COMPARISON OF TWO GENERATIONS OF WELLCOZYME KITS

ABSTRACT: A study to compare the specificity of two generations of Wellcozyme kits was performed using sera obtained from three different groups with different prevalence rates of HIV-1 infection, namely, females with multi-partner sexual contacts (MPSC) with an average HIV prevalence of 20% representing the high risk group, specimens from patients who have been suspected to have been infected with HIV based on clinical diagnosis, and scholarship winners with a prevalence rate of 3.4%. ELISA was performed on 1000 samples from each of the first two groups and 377 samples from the third group using both generation of kits. The percentage of false positivity using the first generation kit was 16.3% (33/202), 5.1% (14/271),36% (9/39) and using the second generation kit, 7.94% (12/151), 0.25% (1/399) and 5.8% (1/19) in MPSC females, suspected AIDS patients and scholarship students respectively. ELISA false positivity was highest in the group with a low HIV sero-prevalence rate. The result of the study, in relation to the specificity of the kits, is presented. Students who have won scholarships to countries that require HIV testing

PREVALENCE OF HIV -1 INFECTION AMONG OUT PATIENTS OF ASSELA TOWN, ETHIOPIA, 1989

Several surveys in Ethiopia, among population groups practicing risky sexual behaviour, demonstrated a rapid progression of the HIV -1 epidemic. Among females involved in multi-partner sexual contacts (MPSC), the HIV prevalence rates rose from 18.5% in 988, to 29.2% in 1989 (1); among the long distance truck drivers the rate has also been increasing (2). As no comparative study was made in the general population of Ethiopia, a serosurvey was initiated in Assela town in December, 1989. Three years earlier (1985 -1986) during a survey aimed at determining hepatitis B prevalence, 300 outpatients of Assela Hospital were also tested for HIV-l infection (3). Two specimens were found repeatedly reactive for HIV-l by ELISA test, but the confirmatory tests Western Blot (WB) gave negative results. The present survey was designed to use the same methodology and sample selection as in the previous survey. All persons in the age group 15 to 40 years applying for medical aid during morning sessions of the outpatient department of Assela hospital, gave 5ml of blood, with no linkage to personal identification. Collection of blood samples continued until the number of persons in the study equaled the target number of the survey conducted in 1985 -1986

PROGRESSION OF HUMAN IMMUNODEFICIENCY VIRUS EPEDEMIC IN ETHIOPIA

SUMMARY: A series of HIV sero-prevalence surveys have been carried out in Ethiopia within the framework of the medium term plan for AIDS Control. The surveys were designed to monitor progression of the HIV epidemic in the populations experiencing various risk behaviours as well as in the general population. Sex workers were represented by 2056 randomly selected females practicing multi-partner sexual contact (MPSC) in seven urban areas in 1988, and by 1987 persons in 1989. Similarly, 995 employees of thee Ethiopian Freight Transport Corporation (EFTC), (drivers, assistants, and technicians) were tested in 1988, and 555 in 1989. A survey was also conducted in December 1989 among 318 out patients in Assela Hospital. The average HIV prevalence rate in the country in 1988 among MPSC females was 18.5%. In the second year the average prevalence rate in the seven towns increased to 29.2%. This showed a progression rate of 57.8% in a 12 months period. The progression rates were higher in the initially low prevalence areas and vice versa (r = -0.92). Among the EFTC employees the rate of progression was 33.0% in the drivers and 78.0% in the technicians (initial prevalence rates were 17.3% and 4.1% respectively). The sero-conversion rate was 7.2 % among these EFTC workers within 12 months. No HIV sero-positive person was found among 300 hospital outpatients in Assela hospital in the 1985-86 survey while by the end of 1989 3.5% of the same population group were infected. The results of consecutive testing of blood donors also indicated that HIV prevalence has been increasing steadily, though at a lower rate than among those groups who practiced risk behaviour. These studies indicate that HIV infection is progressing among the urban population in Ethiopia. There is an urgent need for intensive health education aimed at changing sexual behaviour and at promotion of condoms in order to decrease further spread of HI

LABORATORY NETWORK FOR HIV INFECTION IN ETHIOPIA

ABSTRACT: One of the main objectives of the Short Tern Plan of the Ethiopian AIDS Control Programme was the establishment of screening laboratories in blood banks in the country and strengthening the Immunology Laboratory of the National Research Institute of Health. As a result, HIV screening laboratories were established in all five blood banks and the National Referral Laboratory for AIDS (NRLA) was established during the first half of the short tenn plan. Based on the Medium Term Plan of the programme which envisaged establishment of HIV screening laboratories in all regional hospitals where a substantial amount of blood transfusion took place, HIV screening laboratories were established. To date there are 24 HIV screening laboratories throughout the country .Nineteen of these laboratories use ELISA tests and 5 use simple/rapid assays. There is a well established quality control and supervision system where each laboratory is visited twice a year and characterized panels of sera are sent to each laboratory three times a year from the NRLA. The plan of the National AIDS Control Programme is to establish screening laboratories in all establishments where blood transfusion is carried out

