and Highland regions was added as a criteria to adjust the priority list of HSS provinces. The consensus reached in the workshop was the basis for proceeding a formal approval at Ministry of Health.ResultsThe data review and panel discussion suggested that the number of provinces to implement HSS should be 20 for PWID, 13 for FSW, and 7 for MSM surveys. While total number of provinces reduced from 40 to 20, all 4 geographical regions of the country were covered. Even with the reduction of the geographical coverage of the HSS, large proportions of the KPs (63.9% of PWID, 58.9% of FSWs and 36% of MSM) were covered under the HSS (Table 2). In February 2017, the Ministry of Health officially approved the 20 priority provinces as a part of the new strategic direction of the Vietnam National HSS.ConclusionsThe data review and panel discussion suggested that the number of provinces to implement HSS should be 20 for PWID, 13 for FSW, and 7 for MSM surveys. While total number of provinces reduced from 40 to 20, all 4 geographical regions of the country were covered. Even with the reduction of the geographical coverage of the HSS, large proportions of the KPs (63.9% of PWID, 58.9% of FSWs and 36% of MSM) were covered under the HSS (Table 2). In February 2017, the Ministry of Health officially approved the 20 priority provinces as a part of the new strategic direction of the Vietnam National HSS.References1. World Health Organization. Regional Office for the Western Pacific, 2016, Joint Review of the Health Sector Response to HIV in Viet Nam 2014.

scholarly journals A Probability Sample for Monitoring the HIV-infected Population in Care in the U.S. and in Selected States

2012 ◽  
Vol 6 (1) ◽  
pp. 67-76 ◽  
Author(s):  
Martin R Frankel ◽  
AD McNaghten ◽  
Martin F Shapiro ◽  
Patrick S Sullivan ◽  
Sandra H Berry ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Clinical Status ◽  
National Level ◽  
State Level ◽  
Population Based ◽  
Medical Monitoring ◽  
Medical Monitoring Project ◽  
Care Outcomes ◽  
Clinical Changes ◽  
Selection Probabilities

Epidemiologic and clinical changes in the HIV epidemic over time have presented a challenge to public health surveillance to monitor behavioral and clinical factors that affect disease progression and HIV transmission. The Medical Monitoring Project (MMP) is a supplemental surveillance project designed to provide representative, population-based data on clinical status, care, outcomes, and behaviors of HIV-infected persons receiving care at the national level. We describe a three-stage probability sampling method that provides both nationally and state-level representative estimates. In stage-I, 20 states, which included 6 separately funded cities/counties, were selected using probability proportional to size (PPS) sampling. PPS sampling was also used in stage-II to select facilities for participation in each of the 26 funded areas. In stage-III, patients were randomly selected from sampled facilities in a manner that maximized the possibility of having overall equal selection probabilities for every patient in the state or city/county. The sampling methods for MMP could be adapted to other research projects at national or sub-national levels to monitor populations of interest or evaluate outcomes and care for a range of specific diseases or conditions.

scholarly journals The state of the HIV epidemic in rural KwaZulu-Natal, South Africa: a novel application of disease metrics to assess trajectories and highlight areas for intervention

2020 ◽  
Vol 49 (2) ◽  
pp. 666-675 ◽  
Author(s):  
Alain Vandormael ◽  
Diego Cuadros ◽  
Hae-Young Kim ◽  
Till Bärnighausen ◽  
Frank Tanser
Keyword(s):  
South Africa ◽  
South African ◽  
Prevalence Ratio ◽  
Population Based ◽  
Epidemic Control ◽  
Hiv Epidemic ◽  
Kwazulu Natal ◽  
Spatial Estimates ◽  
Mortality Ratio ◽  
African Setting

