Publications

This report summarises the findings of the 7th round of HIV serological surveillance, which has been carried out during the period from January-June 2006. On behalf of the Government of Bangladesh, ICDDR,B in close collaboration with Institute of Epidemiology, Disease Control and Research (IEDCR) conducted the surveillance.

The National AIDS Spending Assessment (NASA) is a tool/ method that had been introduced by the UNAIDS Geneva to measure the commitment of a nation in combating a global epidemic disease such as HIV and AIDS. The development of NASA 2006-2007 is a jointly teamwork involved highly motivated senior staffs of the National AIDS Commission, UNAIDS Indonesia, Department of Health and other Sectors at the central level, as well as colleagues from 3 selected provinces.

This report presents the new HIV estimations and its demographic impact analysis based in a workshop that reviewed the data available from the previous HIV estimation workshop, which was held in September 2005 and HIV data for the years 2005 and 2006. The initial discussions were based in the draft estimates produced during the estimates training held in Bangkok in April 2007.

At this point in time, the HIV epidemic in Nepal is still concentrated among high-risk groups, including injecting drug users (IDUs). Nepal has approximately 20,000 IDUs, with at least 5,000 living in the capital, Kathmandu. HIV prevalence among IDUs in Kathmandu is extremely high. In 2003 – the reference year of this analysis – that rate was 68%. This paper has two objectives. The first is to examine the robustness of two different epidemiological models; these models were used to determine the impact of IDU interventions in Nepal when interventions are scaled-up to reach 60% of IDUs, as recommended by UNAIDS. The second objective is to disseminate the outcome of two cost- effectiveness analyses of IDU interventions in Nepal. These analyses used identical data sets to determine the cost-effectiveness ratios under various scenarios of intervention coverage. Nepal has been selected as a case study for two reasons. Firstly, it has good quality cost data information that is easily converted into 2003 prices, and behavioural surveillance data from 2003. Secondly, Nepal was one of four countries in the region where an alpha version of the Asian Effectiveness Model (AEM) (Brown and Peerapatanapokin 2004, Brown T 2005) was available at the time of the analysis (June/July 2007).  

FHI/Vietnam shared results from the female sex workers (FSWs) rapid interviews at a workshop for provincial project staff, health educators, peer educators, drop-in center managers, and partner project managers. The aims of the workshop were to review current status of programming and to develop new approaches to overcome barriers to female sex workers (FSWs) risk behaviors.

The global epidemic of human immunodeficiency virus (HIV) has radically challenged efforts at tuberculosis control and treatment. Tuberculosis is a leading cause of death among HIV patients, with recent reports indicating that between 27 and 80% of tuberculosis patients are coinfected in a variety of settings with measurable prevalence of HIV. HIV prevalence among tuberculosis patients in Afghanistan is currently quite low. However, lack of knowledge of HIV and engaging in high-risk practices, particularly regarding health, make this group vulnerable. Health education sessions regarding HIV, sexually transmitted infection, and blood-borne infections should be implemented for tuberculosis patients during the treatment course.

The Bangladesh Bureau of Statistics has been conducting the Multiple Indicator Cluster Survey since 1993 with the technical support of UNICEF. MICS 2006 was conducted during June through October 2006. The MICS 2006 is the ninth survey conducted in Bangladesh. This final report is based on the MICS 2006. A key findings report was published in June 2007. The Bangladesh Bureau of Statistics conducted the Multiple Indicator Cluster Survey (MICS) between June and October 2006. The main objective of the survey was to provide up-to-date information for assessing the situation of children and women in Bangladesh. The survey also aimed at furnishing data needed for monitoring progress towards goals established by the MDGs, the goals of A World Fit For Children, and other internationally agreed upon goals, as a basis for future action; as well as contributing to the improvement of data and monitoring systems in Bangladesh and strengthening technical expertise in the design, implementation, and analysis of such systems.

In Ho Chi Minh City, Vietnam, reporting rates for tuberculosis (TB) are rising in an emerging HIV epidemic. To describe the HIV epidemic among TB patients and quantify its impact on rates of reported TB, we performed a repeated cross-sectional survey from 1997 through 2002 in a randomly selected sample of inner city TB patients. In more recent years, rising HIV infection rates in TB patients have been documented in Ho Chi Minh City, the major urban area with the highest HIV prevalence in the country. Since 1997, Ho Chi Minh City has also reported increasing TB rates, particularly for young adults. Our study objective was to describe the course of the HIV prevalence among TB patients in Ho Chi Minh City during 1997–2002. By combining our data with the NTP reporting data, we also quantifi ed the effect of HIV on the TB reporting rates in this city.

Bangladesh is threatened by an HIV epidemic. It is important to identify the best way to achieve rapid reductions in sexually transmitted infections (STI) as an effective approach to HIV prevention. Periodic presumptive treatment (PPT) is suggested as a method for STI control; however, it is considered a short-term solution as the epidemiological justification of this approach is weaker as the STI prevalence declines. Enhanced syndromic management (ESM) is an alternative approach that aims to reduce STI prevalence rapidly, through a single round of presumptive treatment of cervicitis, plus, subsequent monthly clinical care through an ESM protocol based on a risk assessment and laboratory tests.

In January 2006, the Chinese government along with WHO and UNAIDS jointly estimated that 650,000 people were living with HIV in China, including about 75,000 AIDS patients. During 2005 there were around 70,000 new HIV infections and 25,000 AIDS deaths.1 These large numbers have to be considered in the context of China's extremely large population which is estimated at around 1,300 million. The figure of 650,000 is lower than the previously published estimate of 840,000 in 2003. This is not because prevalence is falling, but is due to better data and improved methods of estimation. The number of reported AIDS cases is lower than the estimated number because of massive under reporting, especially in the rural areas. This is for a variety of reasons including a shortage of testing equipment and trained health staff, as well as HIV-related stigma.