Transcript WEST BENGAL STATE AIDS PREVENTION AND CONTROL SOCIETY

SENTINEL SURVEILLANCE
IN WEST BENGAL 2005
WEST BENGAL STATE AIDS PREVENTION
AND CONTROL SOCIETY
Presented by: Dr. N Deb, Dy. Director Surveillance
Definition
HIV surveillance can be defined as “A
collection of epidemiological information
of sufficient accuracy and completeness
regarding the distribution and spread of
HIV infection to be relevant to the
planning and implementation of HIV /
AIDS prevention and control programme
activities”.
Objectives
 Determine the geographical spread of HIV infection
 Monitor the trends of HIV epidemic
 Know the prevalence of the infection in high risk group like
Sexually transmitted disease (STD) clinic attendees
 Measure the prevalence of the HIV infection in the general
population through testing the antenatal clinic attendees.
 Measure the prevalence of the infection in the targeted
intervention groups of Female Sex Workers (FSW), Men Having
Sex with Men (MSM) & Injecting Drug Users (IDU)
 Provide information for estimates and future projections of
HIV/AIDS in the country;
 Use such data to mobilize the national political and social
leaders as well as to generate external support for the
programme;
 Provide useful data for appropriate planning of health and
medical care services
Site Selection & Sample Size: ANC,
STD, FSW, IDU & MSM Sites
Sites were selected considering the different geographical
locations, high risk populations & low risk populations

400 samples collected from each ANC sentinel site in a period of 3
month- Sentinel group is the ANC attendees / pregnant women
attending the clinic for the first time during this period.

In the case of STD clinic the sample size is 250 of them 150 from
STD clinic & 100 from Gyno clinic of same institution.

250 samples collected from identified TI clinic for FSW, IDU, MSM in
a period of 3 months- sentinel groups are FSW, IDU, MSM.
1.
Samples were collected (a) Maintaining consecutiveness, (b)
Following inclusion criteria.
2.
Testing done at (a) Pre-designated testing centers at Microbiology/
Virology units of teaching institutions in a unlinked anonymous
manner.
Sentinel Sites
 1998 (R-1):
6 Sites (3ANC+3STD)
 1998 (R-2):
8 Sites (4ANC+4STD)
 1999 (R-3):
8 Sites (4ANC+4STD)
 2000 (R-4):
9 Sites (4ANC+5STD)
 2001 (R-5):
14 Sites (8ANC+6STD)
 2002 (R-6):
19Sites(9ANC+9STD+1IDU)
 2003 (R-7):
27 Sites(9ANC+10STD+1IDU+7FSW)
 2004 (R-8):
28 Sites (9ANC+10STD+1IDU+7FSW+1MSM)
 2005 (R-9):
33 Sites (9ANC+12STD+4IDU+7FSW+1MSM)
New STD & IDU Sites-2005
STD Sites:
 Hoogly DH
 Medinipur Medical College & Hospital
IDU Sites:
 SCIR-Siliguri
 SCIR-Lalgola
 Kripa Foundation-Darjeeling
Sentinel Surveillance Sites:2005
ANC
STD
FSW
IDU
MSM
Site Type
No of Sites
ANC
9
STD
12
FSW
7
IDU
4
MSM
1
Total
33
Analytical Approach:
A Few Illustrative Examples
HIV Sentinel Surveillance Report, West
Bengal :1998-2005
STD
ANC
No. of
Sentinel
Sites
No.
Tested
Total +ve
%
No. of Sentinel
Sites
No.
Tested
Total
+ve
%
-1998
3
750
18
2.40
3
1200
5
0.42
2nd-1998
4
951
12
1.26
4
1320
6
0.45
3rd-1999
4
819
11
1.34
4
1537
2
0.13
4th-2000
5
1101
19
1.73
4
1520
6
0.39
5th-2001
6
1493
12
0.8
8
3200
5
0.16
6th 2002
9
2106
47
2.23
9
3600
11
0.31
7th- 2003
10
2392
64
2.68
9
3425
15
0.44
8th -2004
10
2368
66
2.76
9
3481
15
0.43
9th -2005
12
2511
62
2.47
9
3238
29
0.90
2. 15
Total
(R1+R2+R3+R
4+R5+R6+R7
+R8+R9)
22521
94
0.42
Round
1st
Total
(R1+R2+R3+R4+R
5+R6+R7+R8+R9)
14491
311
HIV Sentinel Surveillance Report, West
Bengal :1998-2005
IDU
FSW
No. of
Sentinel
Sites
No.