Abstract Background South Africa is at the epicentre of the HIV pandemic, with the world's highest number of new infections and the largest treatment programme. Using metrics proposed by the Joint United Nations Programme on AIDS (UNAIDS), we evaluate progress toward epidemic control and highlight areas for intervention in a hyperendemic South African setting. Methods The Africa Health Research Institute (AHRI) maintains a comprehensive population-based surveillance system in the Hlabisa sub-district of KwaZulu-Natal. Between 2005 and 2017, we tested 39 735 participants (aged 15–49 years) for HIV and followed 22 758 HIV-negative and 13 460 HIV-positive participants to identify new infections and all-cause AIDS-related deaths, respectively. Using these data, we estimated the percentage reduction in incidence, the absolute incidence rate, the incidence-mortality ratio and the incidence-prevalence ratio over place and time. Results We observed a 62% reduction in the number of new infections among men between 2012 and 2017 and a 34% reduction among women between 2014 and 2017. Among men, the incidence-mortality ratio peaked at 4.1 in 2013 and declined to 3.1 in 2017, and among women it fell from a high of 6.4 in 2014 to 4.3 in 2017. Between 2012 and 2017, the female-incidence/male-prevalence ratio declined from 0.24 to 0.13 and the male-incidence/female-prevalence ratio from 0.05 to 0.02. Conclusions Using data from a population-based cohort study, we report impressive progress toward HIV epidemic control in a severely affected South African setting. However, overall progress is off track for 2020 targets set by the UNAIDS. Spatial estimates of the metrics, which demonstrate remarkable heterogeneity over place and time, indicate areas that could benefit from additional or optimized HIV prevention services.

scholarly journals HIV prevalence in South Africa through gender and racial lenses: results from the 2012 population-based national household survey

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
M. Mabaso ◽  
L. Makola ◽  
I. Naidoo ◽  
L. L. Mlangeni ◽  
S. Jooste ◽  
...  
Keyword(s):  
South Africa ◽  
Condom Use ◽  
Racial Disparities ◽  
Perceived Risk ◽  
Multiple Logistic Regression Analysis ◽  
Population Based ◽  
Hiv Prevalence ◽  
Black African ◽  
Hiv Epidemic ◽  
Increased Risk

Abstract Background In South Africa, persistence of the HIV epidemic and associated gender and racial disparities is a major concern after more than 20 years of democratic dispensation and efforts to create a more healthy and equal society. This paper profiles HIV prevalence and related factors among Black African men and women compared to other race groups in South Africa using the 2012 population-based national household HIV survey. Methods This secondary data analysis was based on the 2012 population-based nationally representative multi-stage stratified cluster random household sample. Bivariate and multiple logistic regression analysis were used to assess the relationship between HIV prevalence and associated factors by gender and racial profile. Results Overall HIV prevalence was significantly higher (p < 0.001) among both Black African males (16.6%; 95% CI: 15.0–18.4) and females (24.1%; 95% CI: 22.4–26.0) compared to their counterparts from other races. Among Black African males, increased risk of HIV was significantly associated with age group 25–49 years and those 50 years and older compared with young males 15–25 years. Among all males, reported condom use at last sex was significantly associated with increased risk of HIV. High socio-economic status (SES) and perceived risk of HIV were associated with a decreased risk of HIV. Among female condom use at last sex and ever testing for HIV was associated with increased prevalence of HIV only among Black African females. Lower prevalence of HIV was associated with marriage, tertiary education, high SES, having a partner five years younger, perceived risk of HIV, and awareness of HIV status among Black African females. Conclusion Gender and racial disparities rooted in structural and contextual inequalities remain important factors for the maintenance of the generalized HIV epidemic in the country. HIV prevention interventions need to cut across all strata of society but also target risk factors salient for specific groups. Alleviating vulnerability to HIV along gender and racial lines should also be viewed as part of a broader public health strategy.

Demographic and spatial disparity in HIV prevalence among incarcerated population in the US: A state-level analysis

2017 ◽  
Vol 29 (3) ◽  
pp. 278-286 ◽  
Author(s):  
Srimoyee Bose
Keyword(s):  
Hiv Infection ◽  
Infection Rate ◽  
Pearson Correlation ◽  
State Level ◽  
Hiv Prevalence ◽  
The State ◽  
Infection Prevalence ◽  
Spatial Disparity ◽  
Female Prisoners ◽  
The Us

The purpose of this study was to explore empirically the presence of any spatial and demographic disparity in the Human Immunodeficiency Virus (HIV) infection rate among the prison inmates across 48 states in the US and compare the results for 2000 and 2010. HIV infection is a severe health issue for incarcerated populations in the US. In 2010, the rate of diagnosed HIV infection among inmates in state and federal prisons was five times more than the nonincarcerated population. The National Prisoner Statistics database was used to find the demographic disparities in HIV prevalence rate based on incarceration rate, gender, race/ethnicity, the proportion of non-US citizens, and proportion of population below 18 years. State-level spatial mapping, Pearson correlation coefficient, and Moran’s I statistic (univariate and bivariate) were computed based on these demographic characteristics using QGIS and Geoda software. There was a statistically significant pattern of spatial disparity in overall, male and female HIV infection rates across the state prisoners, with South and South-Eastern states facing a higher risk of infection. There was also statistically significant bivariate spatial association of HIV infection rate with the covariates: whites (negative), blacks (positive), non-US citizen (positive), and prisoners under age 18 years (positive) for both 2000 and 2010. There was a statistically significant higher HIV infection rate among the female prisoners in comparison to the male prisoners. It is of prime importance to examine the state-level disparities in HIV infection rate based on place and demographics. This is because evaluating the spatial pattern will help in accessing the relevant local information and provide federal agencies with better knowledge to target interventions and prevention programs toward the subgroup of the population at higher risk and help in controlling and reducing HIV infection prevalence.

