HIV/AIDS/STI Surveillance Report January-December 2005:Report Number 20

This report summarizes the magnitude and trend of HIV/AIDS/STIs in Mainland Tanzania for the annual year January to December 2005. A total of 13,285 AIDS cases were reported to the NACP from the 21 regions during the year 2005. This resulted into a cumulative total of 205,773 reported cases since 1983 when the first 3 cases were identified in the country. About 5.6% (439) of the AIDS cases reported in 2005 were below 15 years of age and most of these are likely to have acquired infection through mother to child transmission. The age group 20-49 years remained the most affected for both sexes, an observation that has remained consistent for several years since the beginning of the epidemic in the country. The observed clustering of cases in the age group 20-49 indicates that the majority of infections occur during the age of maximum sexual activity. As in the previous years, the predominant mode of HIV transmission has remained heterosexual constituting up to 81.6% of all reported AIDS cases during 2005. Mother to child transmission constituted 3.7% and blood transfusion 1.5%. In about 12.8% of the cases, the mode of acquisition of infection was not stated. Of all AIDS cases reported during year 2005, 55.7% were married, while 22.0% were single. The marital status of the remaining cases were; divorced (4.5%), separated (2.3%), cohabiting (2.5%) and widowed (0.3%). In about 12.7% of cases, the marital status was not stated. Readers are cautioned that it is wrong to interpret the data as 55.7% of married couples in Tanzania are HIV positive. They do not represent the proportion of AIDS cases among married couples in Tanzania; rather they reflect the proportion of cases among the different marital categories of patients with AIDS. A total of 129,203 individuals donated blood during the year 2005. The majority of blood donors were males constituting 82.9% of all donors and the rest being females. As in the past year, most blood donors were relatives of patients (98.9%) and the rest were institutional (0.5%) and paid donors (0.5%). The overall prevalence of HIV infection among blood donors during 2005 was 7.9% (95% CI, 7.87-7.92). There were no differences between the prevalence of HIV among blood donors for the year 2004 (7.7%) and that of year 2005 (7.9%) (P-value = 0.05). In the era of ARV delivery one would expect a constant or even a rise in prevalence of HIV infection if incidence remains constant. Using estimations and projections package (EPP) and the spectrum model developed by WHO, it is estimated that, in the year 2005, 1,770,383 people were living with HIV. Of these 656,180 are from urban and 1,114,203 are from rural areas. Sexually transmitted infections (STIs) are a marker of sexual networking and give a clue to the extent of unprotected sex in a community. During the year 2005, a total of 325,998 STI episodes were reported throughout the STI clinics. Of these, 143,616 (44.1%) were reported as genital discharge syndromes, 69,074 (21.2%) were genital ulcer diseases, 76,039 (23.3%) were pelvic inflammatory diseases and the rest 37,269 (11.4%) were reported as other syndromes. Overall, regions reporting the highest number of episodes include Mbeya (43,421), Dar es Salaam (30,556), Mara (30,362), Tanga (26,028) Mwanza (24,942), Dodoma (24,107) and Kilimanjaro (22,245) in decreasing order. The smallest number of episodes was reported from Lindi (558), Singida (1,630) and Kagera. Generally, the number of STI episodes especially syphilis among females was higher than in males. This observation may not be due to a true higher incidence of STI among females, rather it reflects differences in health seeking between females and males. The most affected age groups in both sexes were those of 20-29 years, followed by the age group 30 years and above. During the year 2005, a total of 217,116 new clients accessed Voluntarily Counseling and Testing (VCT) services in Tanzania mainland. This number was reported by counselors from all VCT of 21 regions and excludes those managed by AMREF through the Angaza Project. The increase in the number of clients who tested in 2005 was quite remarkable compared to the trend in the past. This increase is partly attributed to improved access to VCT services following opening of many VCT sites in different areas in the country during this year. It may also be a reflection of the growing awareness of the importance of VCT. The overall HIV prevalence using data from VCT in health facility based sites was 26.9% while it was 11.0% using data from the 34 ANGAZA sites, which are distributed in some areas of the country. The prevalence of HIV infection in the health facility based sites ranged from 5.3% in Manyara to 46.3% in Iringa region. In conclusion, the spread of HIV infection continued as in previous years. Data obtained from various surveys indicate high risk of HIV infection among youth and higher vulnerability to infection among women