The silent HIV epidemic among pregnant women within rural Northern Tanzania

Yahya-Malima, Khadija I.; Olsen, Bjørg E.; Matee, Mecky I.; Fylkesnes, Knut
January 2006
BMC Public Health;2006, Vol. 6 Issue 1, p109
Academic Journal
Background: Many national antenatal clinics (ANC) based HIV surveillance systems in sub-Saharan Africa have limited coverage of remote rural sites, a weakness that compromises adequate estimation, monitoring and development of effective preventive and care programmes. To address this void in rural Manyara and Singida within Northern Tanzania, we conducted antenatal clinic-based sentinel surveillance. Methods: We consecutively enrolled 1377 counselled and consenting pregnant women attending ANC clinics for the first time during the current pregnancy. The study was conducted in six antenatal clinics, within three divisions of rural Manyara and Singida regions in 2003/2004. Interviews were conducted and blood samples for routine purposes were collected and tested for anti-HIV IgG antibody anonymously, using Bionor HIV-1 & 2 assay ®. Results: Among enrolees, 94% (1296/1377) participated fully. The overall prevalence of HIV was 2.0% (95%CI: 1.34-2.97). The highest HIV prevalence was among women aged between 15-19 years in both rural and remote rural populations. The odds of HIV infection was 4.3 (95%CI: 1.42-12.77) times among women reporting more than one lifetime sexual partners compared with those with one partner. HIV infection was associated with history of genital sores or foul smelling discharge, OR 6.8 (95%CI: 2.78-16.66) and age at first pregnancy (2.5 times higher likelihood of infection if before the age of 18 years versus at a later age). Conclusion: Including rural remote sites, as part of the national ANC routine surveillance, is crucial in order to discover imminent silent epidemics such as the one described in this paper. Scaling up HIV prevention efforts is mandatory to prevent the imminent escalation of the HIV epidemic highly associated with a history of sexually transmitted infections (STIs), multiple sexual partners and pregnancies at a younger age. Ignorance of relevant knowledge and low utilisation of condoms underscores the urgency for large-scale preventive efforts. Research to capture a wider representation of the risk factors in the general population should be a priority to enable further customised HIV prevention efforts.


Related Articles

  • `Hopeless' HIV testing fails Britain's unborn children. Day, Michael // New Scientist;05/05/97, Vol. 154 Issue 2076, p6 

    Reports on efforts to institutionalize HIV testing of pregnant women in Great Britain. High rate of infant HIV infection due to lack of routine HIV testing of pregnant women; Drastically reduced rate of infant infection when HIV-infected pregnant women are treated with the drug AZT.

  • Standing in the (AIDS) Gap. Nakkazi, Esther // Christianity Today;Dec2010, Vol. 54 Issue 12, p18 

    The article focuses on HIV prevention programs for expectant mothers in Uganda. It reports on the U.S. government's provision of 1.4 billion U.S. dollars to fight HIV in the East African country, with nearly 100,000 Ugandans newly infected each year. Addy Kekitiinwa of Baylor College of Medicine...

  • Unethical Clinical Trials Still Being Conducted in Developing Countries. Carome, Michael // Health Letter;Oct2014, p5 

    The article discusses the unethical trials that were testing new methods for preventing the spread of HIV infection from pregnant women to their babies before or after giving birth in developing countries in Africa, Asia and the Caribbean.

  • Do women understand prenatal screening for fetal abnormality? Ockleford, Elizabeth; Berryman, Julia; Hsu, Ron // British Journal of Midwifery;Jul2003, Vol. 11 Issue 7, p445 

    Examines pregnant women's understanding of the purpose of prenatal screening for fetal abnormality in Great Britain. Ultrasound scans; Serum testing; Decision-making.

  • Overutilization of antenatal care in Norway. Backe, Bjorn // Scandinavian Journal of Public Health;Jun2001, Vol. 29 Issue 2 

    :Background: It has long been a common belief in Norway that all pregnant women attend antenatal care, but no documentation has been provided. In 1984, official guidelines were issued recommending a reduction of the number of routine visits. However, no studies have been performed in order to...

  • Your pregnancy: New tests, new fears. Rothman, Barbara Katz // Glamour;Sep93, Vol. 91 Issue 9, p272 

    Discusses the ethical issues and psychological consequences of prenatal diagnosis. Option given to women; Effect of knowing too much in advance; Lack of a guarantee for a healthy baby; Forms of prenatal diagnosis; Failures of prenatal counseling.

  • why are women saying no to amnio? Lombardi, Lisa // Redbook;Jan2003, Vol. 200 Issue 1, p94 

    Investigates the reasons for the ambivalence of pregnant women toward amniocentesis. Information on why women do not feel compelled to find out if there is a problem on their pregnancy; Tests which are being hated by pregnant women; Theories behind the decision of a couple to skip amniocentesis.

  • High Rates of HIV Seroconversion in Pregnant Women and Low Reported Levels of HIV Testing among Male Partners in Southern Mozambique: Results from a Mixed Methods Study. De Schacht, Caroline; Hoffman, Heather J.; Mabunda, Nédio; Lucas, Carlota; Alons, Catharina L.; Madonela, Ana; Vubil, Adolfo; JrFerreira, Orlando C.; Calú, Nurbai; Santos, Iolanda S.; Jani, Ilesh V.; Guay, Laura // PLoS ONE;Dec2014, Vol. 9 Issue 12, p1 

    Introduction: Prevention of acute HIV infections in pregnancy is required to achieve elimination of pediatric HIV. Identification and support for HIV negative pregnant women and their partners, particularly serodiscordant couples, are critical. A mixed method study done in Southern Mozambique...

  • An Assessment of the Clinical Utility of Routine Antenatal Screening of Pregnant Women at First Clinic Attendance for Haemoglobin Genotypes, Haematocrit, ABO and Rh Blood Groups in Port Harcourt, Nigeria. Jeremiah, Zaccheaus Awortu // African Journal of Reproductive Health;Dec2005, Vol. 9 Issue 3, p112 

    This prospective study was designed to provide the frequencies of the haemoglobin genotypes, ABO and Rh blood groups and their effects on the haematocrit values among pregnant women in Port Harcourt. One hundred and eighty (180) pregnant women at their first clinic attendance and in their first...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics