Progress in the control of schistosomiasis in Zimbabwe since 1984

A clinical study on the measures taken in the management and control of Schistosomiasis as a public health problem in Zimbabwe since 1984.Schistosomiasis remains the second most important parasitic disease in Zimbabwe. In terms of its combined morbidity and prevalence, schistosomiasis is thought to be the most important helminth infection of man. Since 1984, a number of control programmes have commenced around the country and a national control programme aimed at reducing morbidity is being implemented. The strategy adopted in Zimbabwe is a community based approach integrated in the primary health care syste

Community perception of mosquitoes, malaria and its control in Binga and Gokwe Districts, Zimbabwe

A journal article on the importance of community participation in health care initiatives in rural Zimbabwe.The success of community participation in primary health care depends on the peoples’ knowledge, attitudes and practices in relation to the diseases that affect them. Given the changing health care delivery system in Zimbabwe, greater self reliance on the part of affected communities is expected to play a greater role in future. As far as malaria prevention and control is concerned, this is designed to operate in largely marginalized communities which have previously relied on state run control operations. Annual indoor house spraying using residual insecticide remains the main method for malaria control in Zimbabwe but the trend is shifting towards integrated control encompassing the use of personal protection for prevention and environmental and biological means for source reduction of vector mosquitoes. The use of insecticide impregnated bed nets has gained popularity with the World Health Organization as a malaria control measure following successful trials in West and East Africa

Bilharzia in a small irrigation community: an assessment of water and toilet usage

A study on the hygienic usage of pit- latrines to avert bilharziasis in rural Zimbabwe.A questionnaire study was conducted in the Mushandike small scale irrigation schemes in Zimbabwe to investigate the following: 1) to establish whether field latrines are used or not; 2) to find out why people visit natural water bodies for bathing and laundry instead of using water from boreholes for these purposes; 3) to assess people’s knowledge on the transmission and control of schistosomiasis. Results of the study indicated that die field latrines tire utilized and that the borehole water is not preferred for bathing and laundry because of its hardness and oily nature. The results further indicated that the community was aware of schistosomiasis but their knowledge on transmission and control of the disease was limited. Possible reasons for tire observations made tire discussed in die paper and recommendations emanating from the study are stated

Why has HIV spread so rapidly in southern Africa?

Zimbabwe, like most countries in southern Africa, has one of the most devastating HIV epidemics seen to date According to available information, HIV is thought to have begun to spread rapidly within Zimbabwe in the mid-1980s with adult HIV prevalence reaching approximately 9% by 1990. The most recent published sentinel surveillance figures for Zimbabwe suggest that the national level of HIV prevalence among women attending antenatal clinics increased from 29% in 1997 to 35% in 2000. Even after adjusting for likely selection bias in sentinel sites, it was estimated that HIV prevalence amongst adults in Zimbabwe had increased from 25% to 30% during the intervening 3-year period. In trying to explain this trend most analysts have focused on behavioural and sociological aspects of why HIV has spread so rapidly in southern Africa. These include studies on patterns of infection and demographic impact by socio-demographic risk group and relative levels of HIV infection among more and less educated people. A comprehensive review of HIV/AIDS in southern Africa has recently been produced covering a broad perspective of the problem, ranging from epidemiology, psychosocial and cultural determinants, government policies and country level experiences. This paper examines social and biomedical perspectives in an attempt to provide plausible explanations of the rapid spread of HIV in southern Africa. The Zimbabwe Science News Volume 35 (1+ 2) 2001, pp. 11-1

Shared and SAHARA (social aspects of HIV/AIDS research alliance)

