Prevention of mother-to-child transmission of HIV in a refugee camp setting in Tanzania.

The objective of this article is to describe the results of a 2-year pilot programme implementing prevention of mother to child HIV transmission (PMTCT) in a refugee camp setting. Interventions used were: community sensitization, trainings of healthcare workers, voluntary counselling and HIV testing (VCT), infant feeding, counselling, and administration of Nevirapine. Main outcome measures include: HIV testing acceptance rates, percentage of women receiving post test counselling, Nevirapine uptake, and HIV prevalence among pregnant women and their infants. Ninety-two percent of women (n=9,346) attending antenatal clinics accepted VCT. All women who were tested for HIV received their results and posttest counselling. The HIV prevalence rate among the population was 3.2%. The overall Nevirapine uptake in the camp was 97%. Over a third of women were repatriated before receiving Nevirapine. Only 14% of male counterparts accepted VCT. Due to repatriation, parent's refusal, and deaths, HIV results were available for only 15% of infants born to HIV-infected mothers. The PMTCT programme was successfully integrated into existing antenatal care services and was acceptable to the majority of pregnant women. The major challenges encountered during the implementation of this programme were repatriation of refugees before administration of Nevirapine, which made it difficult to measure the impact of the PMTCT programme.

Tuberculosis in a prison population in Mwanza, Tanzania (1994-1997).

SETTING: Bugando Medical Centre, a referral consultant hospital in the lake zone to which all inmates from Butimba prison are admitted and treated. OBJECTIVE: To determine the extent of open (smear-positive) tuberculosis and other types of tuberculosis among prisoners with tuberculosis. DESIGN: A retrospective cohort study. Case notes of 501 prisoners from January 1994 to December 1997 were retrieved and reviewed. RESULTS: The proportion of open tuberculosis in this study was high, with 204 prisoners (40.7%) having smear-positive tuberculosis. Co-infection was recorded in the majority of patients; HIV/AIDS was recorded in 25.9% of cases. The mean length of imprisonment at the time of diagnosis was 19 months. CONCLUSION: The proportion of open, smear-positive tuberculosis among prisoners admitted with tuberculosis is high. Intervention measures specifically targeting this population are urgently needed in order to contain tuberculosis disease in the prison population.