HIV epidemic in South Africa: A comparison of HIV epidemic patterns of two extreme provinces in South Africa

2014 ◽  
Vol 19 (1) ◽  
Author(s):  
Khangelani Zuma ◽  
Khanyisile Manzini ◽  
Neo Mohlabane
Keyword(s):  
South Africa ◽  
Age Groups ◽  
Secondary Data ◽  
Population Based ◽  
Hiv Prevalence ◽  
Western Cape ◽  
Age Group ◽  
Recent Infection ◽  
Hiv Epidemic ◽  
Kwazulu Natal

Background: South Africa is experiencing one of the worst HIV epidemics, which varies by province and by districts within each province.Objective: To explore and compare HIV trends and patterns between two provinces in South Africa. Method: ‘Know your epidemic’ synthesis suggests that HIV prevalence is rising in older age groups and falling in younger people. Using secondary data analyses of population-based and antenatal care surveillance (ANC) surveys, we explored trends and patterns in HIV prevalence in KwaZulu-Natal and Western Cape.Results: Even though KwaZulu-Natal has the highest HIV prevalence in the country (15.5% compared with 3.8% in the Western Cape), there is considerable recent decline (6%) in HIV prevalence in KwaZulu-Natal, compared with a 2% increase in the Western Cape, based on ANC data, in youth aged 15 to 24 years. These results are consistent with those from a population-based survey where a decline of 0.3% in HIV prevalence in KwaZulu-Natal was observed as compared with an increase of 0.7% in Western Cape youth. Both ANC results and population-based surveys conducted in different years show a decline in HIV prevalence amongst youth in KwaZulu-Natal compared with an increase in the same age group in the Western Cape. HIV infection in this age group is associated with recent infection, thus indicating an increasing epidemic in the Western Cape compared with KwaZulu-Natal.Conclusion: Interventions aimed at curbing infections such as sexual abstinence and condom promotion in this age group need to be implemented extensively in the Western Cape. These should include HIV counseling and testing campaigns. Agtergrond: Suid-Afrika ondervind een van die ergste MIV-epedemies, wat verskil ten opsigte van elke provinsie en distrik en binne elke provinise. Doelstelling: Om MIV-voorkoms en -patrone tussen twee provinises in Suid-Afrika te ondersoek en vergelyk.Metode: ‘Ken jou epidemie’ sintese dui daarop dat die voorkomssyfer van MIV in ouer ouderdomsgroepe styg en daal by jonger mense. Ons het sekondêre data analieses van bevolkingsgebaseerde en swangerskapsorg waarnemingsopnames (ANC) gebruik om neigings en patrone in MIV-voorkoms in Kwa-Zulu Natal en die Wes-Kaap, vas te stel.Resultate: Ofskoon Kwa-Zulu Natal die hoogste voorkoms in Suid-Afrika (15.5% vergelyk met 3.8% in die Wes-Kaap) het, is daar ‘n aansienlike onlangse afname (6%) in die voorkoms van MIV in Kwa-Zulu Natal waargeneem, vergelyk met die 2% verhoging in die Wes-Kaap, gebasseer op ANC data, in jongmense in die ouderdomsgroep 15–24 jaar. Hierdie resultate is konsekwent met dié van die bevolkingsgebaseerde opname, waar ‘n afname van 0.3% in MIV-voorkoms in Kwa-Zulu Natal waargeneem is, vergelyk met ‘n toename van 0.7% in die jeug van die Wes-Kaap. Altwee die ANC-resultate en die bevolkings-gebaseerde opnames wat in verskillende jare uitgevoer is, wys ’n afname in MIV-voorkoms onder die jeug in Kwa-Zuly Natal vergelyk met ’n toename onder dieselfde ouderdomsgroep in die Wes-Kaap. MIV-infeksie onder hierdie ouderdomsgroep word verbind met ’n onlangse infeksie, wat ’n toename van die epidemie in die Wes-Kaap, vergelyk met Kwa-Zulu Natal aandui.Gevolgtrekkings: Ingryping, wat daarop gemik is om infeksies soos seksuele onthouding en die reklame van kondome vir hierdie ouderdomsgroep, behoort wyd in die Wes-Kaap geimplementeer te word. Hierdie behoort voorligtings- en toetsveldtogte in te sluit.

