Epidemiological features of HIV infection among pregnant women in Botswana Yadav Bindeshwar P...
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Epidemiological features of HIV infection among pregnant women in Botswana Yadav Bindeshwar P Anderson Marina G Mine Madisa Moyo Sikhulile Seipone Khumo
Epidemiological features of HIV infection among pregnant women in Botswana Yadav Bindeshwar P Anderson Marina G Mine Madisa Moyo Sikhulile Seipone Khumo
Epidemiological features of HIV infection among pregnant women
in Botswana Yadav Bindeshwar P Anderson Marina G Mine Madisa Moyo
Sikhulile Seipone Khumo
Slide 2
Background Information on epidemiological characteristics of
epidemic is essential to develop strategies, programmes and
activities to combat HIV epidemic in a country. To provide evidence
based information for intervention 2009 Botswana ante-natal
sentinel surveillance aimed to study epidemiological features of
transmission of HIV infection among pregnant women
Slide 3
3 Objectives: To determine prevalence of HIV infection among
pregnant women as marital status To determine prevalence of HIV
infection among pregnant women as occupation To determine
proportion of number of pregnancies as HIV seroprevalence status To
determine seroconversion over time among pregnant women prevalence
of HIV infection among pregnant women as marital status To monitor
trends of HIV infection among pregnant women of 15-49 years old
over time, and across sites. To use left over blood for routine
tests during ANC visits to determine HIV prevalence, and HIV
incidence.
Slide 4
Methodology Survey Design an anonymous, unlinked,
cross-sectional survey. Study population Pregnant women aged 15 to
49 years attending public health facilities Facilities participated
In all 24 districts of the country 262 facilities Data collection
period 13 July 2009 9 October 2009
Slide 5
Socio-demographic health status variables used in survey Age of
participant (years) Marital status Gravidity (number of
pregnancies) Educational level of participant (grade 0- University)
Employment status Main occupation Previous HIV status HAART
status
Slide 6
First ANC visit of current pregnancy YES NO (not eligible for
survey) Routine prenatal consultation Completion of ANC record
Routine blood draw** Completion of survey form Two tubes: 1.Purple
top tube (name and barcode) 1.Mix 5 10 times 2.Red top tube (name
& code) 1.Let it stand and clot PURPLE TOP Mix Send to District
lab to do routine testing for Hb and blood grouping. Vial with Name
Do routine syphilis testing at the District Lab Send results to
health facility and National Health Lab RED TOP Transport tube on
upright in rack in cooler box to the local lab Completed survey all
forms accompany specimen to district lab then National Health
Laboratory DBS Cards preparation (see SOP): Prepare 3 DBS cards Dry
in appropriate racks Pack and send to National Health Laboratory
weekly For HIV testing Result sent back to health facility.
Specimen Flow First ANC visit of current pregnancy YES NO (not
eligible for survey) Routine prenatal consultation Completion of
ANC record Routine blood draw** Completion of survey form Two
tubes: 1.Purple top tube (name and barcode) 1.Mix 5 10 times 2.Red
top tube (name & code) 1.Let it stand and clot PURPLE TOP Mix
Send to District lab to do routine testing for Hb and blood
grouping. Vial with Name Do routine syphilis testing at the
District Lab Send results to health facility and National Health
Lab RED TOP Transport tube on upright in rack in cooler box to the
local lab Completed survey all forms accompany specimen to district
lab then National Health Laboratory DBS Cards preparation (see
SOP): Prepare 3 DBS cards Dry in appropriate racks Pack and send to
National Health Laboratory weekly For HIV testing Result sent back
to health facility.
Slide 7
Data Analysis Valid forms 7339 were analyzed using Microsoft
Excel and Epi Info version 3.5.1 statistical software
Slide 8
Sociodemographic status of the participants 73% were below 30
years of age, 80% were single mother, 7% co-habiting 37% had 3 or
more number of pregnancy 20% domestic helper followed by 13%
professionals 58% (1383/2399) among total tested positive were
known earlier positive 3713 (out of 7339) were known negative
before the current pregnancy
Slide 9
Slide 10
Married had lowest prevalence and living together highest
through out 2000-2009
Slide 11
HIV prevalence among antenatal women as number of pregnancy No.
of pregnancyTotalHIV positiveHIV Prevalence (%) 1248043217.4
2215970632.7 3131658944.8 4 & more138467248.6
Slide 12
40 years and above are small in umber. Therefore not included
here.
Slide 13
No. of pregnancy Confirmed Known Positive % Confirmed Known
PositiveOthers% Others 11218.7235939.6 236726.5179230.1
337827.393815.7 4 & more51737.486714.6
Total1383100.05956100.0
Earlier not tested1967 Present tested negative1529 (78%)
positive438 (22%)
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Slide 21
CONCLUSIONS Co-inhibiting women and single women are at high
risk of getting HIV infection in compare to married women. HIV
positive women may be considered as high risk group for
transmission of HIV infection as they have more number of pregnancy
in compare to women who are HIV negative or unknown to HIV status.
A large number of HIV positive pregnant female are unaware of their
HIV status
Slide 22
Recommendations In addition, sociological study would provide
in put to understand better the high transmission rate among some
sub population. To study risk factors for high prevalence rate
among co-inhibiting women. Encourage people who practice unsafe sex
for voluntary testing