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JAMA. 2004 Jan 7; 291(1):31-32.The global AIDS epidemic infected an estimated 5 million individuals in 2003, bringing the world total of individuals living with human immunodeficiency virus (HIV) and AIDS to 40 million, said officials from the Joint United Nations Programme on HIV/AIDS (UNAIDS). The disease claimed about 3 million lives--the highest toll ever for a single year. Although sub-Saharan Africa remains the most severely affected region, tallying two thirds of all infections and more than two thirds of all deaths, HIV also is spreading rapidly in Eastern Europe and making worrisome inroads in Asia, threatening the immense populations of China and India. (excerpt)
The AIDS epidemic in Tanzania: rate of spread of HIV in blood donors and pregnant women in Dar es Salaam.
SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES. 1992; 24(6):701-6.Based on test results from blood samples of blood donors, pregnant women, and children (ages 5 to 15 years), data on reported acquired immunodeficiency syndrome (AIDS) cases, and the calculated influence of the "transient effect" (an effect caused by the variability of individual incubation periods), the prevalence of human immunodeficiency virus (HIV) in the total population of Tanzania is approximately 2.8% (650-700,000 cases in 24 million people). For pregnant women, the prevalence of HIV rose evenly from 1.3% in 1984-85 to 14% in 1991, a tenfold increase with an average doubling time of about 24 months. The prevalence in blood donors rose from 2.0% in 1984-85 to 10.0% in 1988, with an average doubling time of about 21-32 months. No children tested positive. The cumulative number of AIDS cases in Tanzania reported to the World Health Organization (WHO) rose from 462 in July 1986 to 27,396 in September 1991, resulting in an average doubling time of 10 months. However, based on information from the Epidemiology Unit of the Tanzanian National AIDS Control Programme, the doubling time for reported AIDS cases, calculated annually, rose from less than half a year to 2 years. In view of this, estimates of rates of spread and future projections should not be based on the number of reported AIDS cases in the first 5 years of the epidemic when the "transient effect" is greatest (a large number of cases will have a short incubation period). Since the doubling times calculated from seroprevalence studies agree with those calculated from AIDS case data in 6-8 year old epidemics, projections should be made based on the former. Epidemiological studies involving sexual behavior would identify target populations for intervention.
NURSING RSA. 1992 Aug; 7(8):11.South Africa needs to implement effective interventions immediately to prevent the AIDS pattern which exists in other African countries; e.g., Uganda, where 25% of the youth have AIDS. An official from the Department of National Health and Population Development's AIDS Unit said at a national conference on home based care for persons with AIDS in June 1992 that 1 in 50 young adults in South Africa is HIV positive. HIV prevalence is greatest in Natal and lowest in the Cape. HIV infection is greatest in people with sexually transmitted diseases and in those with newly diagnosed tuberculosis. By August 1994, 750,000 people will be infected with HIV. Interventions espoused and implemented by the AIDS Unit include condom distribution and a communication and education campaign encouraging condom use and partner reduction. Another speaker at the conference highlighted the disadvantages women face which make them vulnerable to acquiring HIV. These disadvantages include the traditional subordinate role of women (particularly Black women) in the family, economic dependency on men, and inadequate access to education. Based on these disadvantages, WHO's Global Program on AIDS is developing a woman-based strategy which includes health and social services for women, home-based care, HIV surveillance of women attending certain clinics, distribution of information and education for women, and supportive social environment. The Program for Appropriate Technology in Health has developed a dipstick test for HIV antibodies (HIV Immuno-Dot), designed to reduce HIV transmission through blood transfusions. It does not need a skilled technician, a refrigerator, or a laboratory. It is inexpensive and produces results in 3 hours. 8 tabs, making up a strip, have dots of a synthetic peptide from the GP41 molecule, and HIV-1 envelope protein. HIV-1 antibodies bind to the strip. Placing the strip in a solution turns the dots red if the blood is HIV-1 infected. This red dot warns health workers not to use the donated blood.