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HIV/AIDS/STI Surveillance Report:Report Number 22

Ramadhani, A. , Somi, G., Josiah, R. , Matee, M., Hokororo, J. , Nondi, J. , Sambu, V. , Lema, L. , Kilama, B. , Mlingi, G. , Mogela, D. , Nkingwa, M. , Lengaki, L. , Urassa, J. , Bukuku, M. , Nkambazi, M. , Rabiel, B. , Ngilangwa, D. , Kisendi, R. , Rwebembera, A. , Msobi, N. , Mpenzwa, E. and Guni, E. B. (2011) HIV/AIDS/STI Surveillance Report:Report Number 22. Technical Report. UNSPECIFIED. (Unpublished)

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Abstract

This report presents a summary of the activities of the Tanzanian NACP of the MoHSW in dealing with the HIV pandemic as of December 2010. It includes analysis of the following interventions: blood transfusion services, HIV care and treatment, Counselling and Testing for HIV infection, Prevention of Mother to Child Transmission of HIV infection (PMTCT) as well as M&E reports and surveillance of HIV infection in the country. The following have been achieved regarding the blood transfusions services in the country; the number of voluntary donors increased from 61,954 in 2009 to 74,836 in 2010 i) the overall prevalence of some Transfusion Transmissible Infections (TTIs) among voluntary blood donors has continued to decrease; HIV from 2.6% in 2009 to 1.6% in 2010 and HBV infection from 6.1% in 2009 to 4.9% in 2010. However, the prevalence of HCV infection has increased from 0.6% in 2009 to 1.2% in 2010 and that of syphilis from 1% in 2009 to 1.2% in 2010. Notably, the supply of safe blood from zonal centers has not met facility requirements and hence some hospitals continue to collect blood from replacement donors. The continued scaling of PMTCT services, which started in 2003, has resulted in increased number of PMTCT implementing sites from 3029 in 2008 to 4301 in 2010, ii) pregnant women reached at ANC by PMTCT services from 958,103 in 2008 to 1,660,894 in 2010 iii) pregnant women tested for HIV (ANC+LD) from 919,377 to 1,414,051 in 2010 iv) pregnant women opted for exclusive breast feeding from 41,347 to 65,511 in 2010 v) Proportion of women reached at ANC Vs total estimated pregnant women in the population from 61 % in 2008 to 99.7% in 2010. The HIV early infants’ diagnostic services started in 2009 and by 2010 a total number of 22,033 infants were tested for HIV infection and among them 9.8% were positive. Notably, the number of pregnant women tested HIV+ at ANC & LD and hence received Prophylaxis had remained low In the year 2010 the total number of clients referred to HTC services from different services was 806,113, compared with 1,003,918 clients in 2009. Over the years, the major source of clients for HTC services has remained to be self referrals which accounts for about 80% of all clients, while the remaining sources (TB, STI Clinic, OPD, IPD, BTS, and HBC) accounts for about 20%, with TB clinics contributing only 1%. The reduction in clients referred to HTC services in 2010 need to be investigated. Equally, the low percentage of referrals from TB clinics needs to be addressed given the necessity of integrating TB and HIV activities. Regarding HIV care and treatment services; i) the number of health facilities providing and reporting HIV care and treatment services reached 909, which is 17% of all public health facilities in the country The cumulative number of clients enrolled in HIV care and treatment increased from 403,378 in 2008 to 594,651 in 2009 to 740,040 in 2010, which is 57 % of the 1,300,000 country’s estimated PLHIV the cumulative number of clients on ART increased from 202,181 in 2008 to 303,664 in 2009 to 384,816 in 2010. Out of these figures, the number of children enrolled was 33,422 in 2008, 47,044 in 2009 and 58,245 in 2010.Despite the noted success in the HIV care and treatment services, a number of significant challenges still exists; i) From the national database, the percentage of health facilities that offer ART is only 14.6% (909 out of 6,216) ii) the percentage of adults and children with HIV known to be on treatment 36 months after initiation of antiretroviral therapy (UA) is only 63% for adults and 72% for children iii) the percentage of persons who attended all clinic appointments for HIV care and treatment services during a year ranges from 27% to 45%. During the year 2010, a total of 243,944 STI episodes were reported to NACP by STI clinics countrywide, which is an increase from 188,611 episodes reported in 2009. Of these episodes, genital
discharge syndromes increased from 61,844 (32.8%) in 2009 to 90,499 (37.1%), genital ulcer disease episodes decreased from 88,541 (46.9%) in 2009 to 39,230 (16.1 %) in 2010, 48,892 (20.0%) pelvic inflammatory diseases increased from16,713 (8.9%) in 2009 to 32,490 (13.3%), while VDLR/RPR
positive and the rest increased from 21,513 episodes in 2009 to 32,833 episodes in 2010. As can be seen from these data, the major cause for the increase of STIs cases in 2010 appears to be the genital discharge syndromes, and to a lesser extent PID and VDRL/RPR positive cases. The continued use of the nontreponemal tests needs to be considered in the next round. The increase in the number of STI cases as well as significant regional variations needs to be investigated! As of December 2010 only three regions (Mtwara, Manyara and Morogoro) have started reporting for HBC services using the newly developed recording and reporting tools. Even in these regions only 277 (42.2%) health facilities are providing HBC services. There is a need of training HBC providers on the revised HBC recording and reporting to improve the amount and quality of data. Finally, the performance of the health sector in dealing with the HIV pandemic is summarized in chapter 7. The indicators assess progress made over time as well as reference material for subsequent reporting. In conclusion, despite the noted achievements in 2010, a number of challenges need to be addressed the low proportion of donor blood that is screened through the established NBTS ii) the recording and reporting systems need to be strengthened to ensure regular, complete and timely reports iii) strengthening of the ARV supply chain iv) improvement of the care and treatment, VCT and STI services to make them more user friendly v) further improvement of the co-ordination of various stakeholders vi) training and retraining as well as recruitment of a substantial number of new staff vi) ensure regular supportive supervision at all levels and vii) conduct operational research aiming at problem solving

Item Type: Report (Technical Report)
Keywords: HIV/AIDS,Tanzania, Blood transfusion, PMTCT, HIV infection, Counseling and Testing
Subjects: HIV > Surveillance
HIV > Treatment
Divisions: Ministry of Health and Social Welfare > National AIDS Control Programme (NACP)
Depositing User: Mr Joseph Madata
Date Deposited: 13 Dec 2012 10:48
Last Modified: 13 Aug 2013 06:10
URI: http://ihi.eprints.org/id/eprint/975

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