scholarly journals Albuminuria: population epidemiology and concordance in Australian children aged 11–12 years and their parents

BMJ Open ◽  
2019 ◽  
Vol 9 (Suppl 3) ◽  
pp. 75-84 ◽  
Author(s):  
Nicholas G Larkins ◽  
Siah Kim ◽  
John B Carlin ◽  
Anneke C Grobler ◽  
David P Burgner ◽  
...  
Keyword(s):  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Population Based ◽  
Cross Sectional Study ◽  
Linear Regression Models ◽  
Creatinine Concentration ◽  
Cross Sectional ◽  
Urine Albumin ◽  
Genetic Heritability ◽  
Parent Child

ObjectivesTo describe the distribution of albuminuria among Australian children aged 11–12 years and their parents, and assess its intergenerational concordance within parent–child dyads.DesignPopulation-based cross-sectional study (the Child Health CheckPoint), nested within the Longitudinal Study of Australian Children.SettingAssessment centres (seven Australian cities and eight regional towns) and home visits across Australia, February 2015 to March 2016.ParticipantsOf all participating CheckPoint families (n=1874), 1557 children (46.2% girls) and 1454 parents (85.5% mothers) provided random urine samples at the visit; samples from menstruating females were excluded.Outcome measuresUrine albumin-to-creatinine ratio (ACR) and its components (urine albumin and creatinine concentration); albuminuria was defined as an ACR ≥3.4 mg/mmol. Pearson’s correlation coefficients and multivariable linear regression models assessed parent–child concordance, using log-transformed data due to skewing. Survey weights and methods were applied to account for the complex sample design.ResultsThe median ACR for children was 1.03 mg/mmol (IQR 0.65–1.97) and 1.01 mg/mmol (IQR 0.60–2.09) for adults. The median ACR was higher in girls (1.20, IQR 0.71–2.65) than boys (0.90, IQR 0.61–1.65) and in mothers (1.13, IQR 0.63–2.33) than fathers (0.66, IQR 0.41–1.05). Albuminuria was detected in 15.1% of children (girls 20.8%, boys 10.1%) and 13.5% of adults (15.1% mothers, 4.0% fathers) had albuminuria. There was a small correlation between parent and child ACR (Pearson correlation coefficient 0.06, 95% CI 0.01 to 0.12).ConclusionsAlbuminuria is common among Australian children and adults, which is of concern because it predicts risk for kidney and cardiovascular disease, and mortality. The weak concordance among intergenerational pairs for urine ACR suggests either that genetic heritability is low or that it becomes evident only at later offspring life stages.

scholarly journals Epidemiology of Endometriosis in Spain and Its Autonomous Communities: A Large, Nationwide Study

2021 ◽  
Vol 18 (15) ◽  
pp. 7861
Author(s):  
Almudena Ávalos Marfil ◽  
Enriqueta Barranco Castillo ◽  
Raúl Martos García ◽  
Nicolás Mendoza Ladrón de Guevara ◽  
Maryna Mazheika
Keyword(s):  
National Level ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Incidence Rates ◽  
Reproductive Age ◽  
Hospital Data ◽  
Autonomous Communities ◽  
Spanish Study ◽  
Classification Of Diseases ◽  
Icd 10

A retrospective population-based study aimed to assess the incidence of endometriosis in the general population in Spain and in each of its autonomous communities. The authors used the incidence of diagnosed endometriosis in the minimum basic dataset at discharge in the national hospital discharge registry of Spain. This analysis was carried out with hospital data with a diagnosis of endometriosis (International Classification of Diseases (ICD)-9 code 617.xx and ICD-10 code N80.xx) and covered the period from 1 January 2014 to 31 December 2017 and a population of 12,775,911 women of reproductive age (15–54 years). The data were then analyzed at the national level and separately for each autonomous community. This nationwide Spanish study estimated the overall incidence of endometriosis among autonomous communities in Spain to be 16.1 per 10,000 women (range, 6.8 to 24). The mean age of the 20,547 women diagnosed with endometriosis during the study period was 36.8 ± 5.4 years. The types (proportions) of endometriosis were uterine (28.4%), tubo-ovarian (35.2%), peritoneal (8.1%), vesical (6.8%) and intestinal (3.2%) endometriosis. Further studies are needed to assess the reasons for the decrease in the observed incidence and for the significant differences in the regional incidence rates of this disease.