Tested
Total
+ve
1st-1998
-
-
2nd-1998
-
3rd-1999
MSM
%
No. of
Sentine
l Sites
No.
Teste
d
Total
+ve
%
No. of
Sentinel
Sites
No.
Teste
d
Total
+ve
%
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
4th-2000
-
-
-
-
-
-
-
-
-
-
-
-
5th-2001
-
-
-
-
-
-
-
-
-
-
-
-
6th 2002
-
-
-
-
1
205
3
1.46
-
-
-
-
7th- 2003
7
1750
113
6.46
1
230
6
2.61
-
-
-
-
8th -2004
7
1750
72
4.11
1
225
5
2.22
1
150
2
1.33
9th -2005
7
1383
94
6.80
4
998
74
7.41
1
186
1
0.54
5.71
(R6+
R7+R
8+R9
)
1658
88
5.31
(R8+
R9)
336
3
0.89
Round
Total
(R1+R2+R3+R4+
R5+R6+R7+R8+
R9)
4883
279
HIV Infection Trend-1998-2005
Percentage Prevalence of HIV Infection -STD ,ANC FSW,
IDU, MSM Sites in West Bengal (1998-2005)
Percentage Prevalence
8
7.41
7
6.46
6.8
6
5
4.11
4
3
2
1
2.68
2.23
2.32
0.42
1.26
0.45
1.34
1.73
2.61
0.8
0.13
0.39
1.46
0.16
0.31
2.79
2.22
1.33
2.47
0.9
0.44
0.43
0
0.54
R-1: 1998 R-2:1998 R-3: 1999 R-4: 2000 R-5: 2001 R-6: 2002 R-7: 2003 R-8: 2004 R-9: 2005
Time Period (1998-2005)
STD
ANC
IDU
FSW
MSM
% Prevalence 2003 ………..2005
8
7.41
7
6.46
6.8
6
5
4.11
4
3
2.68 2.79
2.47
2
2.61
2.22
0.9
1.33
0.44 0.43
1
0.54
0
STD
ANC
2003
FSW
2004
IDU
2005
MSM
% Prevalence District wise in West Bengal-2004-2005
1.25
ANC
0.26
Koochbehar
0
Darjeeling
0.5
STD
0.84
3.02
0.94
0.93
0.82
2004
0
0
0
0
2.27
0.41
Dakshin
Dinajpur
Bankura
0.5
2.25
South 24
PGS
0
4.8
Kolkata
19.74
0.65
1
0
0.5
1
1.5
% Prevalence
2.04
0.82
Burdwan
1.25
Burdwan
3.24
1.2
South 24 Pgs
2
2.5
1.51
1.6
2.46
East Medinipur
0
4.8
1.65
Jalpaiguri
0.5
Uttar
Dinajpur
Howrah
2005
1.5
Purba
Medinipur
3.4
Murshidabad
0
Purulia
Hoogly
Nadia
0.25
Maldah
1.19
Paschim
Medinipur
2.25
Kolkata
0
5
10
15
% Prevalence
20
25
% Prevalence District wise in West Bengal-2004-2005
2.54
Murshidabad
FSW
2
6
5.6
Jalpaiguri
8
Purba
Medinipur
9.6
2005
2004
6.67
Kolkata
2.8
6.8
Burdwan
4.4
8
South 24
Pgs
1.6
0
2
4
6
8
% Prevalence
10
12
ANC Sites - 2005
HIV
S.No
District Name
Site Name
1
Kolkata
Abinash Dutta Maternity
Home
400
9
2.25
2
0.50
2
Uttar Dinajpur
Raiganj District Hospital
400
2
0.50
19
4.75
3
Maldah
Malda District Hospital
400
1
0.25
22
5.50
4
South 24 PGS
Bijaygarh State General
Hospital
89
2
2.25
3
3.37
5
Coochbehar
Coochbehar District Hospital
(MJN)
391
1
0.26
6
1.53
6
Darjeeling
Darjeeling District Hospital
359
3
0.84
9
2.51
7
Burdwan
Durgapur SD Hospital
400
5
1.25
5
1.25
8
Purulia
Purulia District Hospital
400
6
1.50
10
2.50
9
Purba
Medinipur
Tamluk District Hospital
399
0
0.00
14
3.51
3238
29
0.90
90
2.78
Total
Number
Tested
Number
Positive
VDRL
%
Positive
Number
Positive
%
Positive
STD Sites-2005
HIV
S.No
District Name
Site Name
1
Nadia
Krishnagar Sadar Hospital
215
2
0.93
6
2.79
2
Hoogly
Hoogly District Hospital
