OVERVIEW OF HIVAIDS PANDEMIC By Dr Sewangi

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OVERVIEW OF HIV/AIDS PANDEMICBy Dr Sewangi
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Approach

• Global situation
• Africa situation
• Tanzania situation
• Impact of HIV/AIDS
• Discussion

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Summary of present global situation of HIV/AIDS
(UNAIDS by December 2003)

• The overall global prevalence is 1.1

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Africa situation by December 2003

• In Sub Saharan Africa, HIV infection has risen
  higher than thought possible, exceeding 30.
• It is the home to 26 million PLWHA,
• 3 million newly
  infected,
• 2.2 million death
• Botswana and Swaziland 39
• Lesotho 30
• Namibia 27
• Zimbabwe and South Africa 25
• Zambia 20
• Mozambique 18
• Malawi 16
• Kenya 13
• Tanzania 12
• Cameroon 10
• Gambia, Mauritania lt1
• Overall prevalence of 7.5 8.5
• Each country has its own initiatives to fight
  this epidemic.

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Tanzania situation

• National AIDS Control Programme (NACP) report
• 1983 1st cases of AIDS occurred in Kagera
  region
• 1985 HIV/AIDS epidemic was confirmed in
  Tanzania
• 1986 All regions had reported AIDS cases
• 2002 12,675(89.8 of 2001) AIDS cases were
  reported to NACP from the 21 regions of Tanzania
  mainland and age group mostly affected is 20-49
  yr
• 1983 2002 total 157,173 were reported to NACP

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• Est. 1 out of 5 AIDS cases are reported to
  National AIDS Control Programme (NACP).
  Therefore, NACP estimated 63,375 cases occurred
  in 2002 and 785,865 cumulative AIDS cases
  occurred since 1983 until 2002
• HIV/AIDS estimates by the end of 2002
• 1,894,160 people were HIV infected in Tanzania
• 30 are aged 15 24 yr
• 70 are aged 25 49 yr
• gt140,000 people died of AIDS
• Nearly 810,000 children (lt15yrs) were orphans in
  Tanzania (42 of all orphans)
• 12 of adults aged 15 49 yrs were HIV infected

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• Prevalence in specific groups(2002)
• i). Pregnant women
• HIV prevalence among pregnant women varied from
  5.6 in Kagera to 16.0 in Mbeya
• ii). Blood donors
• Overall HIV prevalence of 9.7
• Male alone 9.1
• Female alone 12.3
• iii). In general
• Males aged 15 24 years lowest risk of
  infection
• Males aged 30 39 years highest risk of
  infection
• Females aged 25 34 years highest risk of
  infection
• Urban gt Rural

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The five leading regions (NACP)

• AIDS cases
• Mbeya(31,172),DSM(24,501),KLM(10,042),
  Rukwa(9,194),Kagera(9,072).
• ANC attendees
• Mbeya(16),DSM(12.8),Mtwara
• (7.1),KLM(6.3), Dodoma(6.1)
• Blood donors
• Kagera(18), Iringa(14.8), Mbeya(12.7), Singida
  Ruvuma(10.9),Mara(10.3).

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• Possible sources of infection for the reported
  AIDS cases (NACP 2002)
• Blood transfusion 0.3
• Mother to children 5.9
• Heterosexual - 82.1
• Other 1.7
• Not stated 10

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• Marital status for the reported AIDS cases (NACP
  2002)
• Single 25
• Married 56
• Divorced - 5
• Separated - 4
• Cohabiting - 1
• Widowed - 1
• Not stated - 8

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Actions taken

• 1985 - NACP was established and worked through
  Short and Medium Term Plans (S/MTP) under the
  support of Global Programme on AIDS of WHO
• 1989 - National AIDS Committee (NAC) was formed
  to support and complement NACP
• 1998/2002 - MTP III Third 5 years Medium Term
  Plan
• Health sector focus
• Multisectoral response
• Community involvement

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• 1999 -NABA (National Advisory Board on
  AIDS) was formed to further support and
  complement NACP.
• - HIV/AIDS declared a National Disaster by
  His Excellency President of Tanzanian
  Republic
• 2001 -TACAIDS established under the Act of
  Parliament under the Prime Ministers office
  to facilitate and strengthen the expanded
  response to the epidemic
• -National Policy on HIV/AIDS
• 2003/(? 2007)
• -National Multi-sectoral Strategic Frame work
  (NMSF) was formulated

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Impact of HIV/AIDS

• Socio-demographically
• Mortality rate
• AIDS is projected to increase infant mortality up
  to twofold and child to threefold
• Mortality among adults (15 49 years) may triple
  in some areas
• Life expectancy
• Expected to be 47 years instead of 57 years
• Population( many couples have children before
  they develop AIDS)
• AIDS distorts the population pyramid, removing
  adults of sexually active age and living children
  and elderly.
• Population growth will be attenuated due to lower
  fertility as result of AIDS
• Orphan-hood
• This is an era of orphans as many children
  younger than 15 years have lost a parent or both.

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Economically

• AIDS strikes adults during their most
  economically productive years
• Reduced productivity and increased costs due to
• Increased absenteeism (ill health, nursing the
  sick family members, attending funerals)
• Workers will be less productive and not able to
  carry out more demanding physical jobs
• Employees who die or retire on medical grounds
  have to be replaced and their replacements may be
  less skilled and experienced and require training
• Employers may increase the size of the workforce
  to provide for absenteeism
• As skilled workers become scarcer wages may
  increase

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Brain storming

• Why such a high prevalence among married people?
• Why do our children get HIV infected?
• What is the impact of HIV/AIDS in your sector?

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Agriculture sector

• change to crops which are less labor demanding
• less soil is cultivated
• financial resources more used for funeral,
  nursing or medicines and not for seeds or
  investment in farming or livestock
• livestock and farms are sold to generate income
  for additional expenses

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Thank you