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Free Content Risk factors for HIV/AIDS in a low HIV prevalence site of sub-Saharan Africa

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Summary We conducted a hospital-based survey on prevalence and risk factors of HIV-1/2 and other viral infections in Zanzibar archipelago. Blood samples, socio-demographic and behavioural data were collected from 2697 patients. The overall HIV prevalence was 2.9%. About 1.4%, 2.1%, 4.2% of antenatal clinic (ANC) attendees and 2.1%, 3.7%, 5.3% of blood donors were, respectively, HIV-Abs-, HTLV-Abs- and HBs-Ag-positive; 5.5% of blood donors were HCV-affected. Co-infections were rare. Exactly 3.4% of the children aged 6–10 years were HIV-positive. People aged 26–35 years [adjusted odds ratio (AOR) 4.4, 95% CI (confidence interval) 1.72–11.22;  = 0.002], illiterate subjects (AOR 3.6, 95% CI 1.65–7.98;  = 0.001) mobile workers (AOR 7.0, 95% CI 1.41–34.62;  = 0.02) and previously operated patients (AOR 1.9, 95% CI 1.02–3.66;  = 0.04) were at higher risk for HIV/AIDS. Any of the examined factors were associated with hepatitis B virus, hepatitis C virus and human T lymphotropic virus type 1/2 transmission. HIV/AIDS prevention strategies must primarily be addressed to traditional high-risk groups and secondarily to unsafe health care procedures in relatively preserved sub-Saharan areas.

Nous avons mené une surveillance à partir de l'hôpital sur la prévalence et les facteurs de risque pour le VIH-1 et 2 ainsi que pour d'autres infections virales dans l'archipel de Zanzibar. Des échantillons de sang, des données sociodémographiques et comportementales ont été collectées chez 2697 patients. La prévalence du VIH était de 2,9% de manière globale. 1,4%; 2,1% et 4,2% des visiteurs de cliniques prénatales ainsi que 2,1%; 3,7% et 5,3% des donneurs de sang étaient positifs respectivement pour les anticorps anti VIH, anti HTLV et pour l'antigène anti HBs. 5,5% des donneurs de sang étaient infectés par le VHC. Les co-infections étaient rares. 3,4% des enfants de 6 à 10 ans étaient HIV positifs. Les personnes âgés de 26 à 35 ans (AOR: 4,4; IC95%: 1,72–11,22; p = 0,002), les personnes illettrées (AOR: 3,6; IC95%: 1,65–7,98; p = 0,001), les ouvriers mobiles (AOR: 7,0; IC95%: 1,41–34,62; p = 0,02) et les patients précédemment opérés (AOR: 1,9; IC95%: 1,02–3,66; p = 0,04) avaient un plus grand risque pour le VIH/SIDA. Tous les facteurs examinés étaient associés à la transmission du VHB, du VHC et du HTLV. Les stratégies de prévention du VIH/SIDA doivent principalement cibler les groupes à haut risque traditionnels et secondairement les procédures de santé peu sûres.
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Keywords: Africa; Afrique; HIV; VIH; blood-borne pathogens; exposición sanitaria; exposition aux soins de santé; facteurs de risque; factores de riesgo; health care exposure; pathogènes sanguins; patógenos parenterales; risk factors; África

Document Type: Research Article

Affiliations: 1:  Infectious Diseases Unit, Department of Clinical Sciences ‘L. Sacco’, University of Milan, Milano, Italy 2:  Zanzibar AIDS Control Program, Ministry of Health and Social Welfare, Zanzibar, Tanzania 3:  Public Health Laboratory – Ivo de Carneri, Wawi, Chake-Chake, Pemba, Tanzania 4:  Institute of Biomedical Technologies – National Research Council, Milan, Italy

Publication date: September 1, 2007

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