147
5
3.40
6
4.08
3
Murshidabad
Berhampur District Hospital
250
12
4.80
5
2.00
4
Purba Medinipur
Haldia SD Hospital
250
4
1.60
16
6.40
5
Paschim
Medinipur
Mednipur Medical College Hospital
84
1
1.19
3
3.57
6
Burdwan
Burdwan Medical College Hospital
245
5
2.04
26
10.61
7
Dakshin Dinajpur
Balurghat Sadar Hospital
176
4
2.27
1
0.57
8
Kolkata
Kolkata Medical College & Hospital
250
12
4.80
24
9.60
9
Bankura
Bankura Sammilani Medical
College Hospital
199
3
1.51
19
9.55
10
Jalpaiguri
Jalpaiguri District Hospital
249
0
0.00
6
2.41
11
South 24 PGS
M R Bangura Hospital
247
8
3.24
8
3.24
12
Howrah
Howrah District Hospital
199
6
3.02
7
3.52
2511
62
2.47
127
5.06
Total
Number
Tested
Number
Positive
VDRL
%
Positive
Number
Positive
%
Positive
FSW Sites-2005
HIV
VDRL
S.No
District Name
Site Name
1
South 24 PGS
Diamond Harbour TI Project
250
20
8.00
5
2.00
2
Kolkata
Kolkata SHIP TI Project
250
26
10.40
51
20.40
3
Burdwan
Durgapur 9 RLA TI project
250
17
6.80
39
15.60
4
Purba
Medinipur
Haldia (VES) TI project
250
20
8.00
24
9.60
5
Jalpaiguri
Jalapaiguri TI Project
50
3
6.00
13
26.00
6
Kolkata
Kolkata DMSC TI project
215
5
2.33
14
6.51
7
Murshidabad
Berhampur TI project
118
3
2.54
14
11.86
1383
94
6.80
160
11.57
Total
Number
Tested
Number
Positive
%
Positive
Number
Positive
%
Positive
IDU & MSM Sites-2005
IDU
HIV
S.No
District Name
Site Name
1
Kolkata
SCIR_Kolkata
250
7
2.80
7
2.80
2
Murshidabad
SCIR-Lalgola
248
2
0.81
15
6.05
3
Darjeeling
SCIR-Siliguri
250
40
16.00
2
0.80
4
Darjeeling
Kirpa
Foundation,Darjeeling
250
25
10.00
21
8.40
998
74
7.41
45
4.51
Total
Number
Tested
Number
Positive
VDRL
%
Positive
Number
Positive
%
Positive
MSM
HIV
S.No
1
Total
District Name
Site Name
Kolkata
Manas Bangla
Number
Tested
Number
Positive
VDRL
%
Positive
Number
Positive
%
Positive
186
1
0.54
2
1.08
186
1
0.54
2
1.08
ANC Sites-2005
No. of Sites-9
Sample Tested-3238
Found Positive -29
Percentage Prevalence-0.90%
HIV Prevalence by Age Group
0.95
1.00
0.83
0.80
0.51
0.60
HIV Prevalence by Locality
0.40
0.20
0.00
0
15-19
20-29
30-44
HIV %
Prevalence
HIV %
Prevalence
Age, Locale, Migration & Literacy
Distribution-ANC Sites
1.25
1.40
1.20
1.00
0.80
0.60
0.40
0.20
0.00
45-49
0.55
Urban
Age Group
Locality
0.9
0.89
Yes
No
Migration
HIV Prevalence by Literacy
HIV %
Prevalence
HIV %
Prevalence
HIV Prevalence by Migration
0.91
0.90
0.90
0.89
0.89
R ural
1.50
1.00
0.50
1.17
1.01
0.7
0
0.00
Illiterate Literate & Till 12th
till 5th
Education
Graduate
& above
HIV % Prevalence
2.50
2.00
1.50
1.00
0.50
0.00
Agri/Unskilled
worker
0.38
Occupation
Student
0.7
1.1
Unemployed
1.31
Business
2.08
Service Class
People
Hotel Staff
Indust./Factory
workers
Truck/Auto/Taxi
Driver
