Aspectos epidemiológicos da morbimortalidade pelo vírus da imunodeficiência humana no nordeste brasileiro / Epidemiological aspects of morbimortality due human immunodeficiency virus in the brazilian northeast / Aspectos epidemiológicos de la morbimortalidad por el virus de la inmunodeficiencia humana en el nordeste brasileño

Objetivo: descrever os aspectos epidemiológicos da morbimortalidade pelo Vírus da Imunodeficiência Humana no nordeste brasileiro entre 2013 e 2017. Métodos: estudo descritivo e transversal realizado com dados do Sistema de Informações Hospitalares. Selecionou-se as variáveis: unidades federativas, sexo, faixa etária, e cor/raça. Resultados: registrou-se 34.647 internações no nordeste brasileiro. Destes, 4.031 evoluíram para o óbito, correspondendo a mortalidade de 11,63%. Evidenciou-se maior morbidade (30,77%) e óbito (19,40%) em Pernambuco e maior mortalidade em Alagoas (19,40%). Os homens prevaleceram nas internações (65,98%), óbitos (69,51%) e mortalidade (12,26%). Os adultos entre 35 e 39 anos tiveram maior morbidade (17,66%) e óbitos (17,39%), já os idosos ≥80 anos, tiveram maior mortalidade (22,64%). A raça/cor parda prevaleceu nas internações (51,36%) e óbitos (49,71%) e os indígenas na mortalidade (50%). Conclusão: a epidemiologia das infecções reflete na necessidade de intervenções em saúde principalmente no estado de Alagoas por apresentar maior mortalidade pela patologia

Objective: to describe the epidemiological aspects of morbimortality due Human Immunodeficiency Virus in the Brazilian northeast between 2013 and 2017. Methods: descriptive and cross-sectional study with data collected through the hospital information systems. It were selected the variables: federative units, sex, age groups and color/race. Results: it was registered 34.647 hospitalizations in Brazilian northeast. Of these, 4.031 died, corresponding to the mortality of 11,63%. It were evidenced higher morbidity (30,77%) and death (19,40%) in Pernambuco and higher mortality in Alagoas (19,40%). The men have prevailed in the hospitalizations (65,98%), deaths (69,51%) and mortality (12,26%). The adults between 35 and 39 years old had greater morbidity (17,66%) and deaths (17,39%) and the elderly ≥80 years old had greater mortality (22,64%). The brown color/race have prevailed in the hospitalizations (51,36%) and deaths (49,71%) and the indigenous in the mortality (50%). Conclusion: the epidemiology of infections reflects in the need of health care interventions, mainly in the state of Alagoas for presenting greater mortality due pathology

Objetivo: describir los aspectos epidemiológicos de la morbimortalidad por el Virus de la Inmunodeficiencia Humana en el nordeste brasileño entre 2013 y 2017. Métodos: estudio descriptivo y transversal realizados con datos del Sistema de información hospitalaria. Fueran seleccionada las variables: unidades federativas, sexo, grupo de edad y color/raza. Resultados: se ha registrado 34.647 hospitalizaciones en el nordeste brasileño. De estos, 4.031 evolucionaron a óbito, correspondiendo la mortalidad de 11,63%. Se evidenció una mayor morbilidad (30,77%) y muertes (19,40%) en Pernambuco y mayor mortalidad in Alagoas (19,40%). Los hombres prevalecieron en la morbilidad (65,98%), muertes (69,51%) y mortalidad (12,26%). Los adultos entre 35 y 39 años tuvieran mayor morbilidad (17,66%) y muertes (17,39%), y las personas mayores ≥80 años tuvieran mayor mortalidad (22,64%). La color/raza parda prevaleció en las hospitalizaciones (51,36%) y muertes (49,71%) y los indígenas en la mortalidad (50%). Conclusión: la epidemiología de las infecciones refleja en la necesidad de intervenciones en la salud principalmente en el estado de Alagoas por presentar mayor mortalidad pela patología

