HIV prevalence and incidence among women at higher risk of infection in Addis Ababa, Ethiopia.

This study aimed to estimate HIV incidence among women at higher HIV risk in Addis Ababa, Ethiopia using cross-sectional data. To refine the estimate, we sought to determine a local correction factor by estimating a false recent rate for the BED assay. The overall study had two parallel phases: cross-sectional incidence and BED false recent (BED FR). A total of 1856 women at higher HIV risk were enrolled into the cross-sectional phase. For the BED FR, 500 women and 70 men with known HIV infection of greater than 12 months were enrolled. Rapid HIV tests were used to assess participant HIV status. Samples from women with positive results on HIV rapid testing were then analyzed using the BED assay to determine incident HIV infections. The overall HIV prevalence was 11.3%, with women greater than 25 years old having a higher prevalence (26.5% vs. 7.9% for younger women). The overall unadjusted HIV incidence was 3.3%. The estimated HIV incidence was 2.6% when adjusted using the locally derived false recent rate of 3.5%. Similar incidence rates were found between the younger and older age groups. This is one of the first field-based studies of HIV incidence in Ethiopia; it demonstrates that there is sufficient incidence to warrant further HIV prevention efforts among women at higher risk of HIV infection.

Blood safety & prevalence of transfussion transmissible viral infections among donors at the Red Cross Blood Bank in Gondar University Hospital.

BACKGROUND: Although millions of lives are saved by blood transfusion, unsafe transfusion is also putting millions of people at risk of Transfusion Transmissible Infections (TTI). In Ethiopia the safety and magnitude of blood transfusion and TTIs is not well investigated OBJECTIVE: to investigate the magnitude of TTIs and assess TTI related risk factors among blood donors. METHODS: Cross-sectional study among blood donors at the Red Cross Society Blood Bank in Gondar University Hospital, North West Ethiopia. RESULTS: The study was conducted among 600 adult blood donors between April and July 2004. Their mean age was 28 +/- 10.4 years (range: 16-64) and 66% of them were urban dwellers. The donors included farmers (30.7%), daily laborers (22.7%) and students (20%). All the donors were first time donors and 75% of the donations were replacement donations by remunerated donors or family members. The prevalence of HIV, Hepatitis B surface antigen (HBSAg) and Hepatitis C virus (HCV) infections were 4.5% (95%CI: 3.0-6.6), 8.2% (95%CI: 6.2-10.7) and 5.8% (95%CI: 4.2-8.1), respectively. The overall discard rate of donated blood because of these viral markers was 16.3%. In univariate analysis, HCV infection was significantly associated with presence of HIV (OR: 5.36, 95%CI: 2-14.3). Experiences of traditional surgical incisions or phlebotomy were present in 93.8% of donors. While 6.5% of donors admitted a history of multiple sexual partners, none of them admitted a history of any sexually transmitted infections (STI). CONCLUSION: The prevalence of TTIs among blood donors is very high. The majorities of blood donors are replacement or paid donors with one or more of the risk factors for TTIs implying that blood transfusion is unsafe. These findings call for the urgent implementation of the national strategy for safe blood transfusion in Ethiopia. As the utilization of advanced technology and skilled-personnel-based screening of blood are not in the immediate horizon, establishing stringent selection criteria of donors and setting clinical indications for transfusion would be indispensable and cost-effective interventions to minimize the risk of TTIs to blood recipients in Ethiopia.