scholarly journals Estimating District HIV Prevalence in Zambia Using Small Area Estimation Methods (SAE)

2021 ◽  
Author(s):  
Chris Mweemba ◽  
Peter Hangoma ◽  
Isaac Fwemba ◽  
Wilbroad Mutale ◽  
Felix Masiye
Keyword(s):  
Small Area ◽  
Small Area Estimation ◽  
National Level ◽  
Population Based ◽  
Hiv Prevalence ◽  
Estimation Methods ◽  
Population Mobility ◽  
African Region ◽  
Area Estimation ◽  
Very High

Abstract BackgroundThe HIV/AIDS pandemic has had a very devastating impact at a global level, with the Eastern and Southern African region being the hardest hit. The considerable geographical variation in the pandemic means varying impact of the disease in different settings, requiring differentiated interventions. While information on the prevalence of HIV at regional and national levels is readily available, the burden of the disease at smaller area levels, where health services are organized and delivered, is not well documented. This affects the targeting of HIV resources. There is need for studies to estimate HIV prevalence at appropriate levels to improve HIV related planning and resource allocation. MethodsWe estimated the district level prevalence of HIV using Small-Area Estimation (SAE) technique by utilizing the 2016 Zambia Population-Based HIV Impact Assessment Survey (ZAMPHIA) data and auxiliary data from the 2010 Zambian Census of Population and Housing and the HIV sentinel surveillance data from selected antenatal care clinics (ANC). SAE Models were fitted in R Programming to ascertain the best HIV predicting model. We then used the Fay-Herriot (FH) model to obtain weighted, more precise and reliable HIV prevalence for all the districts.ResultsThe results revealed variations in the district HIV prevalence in Zambia, with the prevalence ranging from as low as 4.2% to as high as 23.5%. Approximately 35% of the districts (n=26) had HIV prevalence above the national average, with one district having almost twice as much prevalence as the national level. Some rural districts have very high HIV prevalence rates. ConclusionsHIV prevalence in Zambian districts is driven by population mobility Districts located near international borders, along the main transit routes and adjacent to other districts with very high prevalence, tend to have high HIV prevalence. The variations in the burden of HIV across districts in Zambia points to the need for a differentiated approaches in HIV programming in Zambia. HIV resources need to be prioritized towards districts with high population mobility.

A(H1N1)v cases of the 2009/2010 and 2010/2011 influenza seasons in the Medical and Health Sciences Centre of Debrecen University

2012 ◽  
Vol 153 (17) ◽  
pp. 649-654
Author(s):  
Piroska Orosi ◽  
Judit Szidor ◽  
Tünde Tóthné Tóth ◽  
József Kónya
Keyword(s):  
High Risk ◽  
Influenza Season ◽  
National Level ◽  
Organ Transplant ◽  
High Risk Patient ◽  
Risk Groups ◽  
Health Sciences ◽  
World Health ◽  
Transplant Patients ◽  
Health Organization

The swine-origin new influenza variant A(H1N1) emerged in 2009 and changed the epidemiology of the 2009/2010 influenza season globally and at national level. Aims: The aim of the authors was to analyse the cases of two influenza seasons. Methods: The Medical and Health Sciences Centre of Debrecen University has 1690 beds with 85 000 patients admitted per year. The diagnosis of influenza was conducted using real-time polymerase chain reaction in the microbiological laboratories of the University and the National Epidemiological Centre, according to the recommendation of the World Health Organization. Results: The incidence of influenza was not higher than that observed in the previous season, but two high-risk patient groups were identified: pregnant women and patients with immunodeficiency (oncohematological and organ transplant patients). The influenza vaccine, which is free for high-risk groups and health care workers in Hungary, appeared to be effective for prevention, because in the 2010/2011 influenza season none of the 58 patients who were administered the vaccination developed influenza. Conclusion: It is an important task to protect oncohematological and organ transplant patients. Orv. Hetil., 2012, 153, 649–654.

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