Relações sexuais desprotegidas entre usuários de crack no Estado de Pernambuco / Unprotected sex among crack users in the Pernambuco state

Introdução: Altas prevalências de HIV e relações sexuais desprotegidas têm sido frequentemente verificadas entre usuários de drogas, mesmo nas formas não injetáveis, como o crack, sendo, portanto, uma das práticas, persistentes de disseminação desse vírus no Brasil. Objetivos: Estimar a prevalência de relações sexuais desprotegidas e seus fatores associados, entre sexo, em usuários de crack no Estado de Pernambuco. Materiais e métodos: Estudo de corte-transversal, de uma amostra de usuários de crack atendidos pelo Programa ATITUDE em Pernambuco, realizado entre 2014 e 2015. Foram considerados usuários de crack aqueles indivíduos que atenderam ao critério da Organização Pan-americana de Saúde para definição de usuários de drogas de alto risco de transmitir HIV. Para verificação de diferenças por sexo foi empregado o teste qui quadrado. O efeito dos fatores estudados sobre as relações sexuais desprotegidas foi estimado por meio do modelo de regressão simples e as variáveis com p 0,20 foram selecionados para análise multivariada, sendo considerado o nível de significância de 5 por cento. Resultados: Foram analisados 1.062 casos (819 do sexo masculino e 243 do sexo feminino). O maior percentual tinha de 25 a 34 anos (46 por cento), de cor parda (65,1 por cento), e vivendo em situação de rua (56,9 por cento). O uso inconsistente do preservativo entre os homens (74,7 por cento) foi associado a está na vigência de drogas; não uso do preservativo na primeira relação sexual; autopercepção de grande chance de infectar-se por HIV; ter parceiro fixo; e não ter acesso a preservativo...

JACQUES, Iracema de Jesus Almeida Alves. Unprotected sex among crack users in the Pernambuco state. 2016. Dissertação (Mestrado Acadêmico em Saúde Pública) -Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife. 2016ABSTRACTIntroduction:High prevalence of HIV and unprotected sex have often been observed among drug users, even in non-injectable forms, such as crack, therefore, being considered one of the practices related to the dissemination of HIV in Brazil. Objectives: To estimate the prevalence of unprotected sex and its associated factors, among sex, in the crack users of the Pernambuco State. Materials and Methods: Cross-sectional cohort study from a sample of crack users assisted by ATTITUDE Program in Pernambuco, carried out between 2014 and 2015. Were considered as crack users those individuals who meet the criteria of the Pan American Health Organization for drug users with high risk of to transmit HIV. To verify differences according to sex we used the chi-squared test. The effect of the factors studied over unprotected sex was estimated by simple regression model and the variables with p <0.20 were selected for multivariate analysis, being considered the ignificance level of 5%. Results: Were analyzed 1,062 cases, being 819 (77.1%) male and 243 (22.9%) female. The highest percentage were between 25 and 34 years (46%), single (80.2%), skin color brown (65.1%), and living on the streets (56.9 %)...

Toxoplasma gondii infection: seroprevalence and associated risk factors among primary schoolchildren in Lagos City, Southern Nigeria

INTRODUCTION: Toxoplasma gondii infection has been described as the most widespread zoonotic infection of humans and other animals. Information concerning T. gondii infection among schoolchildren is unavailable in Lagos City, Nigeria. METHODS: This cross-sectional study investigated the seroprevalence and risk factors associated with T. gondii infection among primary schoolchildren (PSC) from a community located in the center of Lagos, southern Nigeria, from November 2013 to March 2014. A total of 382 PSC were screened for the presence of sera anti-T. gondii antibodies using a latex agglutination test (TOXO Test-MT, Tokyo, Japan). A cutoff titer of ≥ 1:32 was considered positive, while titers ≥ 1:1,024 indicated high responders. Questionnaires were also used to obtain data on possible risk factors from parents/guardians. RESULTS: The overall seroprevalence was 24% (91/382), and 83.5% (76/91) of seropositive PSC were classified as high responders. Among the risk factors tested, including contact with cats and soil, consumption of raw meat and vegetables, and drinking unboiled water, none showed statistical significance after multivariate adjustment. No associations were observed among age, gender, body mass index (BMI), and parents' occupation/educational level. CONCLUSIONS: The findings in this study show evidence of active infection, and hence, there is need for urgent preventive measures in this city. Further investigation is required to clarify the transmission routes. Policy makers also need to initiate prevention and control programs to protect pregnant women and immunocompromised patients in particular because they are more severely affected by T. gondii infection. .