Internal presentation at the HSRC seminar series, Pretoria, 14 January

A framework for HIV/AIDS vaccine research in Zimbabwe

Two decades into the HIV pandemic, sub-Saharan Africa continues to bear a disproportionate burden of the HIV infections. Whilst most countries in sub-Saharan Africa have established National AIDS Control Programmes, interventions such as behaviour modification, condom promotion and treatment of other sexually transmitted infections have not been sufficient to significantly reduce the incidence of HIV infections. Zimbabwe has not been spared by the epidemic, and currently records one of the highest HIV prevalence rates in the world. Whilst efforts to promote known interventions for HIV prevention must be strengthened, preventive HIV vaccines remain the best long-term solution to control the HIV pandemic. However the search for an HIV/AIDS vaccine has been dogged by serious scientific, ethical and operational challenges. Firstly, there currently is no data that unequivocally establishes the existence of sterile immunity against HIV in humans. Secondly, HIV/AIDS vaccine development has been hindered by the extensive variation of HIV, with the various types and subtypes being found in different geographical locations. This genetic variation poses serious challenges to vaccine development. It is not clear whether a vaccine based on antigens of one subtype can protect against a different subtype. This cross protection is essential since the various subtypes are now widely spread all over the world. Operationally, most developing countries where the burden of HIV is highest, lack the capacity to participate effectively in vaccine development, due not only to lack of expertise but more importantly the financial and technical resources for project management, process development, scaling-up and manufacturing issues for vaccine research and development. Furthermore, there are no harmonized international ethical guidelines and regulations for HIV/AIDS vaccine development including requirements for entry into clinical trial, progression through advancing stages of clinical trials, and licensure. In recognition of these challenges, the international scientific community (International AIDS Vaccine Initiative) and other stakeholders have accelerated global vaccine efforts to search for HIV/AIDS vaccine. Although several African countries have participated in international collaborative projects, including HIV prevention trials, infrastructures and capabilities to conduct HIV vaccine trials are virtually non-existent on the continent. It is also recognised that the proactive participation and effective coordination of African scientists, institutions and the community is necessary in order to ensure that appropriate HIV vaccines are developed for Africa. In recognition of this need, African scientists convened a consultative meeting in Kenya under the auspices of the Joint United Nations Programme on AIDS (UNAIDS) to discuss strategies to accelerate the development of HIV vaccines in Africa. This paper presents a framework, based on the recommendations of the Nairobi consultative meeting, on an African Strategy for an HIV Vaccine, that could be adopted for the implementation of the various facets of HIV vaccine research in Zimbabwe. The Zimbabwe Science News Volume 35 (1+ 2) 2001, pp. 51-5

A review of the HIV/AIDS situation in Zimbabwe

Human immunodeficiency virus (HIV) infections continue to spread at alarming rates, particularly in developing countries. The United Nations AIDS organization (UNAIDS) and World Health Organization (WHO) estimate that nearly 40 million people including adults (37.2 million) and children (2.7 million) worldwide were living with HIV by end of 2001, more than 70% of these in the developing world. Not surprisingly, the developing world accounts for over 95% of the estimated 3 million AIDS related deaths in 2001, largely among young adults who would normally be in their peak productive and reproductive years. Sub-Saharan Africa, the global epicenter of the pandemic, harbours over 70% of the people living with AIDS and accounts for nearly 80% of all AIDS-related deaths. It is estimated that almost 90% of all new infections in children under 15 years in 2001 occurred in Africa and that over 95% of all AIDS orphans are also in Africa. All this against the backdrop of a population that is only a tenth of the world's population. Southern African countries are the hardest hit in the world with respect to HIV/AIDS. In Zimbabwe, in particular, HIV sentinel surveillance through antenatal screening shows an increasing prevalence in both urban and rural areas. Zimbabwe, like other southern African countries, unfortunately harbours the virulent HIV-1 subtype C. This paper examines the current epidemiology of HIV/AIDS in Zimbabwe and looks at the demographic, social, and economic impact of the disease. The Zimbabwe response to the epidemic is discussed in terms of AIDS and STD policy, information, education and communication, condom availability, mother to child transmission, care, support and research. The Zimbabwe Science News Volume 35 (1+ 2) 2001, pp. 4-1

The Manicaland HIV/STD Prevention Project: Studies on HIV transmission, impact and control in rural Zimbabwe

The Manicaland HIV/STD Prevention Project is a major collaborative scientific research initiative that has been underway in rural areas of eastern Zimbabwe since the early 1990s. The principal collaborating institutions in the project have been the Biomedical Research and Training Institute and the Blair Research Institute, each based in Harare, Family AIDS Caring Trust, based in Mutare and Rusape, and the Department of Infectious Disease Epidemiology at Imperial College in London (formerly based at the University of Oxford). In its early years, the primary aim of the project was to assess the severity of the HIV epidemic in rural areas of Zimbabwe. Two rural areas in Manicaland were chosen as the initial sites for the study on the basis that one (Honde Valley in Mutasa District) was relatively accessible by tarred road to urban centres whilst the other (Rusitu Valley in Chimanimani District) had a similar cultural and socio-economic background but lay in one of the most remote corners of the country. In this article, we describe the main findings of the Manicaland HIV/STD Prevention Project to date. In the process, we highlight some of the principal challenges faced in the search for effective measures to control the HIV epidemic. We also emphasise the need to identify and develop HIV control strategies that reflect spatial and temporal variations in the local socio-economic and epidemiological context. The Zimbabwe Science News Volume 35 (1+ 2) 2001, pp. 27-4