PROFILE OF AIDS CASES IN ETHIOPIA

SUMMARY: After the first AIDS case was identified in Ethiopia in February 1986, 636 cases have been reported through November 1990. A marked increase in the number of cases was noted from year to year during the five years: 0.3% of all cases were reported in 1986, 2.7% In 1987, 13.4% in 1988, 28.5% in 1989 and 55.2% up to end of November 1990. The large majority of the patients (87.6%) were diagnosed in Addis Ababa hospitals; the remainder were reported from regional hospitals. 445(70.0%) of all patients were males; 191 were females; with a male to female sex ratio of2.3:1. The average age for both sexes was 31.1 years with 32.9 years for males and 26.9 years for females. Sexual contact with multiple partners, history of Sills, and injections received outside of medical institutions, were the three major risk factors identified in 61.3%, 45.6% and 7.9% of the patients respectively. Of the three major clinical features of the WHO case definition, marked weight loss (failure to thrive), was found in 581 (91.4%) of the patients, prolonged fever > 1 month in 542 (85.2%) cases and chronic diarrhea in 296 (46.5%) of the patients. Generalized lymphadenopathy, persistent cough for over 1 month, and generalized pruritic dermatitis were the common minor symptoms identified. It was documented that 361 (60.1 %) of the patients were alive; 163 (27.2%) died

DEVELOPMENT AND MANAGEMENT OF THE AIDS CONTROL PROGRAMME IN ETHIOPIA

Realizing the enormous implications of AIDS (acquired immuno-deficiency syndrome) in terms of human suffering, social effects, and costs for health services, the National Task Force on the Prevention and Control of HIV -infection and AIDS in Ethiopia was established, in 1985 -prior to the first laboratory diagnosis of HIV or reported AIDS case. The Government of the PDRE recognized the extraordinary dimensions of the threat of AIDS to the national health, and responded with full commitment and support from the onset of the Programme onward.Initially, measures focused on the development of a National Policy on AIDS, specific operational guidelines, a situational analysis of the problem, and, an assessment of the existing capability to cope with the problem. In collaboration with experts from the Global Programme on AIDS (GP A), the Ethiopian Short Term and Medium Term Plans for the Prevention and Control of AIDS were developed in March and May of 1987, respectively. National strategy required the development of a strong and comprehensive National AIDS Prevention and Control Programme; the highest priority was given to national programme development

SURVEILLANCE ON AIDS CASES IN ETIllOPIA

SUMMARY: The surveillance system for AIDS cases was introduced in Ethiopia at the beginning of 1989. This was preceded by the preparation of clinical surveillance guidelines and training for physicians at the national and regional levels. The guidelines contained descriptions of the referral system, the activities to be carried out, and recording/reporting forms to be used for this purpose. The trained physicians were given the responsibilities of carrying out the surveillance in their respective hospitals and to maintain regular reporting on the activities .A review of the surveillance activity of the last two years, revealed that 526 (82.7 %) of the patients were reported in 1989 and 1990, after the introduction of the system. Moreover, there was marked improvement in the quality of the reports on the patients. However, from the report presented by different supervisory AIDS, it was identified that the surveillance system was not properly introduced in several health institutions outside Addis Ababa. This indicates the need for regular training and support to the physicians involved in AIDS case surveillance, and for periodic revision of the surveillance system

THE PREVALENCE OF HIV-1 ANTIBODIES IN 106 TUBERCULOSIS PATIENTS

ABSTRACT: Sera were collected from all 106 tuberculosis (TB) patients consecutively seen over a period of six months at the Armed Forces General Hospital. All were tested for the presence of HIV-I antibodies, using the ELISA (Wellcozyme) and confirmed with the Western Blot (Biorad), out of which 7 reacted positively. Six of the seven HIV-I positive patients had pulmonary tuberculosis and only one had the disseminated form as opposed to 31% of the 106 patients presenting with the latter. Five of the HIV -I positive patients had a history of sexually transmitted diseases (STD) compared to 30 of the 99 HIV-I negative patients (39.4%). The study seems to show a positive association between HIV-I infection and tuberculosis. We therefore believe that further studies should be done in this country in order to a certain the association between the two diseases

"FIGHT AIDS TOGETHER" AN INTENSIVE DRIVE TO PREVENT AIDS

INTRODUCTIONIn September, 1990 the Department of AIDS Control (DAC), Ministry of Health of Ethiopia confronted a difficult predicament. The Department had long acknowledged that small as it was, it could not shoulder the responsibility of educating a nation of more than 50 million people. Nevertheless, it had been given the mandate of educating those millions to prevent the spread of AIDS. The dilemma was obvious

INTERSECTORAL COLLABORATION IN AIDS CONTROL IN ETIHIOPIA

Throughout the world, AIDS Control Programmes are confronting the need for Inter-sectoral Collaboration. The very nature of AIDS requires that control and prevention activities take cognizance of factors as diverse yet interconnected as a country's economic and employment picture; literacy level; behavioral practices; religious and societal values; medical services available; healing traditions; sexual norms; status of women; etc. With such a complex of related factors, no Ministry of Health alone can hope to fmd all the solutions. A united and comprehensive approach is necessary .Resolutions and strategies abound which urge such an approach, but experience in establishing such linkages is rare. Nevertheless, Ethiopia has been notably successful in fostering a workable mode of collaboration and today, the cooperative nature of the ACP is clearly evident