Recruitment of Caribbean female commercial sex workers at high risk of HIV infection / Captación de mujeres profesionales del sexo con alto riesgo de infección por VIH en el Caribe

OBJECTIVE: To evaluate novel eligibility criteria and outreach methods to identify and recruit women at high risk of HIV-1 infection in the Caribbean. METHODS: A prospective cohort study was conducted in 2009-2012 among 799 female commercial sex workers in the Dominican Republic, Haiti, and Puerto Rico. Minimum eligibility criteria included exchange of sex for goods, services, or money in the previous 6 months and unprotected vaginal or anal sex with a man during the same period. Sites used local epidemiology to develop more stringent eligibility criteria and recruitment strategies. Participants were asked questions about HIV/AIDS and their level of concern about participating in an HIV vaccine trial. Logistic regression modeling was used to assess predictors of prevalent HIV infection and willingness to participate in a future HIV vaccine study. RESULTS: HIV prevalence at screening was 4.6%. Crack cocaine use [odds ratio (OR) = 4.2, 95% confidence interval (CI) (1.8-9.0)] was associated with and having sex with clients in a hotel or motel [OR = 0.5, CI (0.3-1.0)] was inversely associated with HIV infection. A total of 88.9% of enrolled women were definitely or probably willing to participate in a future HIV vaccine trial. CONCLUSIONS: This study indicated that local eligibility criteria and recruitment methods can be developed to identify and recruit commercial sex workers with higher HIV prevalence than the general population who express willingness to join an HIV vaccine trial.

OBJETIVO: Evaluar nuevos criterios de selección y métodos extrainstitucionales encaminados a detectar y captar a las mujeres con alto riesgo de contraer la infección por virus de la inmunodeficiencia humana (VIH) en el Caribe. MÉTODOS: Del 2009 al 2012, se llevó a cabo un estudio prospectivo de cohortes de 799 mujeres profesionales del sexo en la República Dominicana, Haití y Puerto Rico. Los requisitos mínimos de selección fueron el intercambio de relaciones sexuales por bienes, servicios o dinero en los últimos 6 meses y las relaciones sexuales vaginales o anales sin protección con un hombre durante el mismo período. En cada centro se aplicaron criterios de selección y estrategias de captación más restrictivos, en función de las características epidemiológicas locales. Se formularon a las participantes preguntas acerca de la infección por el VIH/sida y su motivación para participar en un estudio clínico sobre la vacuna contra el VIH. Se usó un modelo de regresión logística con el fin de analizar los factores pronósticos de prevalencia de infección por el VIH y la voluntad de participar en un estudio futuro sobre la vacuna contra el virus. RESULTADOS: La prevalencia de infección por el VIH en el momento del tamizaje fue 4,6%. El consumo de crack se asoció con la infección por el VIH (razón de posibilidades [OR]: 4,2; intervalo de confianza [IC] de 95%: 1,8-9,0) y la práctica de relaciones sexuales con clientes en un hotel o un motel se asoció inversamente con esta infección (OR: 0,5; IC 95%: 0,3-1,0). El 88,9% de las mujeres inscritas manifestó una disposición decidida o probable de participar en un estudio futuro sobre la vacuna contra el VIH. CONCLUSIONES: Los resultados del estudio indican que es posible formular criterios de selección e introducir métodos de captación locales con el propósito de detectar y captar a las mujeres profesionales del sexo, que presentan una prevalencia de infección por el VIH mayor que la población general y manifiestan una buena disposición de participar en un ensayo clínico sobre la vacuna contra el VIH.

Vulnerabilidade e prevalência de HIV e sífilis em usuários de drogas no Recife: resultados de um estudo respondent-driven sampling / Vulnerability and prevalence of HIV and syphilis in drug users, Recife: results of a respondent-driven sampling based study

Os usuários de drogas têm sido desproporcionalmente afetados pelo HIV, desempenhando papel relevante na epidemia de aids no Brasil. Objetivos: Analisar o perfil e indicadores de vulnerabilidade, prevalência e fatores associados à infecção pelo HIV em usuários de drogas do Recife recrutados pelo método respondent-driven sampling (RDS). Materiais e métodos: Estudo sociocomportamental e de soroprevalência, com base no critério da Organização Pan-americana de Saúde para definição de usuários de drogas de alto risco de adquirir/transmitir HIV. Foram feitas entrevista com auxílio de computador com áudio, e realizados testes rápidos para HIV e sífilis, além de VDRL. Bairros de moradia e de uso de drogas foram georreferenciados, os dados ponderados pelo estimador RDS II e os fatores associados avaliados pela odds ratio. Resultados: Foram recrutados 400 usuários de drogas, residentes em 48 por cento dos bairros do Recife, distribuídos nas suas seis regiões político administrativas, e que faziam uso de drogas em 71 por cento dos bairros. A maioria homens (71 por cento), jovens, solteiros, com filhos e baixa condição socioeconômica, 22 por cento em situação de rua. População estigmatizada e criminalizada, com frequente vivência de violência física e sexual. Usavam crack 96 por cento dos usuários, pelo menos quatro dias por semana e consumiam múltiplas drogas. Metade iniciou há mais de seis anos o uso de drogas ilícitas, exceto maconha, antes dos 18 anos de idade, e não faz uso em locais públicos. Referiram trocar sexo por dinheiro ou drogas 27,5 por cento dos homens e 58,6 por cento das mulheres. Metade dos que foram a serviços de saúde, em decorrência de sintomas de DST, não receberam orientação quanto a medidas de prevenção. A cobertura de testagem para HIV foi de 39 por cento, abaixo da verificada para os homens que fazem sexo com outros homens e mulheres profissionais do sexo...

Drug users have been disproportionately affected by HIV, playing an importantrole in the aids epidemic in Brazil. Objectives: To analyze the profile and vulnerabilityindicators, prevalence and factors associated with HIV infection of drug users in Reciferecruited by the respondent-driven sampling (RDS) method. Materials and methods: ASocial behavior and seroprevalence study, using respondent-driven sampling, based on thecriterion of the Pan American Health Organization definition for drug users at high risk ofacquiring/transmitting HIV. Interviews were recorded using computer audio, and HIV andsyphilis rapid tests and VDRL were performed. Local housing and drug use weregeoreferenced were georeferenced, data were weighted according to RDS II estimator andassociated factors assessed by the odds ratio. Results: A total of 400 drug users wererecruited, residing in 48% of neighborhood of Recife distributed in its six politicaladministrative regions, and used drugs in 71% of neighborhood. The majority were male(71%), young, single, with children and low socioeconomic status, with 22% living on thestreets, suffering from stigma and criminalization, with frequent experience of physical andsexual violence. Approximately 96% used crack, at least four days a week and consumingmultiple drugs. Half the sample began with illicit drugs, except marijuana, before reaching 18years, have taken drugs for more than six years and do not taken drugs in public places...

HIV seroprevalence among hospital inpatients with neuropsychiatry and other central nervous system disorders / Seroprevalencia del VIH entre pacientes hospitalizados con trastornos neuropsiquiátricos, y otros desórdenes del sistema nervioso central

OBJECTIVE: To determine the seroprevalence of HIV among inpatients with neuropsychiatric and other central nervous system (CNS) disorders at the University Hospital of the West Indies (UHWI). METHODS: Sera and data of hospital inpatients with disorders of the CNS were prospectively investigated and reviewed at the Virology Laboratory, UHWI, over the period January 1 to December 31, 2007. The study population included inpatients with a principal diagnosis of a neuropsychiatric or other CNS disorder and for whom a serological analysis for HIV had been requested. The CNS disorders were categorized as follows: neuropsychiatric disorder (eg schizophrenia), CNS infection (eg viral, bacterial), motor and psychogenic dysfunction not included in other categories (eg seizures), gross structural brain lesion (eg tumours) and other. HIV prevalence rates were calculated and compared according to age, gender and diagnostic category. RESULTS: Eighty-two patients were included. Sixty-one per cent were males and 39% females. The mean age in years (± SD) was 37.6 (± 16.3). There were significant differences in prevalence rates according to diagnostic category (p = 0.026). All of the patients with psychiatric disorders (n = 40) were HIV-negative and 25% (3 out of 12) of patients with CNS infection were HIV-positive. There were no statistically significant associations demonstrated between HIV and age or gender (p > 0.05). CONCLUSION: Clinicians should have a high index of suspicion for HIV infection when faced with patients with CNS infection. Further research is needed to clearly identify the reasons for the comparatively low prevalence of HIV among the psychiatric patients included in this study.

OBJETIVO: Determinar la seroprevalencia de VIH entre pacientes hospitalizados con trastornos neuropsiquiátricos, y otros desórdenes del sistema nervioso central (SNC) en el Hospital Universitario de West Indies (UHWI). MÉTODOS: Los sueros y datos de los pacientes hospitalizados con desórdenes del SNC, fueron investigados y analizados en el Laboratorio de Virologia, UHWI, durante el período comprendido entre el 1ero. de enero al 31 de diciembre de 2007. Lapoblación del estudio incluyópacientes hospitalizados con un diagnóstico principal de trastorno neuropsiquiátrico u otros desórdenes del SNC. A estos pacientes se les habia ordenado un análisis serológico de VIH. Los trastornos del SNC se categorizaron como sigue: trastornos neuropsiquiátricos (p.ej. esquizofrenia), infecciones del SNC (p.ej. virales, bacterianas), disfuncionespsicogénicas y motoras no incluidas en otras categorias (p.ej. ataques), lesiones cerebrales estructurales severas (p.ej. tumores), y otros. Las tasas deprevalencia de VIH fueron calculadas y comparadas de acuerdo con la edad, el género y la categoria de diagnóstico. RESULTADOS: Se incluyeron ochenta y dos pacientes. El sesenta y uno por ciento eran varones y el 39% hembras. La edadpromedio en años (± SD) fue 37.6 (± 16.3). Hubo diferencias significativas en las tasas deprevalencia según la categoria de diagnóstico (p = 0.026). Todos los pacientes con trastornos psiquiátricos (n = 40) fueron VIH negativos y 25% (3 de 12) de los pacientes con infección del SNC fueron VIH positivos. Sin embargo, no se presentaron asociaciones estadisticamente significativas entre el VIHy la edad o el género (p > 0.05). CONCLUSIÓN: Los clínicos deben tener un indice alto de sospecha de infección de VIH frente a los pacientes con infección del SNC. Se requieren más investigaciones a fin de identificar claramente las razones para una prevalencia comparativamenteincluidos en este estudio.

HBV, HCV and HIV seroprevalence among blood donors in Istanbul, Turkey: how effective are the changes in the national blood transfusion policies?

The national blood transfusion policies have been changed significantly in recent years in Turkey. The purpose of this study was to determine the prevalence of HBV, HCV, and HIV in blood donors at the Red Crescent Center in Istanbul and to evaluate the effect of changes in the national blood transfusion policies on the prevalence of these infections. The screening results of 72695 blood donations at the Red Crescent Center in Istanbul between January and December 2007 were evaluated retrospectively. HBsAg, anti-HCV, and anti-HIV-1/2 were screened by microparticle enzyme immunoassay (MEIA) method. Samples found to be positive for anti-HIV 1/2 and anti-HCV were confirmed by Inno-Lia HCV Ab III and Inno-Lia HIV I/II Score, respectively. The seropositivity rates for HBsAg, anti-HCV, and anti-HIV-1/2 were determined as 1.76 percent, 0.07 percent, and 0.008 percent, respectively. Compared to the previously published data from Red Crescent Centers in Turkey, it was found that HBV and HCV seroprevalances decreased and HIV seroprevalance increased in recent years. In conclusion, we believe that the drop in HBV and HCV prevalence rates are likely multifactorial and may have resulted from more diligent donor questioning upon screening, a higher level of public awareness on viral hepatitis as well as the expansion of HBV vaccination coverage in Turkey. Another factor to contribute to the decreased prevalence of HCV stems from the use of more sensitive confirmation testing on all reactive results, thereby eliminating a fair amount of false positive cases. Despite similar transmission routes, the increase in HIV prevalence in contrast to HBV and HCV may be linked to the increase in AIDS cases in Turkey in recent years.

Crack users, sexual behavior and risk of HIV infection

OBJECTIVE: To compare a sample of injecting cocaine users and crack users, assessing sexual behavior, risk for infection by HIV and its seroprevalence. METHOD: 109 injecting cocaine users and 132 crack users were assessed, using the World Health Organization questionnaire from the expanded "Cross-Site Study of Behaviors and HIV Seroprevalence among Injecting Drug Users" and HIV serology. Data were assessed by Multiple Correspondences Analysis. RESULTS: Crack users showed less time of drug consumption when compared to the injecting cocaine users. Despite this fact, they had higher rates of risky sexual activity, differences in poli-consumption of drugs, and higher rates of involvement in illegal issues. HIV seroprevalence among crack users, although lower than for injecting cocaine users (7 percent vs. 33 percent) is high when compared to the general population at the same age. CONCLUSIONS: Sexual behavior of crack users in the studied sample may be considered a risk factor for HIV infection. Crack users have access to information on HIV/ AIDS, but do not make use of it to change risk behaviors that may expose them to HIV infection and dissemination. HIV seroprevalence among crack users (7 percent) is concerning, which makes it necessary to create preventive strategies for HIV infection and dissemination that are specifically directed toward this population.

OBJETIVO: Comparar uma amostra de usuários de cocaína injetável e usuários de crack avaliando comportamento sexual, risco para contaminação pelo HIV e sua soroprevalência. MÉTODO: Avaliou-se 109 usuários de cocaína injetável e 132 usuários de crack, utilizando o questionário da Organização Mundial de Saúde para o "Estudo Multicêntrico de Comportamentos e Soroprevalência de HIV entre Usuários de Droga Injetável" ampliado e sorologia para o HIV. Os dados foram avaliados pela Análise de Correspondências Múltiplas. RESULTADOS: Os usuários de crack apresentaram menor tempo gasto no consumo de drogas quando comparados com os usuários de cocaína injetável. Apesar disso, tiveram maiores taxas de atividade sexual de risco, diferenças no consumo de múltiplas drogas e maiores taxas de problemas com a justiça. A soroprevalência do HIV entre os usuários de crack, embora inferior aos usuários de cocaína injetável (7 por cento x 33 por cento), é elevada quando comparada à população geral nesta faixa etária. CONCLUSÕES: O comportamento sexual dos usuários de crack da amostra estudada pode ser considerado fator de risco para a contaminação pelo HIV. Os usuários de crack têm acesso à informações sobre HIV/AIDS, porém, não as utilizam para modificar comportamentos de risco que os expõem à possibilidade de contaminação e disseminação do HIV. A soroprevalência do HIV entre eles (7 por cento) é um dado preocupante, o que torna necessário criar estratégias preventivas de contaminação e disseminação do HIV especificamente direcionadas a esta população.

FETP II Guatemala

Contiene: Investigación de campo (Brotes, desastres y estudios de casos), Análisis de Vigilancia (Desnutrución, Mortalidad Materna, Enfermedad Diarreica, Dengue, Programa de Inmunizaciones), Estudios Epidmeiológicos (Protocolos de seroprevalencia de VIH, encuesta de Cobertura, Mortalidad Materna y factores de riesgo), Informes de Resultados de las Investigaciones, Pulicaciones en revistas científicas y boletines, Presentaciones en con ferencias científicas internacionales y nacionales, Congresos, Talleres, Seminarios y Capaitaciones.

Soroprevalência para HIV em gestantes acompanhadas pelo Programa Saúde da Família de Campina Grande, Paraíba / Seroprevalence to HIV in pregnant woman assisted by Programa Saúde da Família of the Campina Grande

A transmissão vertical do Vírus da Imunodeficiência Humana (HIV) é bem documentada na literatura e atualmente no Brasil 90,6% dos casos notificados, abaixo de 13 anos de idade, foram secundários a esta via de transmissão. Neste estudo transversal foi estudada a soroprevalência do HIV em gestantes assistidas pelo Programa Saúde da Família (PSF) da cidade de Campina Grande (Paraíba), com a aplicação de questionário e realização de sorologia para HIV (ELISA, teste rápido e em placa), e os casos soropositivos também testados pelo "Western Blot". Das 386 amostras testadas para HIV, no período de 01 de abril a 30 de agosto de 2001, quatro (1%) resultaram positivas. A vulnerabilidade da população estudada é bem evidenciada pelo baixo grau de escolaridade e renda familiar, refletindo os baixos indicadores de desenvolvimento humano. Em conclusão, os resultados reforçam a necessidade de ampliar na rotina do pré-natal, especialmente no PSF, e no nível secundário de assistência ao parto, o programa de prevenção do HIV em recém-nascidos e a detecção precoce da infecção em gestantes.

Some characteristics of the HIV epidemic in Morocco

The first case of AIDS in Morocco was declared in 1986 and since then the number of AIDS cases has steadily increased. According to the Ministry of Health, the cumulative number of AIDS cases in December 2002 was 1085. HIV in Morocco is acquired mainly through heterosexual intercourse. Individuals aged between 30 and 39 years and in the regions of Marrakech and Agadir have been the most affected. Monitoring of the trend of the epidemic by sentinel surveillance surveys indicates that Morocco is still a low prevalence zone, since prevalence among pregnant women is less than 1%. The estimated number of HIV-infected people in Morocco is around 15 000. It is not clear why the epidemic here has not evolved as it has in the sub-Saharan countries where it is spreading at an alarming rate. Late introduction of HIV-1 subtype B in Morocco, which is relatively less transmissible, circumcision and reduced risk behaviours of Muslims may explain this. Nonetheless, because prevalence has increased in recent years, unless preventive measures are strengthened, the HIV epidemic will worsen in Morocco

Prevalence of HIV and Treponema pallidum infections in pregnant women in Campinas and their association with socio-demographic factors

The anonymous seroprevalence of HIV and syphilis was studied by collecting umbilical cord blood samples from 5,815 women who gave birth in Campinas'hospitals throughout a six-month period. ELISA and Western blot were used for HIV, and VDRL and TPHA for Treponema pallidum screening. While maintaining the anonymity of the women, information was recorded on the hospital of origin, divided into university (public) and private hospitals, as well as on the form of payment (social security, private insurance or direct payment), age, marital status, education, employment and place of residence. Seroprevalence was 0.42 percent for HIV and 1.16 percent for syphilis. There was a significant correlation between a positive reaction to the two infections (p=0.02). After univariate and logistic regression analysis, only university hospitals were shown to be associated with seropositivity for HIV, whereas the same variable and an older age were associated with syphilis. All positive reactions were found either in public hospitals or among social security patients treated at private institutions. The conclusion was that HIV infection is becoming almost as prevalent as syphilis among this population, and affects primarily the lower socio-economic strata. This suggests that routine, voluntary HIV serology should be considered and discussed with patients during prenatal or delivery care whenever a population shows a seroprevalence close to or greater than 1 percent.