Occupation of Spouse -ANC
HIV Prevalence by Occupation (Spouse)
1.88
1.29
0
STD Sites-2005
No. of Sites-12
Sample Tested-2511
Found Positive -62
Percentage Prevalence-2.47%
Sex Distribution-STD Sites
HIV %
Prevalence
HIV Prevalence by Sex
4.00
3.00
2.00
1.00
0.00
3.45
1.8
M ale
F emale
Sex
Age Distribution-STD Sites
HIV %
Prevalence
HIV Prevalence by Age Group
5.00
4.00
3.00
2.00
1.00
0.00
4.36
1.89 1.45
1.3
15- 19
2.79 2.92 2.29 2.5 2.4
2.22
1.92
1.75
20-29
30-44
Age Group
45 -49
Male
Female
Total
Locale Distribution-STD Sites
HIV %
Prevalence
HIV Prevalence by Locality
5.00
4.00
3.00
2.00
1.00
0.00
3.83
2.87 3.16
2.07
1.662.21
Urban
R ural
Locality
Male
Female
Total
Status of Migration-STD Sites
HIV %
Prevalence
HIV Prevalence by Migration
7.00
6.00
5.00
4.00
3.00
2.00
1.00
0.00
6.45
5.07
2.73
2.78
1.732.12
Yes
No
Migration
Male
Female
Total
Literacy Status-STD Sites
HIV %
Prevalence
HIV Prevalence by Literacy
Male
Female
Total
5.00 4.76
3.03 3.71 2.72 3.13
4.00
2.32
3.00
2.02
2.03
2.00
1.1
1.00
0 0 0
0.00
Illiterate Literate & Till 12th Graduate &
till 5th
above
Education
Self Occupation –STD Sites
Male
Female
Total
HIV %
Prevalence
HIV Prevalence by Occupation
6.00 5.22
5.00 3.92 3.77 4.44 3.92
3.67
4.00 3.59
3.00
2.00
1.00
0
0
0.00
5.
7
1
5.13 5.41
3.3 2.96
2.67
2.08
1.96
0
0
Agri/Unskil ed Truck/Auto/Taxi Indust./Factory Hotel Staff Service Class Business
worker
Driver
workers
People
Occupation
000
Unemployed
1.39 1.52 1.52
0 0
Student
Housewife
Clinical Diagnosis-STD Sites
Percentage
Clinical Diagnostics
M ale
F emale
T o tal
100.00
78.62
80.00
62.09
60.00 47.14
37.67
25.97
40.00
7.35
11.62
6.61 7.05 7 2.27 4.18
20.00
0.00
Type of STDs
FSW Sites-2005
No. of Sites- 7
Sample Tested-1383
Found Positive -94
Percentage Prevalence-6.80%
Age, Locale, Migration & Literacy
Distribution-FSW Sites
10.00
8.00
6.00
4.00
2.00
0.00
HIV Prevalence by Locality
8.64
6.02
3.48
15-19
2.44
20-29
30-44
HIV %
Prevalence
HIV %
Prevalence
HIV Prevalence by Age Group
7.59
8.00
6.00
4.00
2.00
0.00
45-49
Urban
HIV Prevalence by Migration
7.41
6.3
Yes
No
Migration
R ural
Locality
HIV Prevalence by Literacy
HIV %
Prevalence
HIV %
Prevalence
Age Group
7.50
7.00
6.50
6.00
5.50
5.95
10.00
8.00
6.00
4.00
2.00
0.00
6.14
8.4
6.37
0
Illiterate Literate & Till 12th Graduate
till 5th
& above
Education
Type of STDs
Genital Wart
1.9
Genital
Ulcers &
Discharge
2.1
Urethral/Cer
vical
Discharge
30.00
25.00
20.00
15.00
10.00
5.00
0.00
Clinical Diagnostics
28.1
Genital
Ulcers
Percentage
Clinical Diagnosis-FSW Sites
0.7
IDU Sites-2005
No. of Sites- 4
Sample Tested-998
Found Positive -74
Percentage Prevalence-7.41%
Age, Locale, Migration & Literacy
Distribution-IDU Sites
HIV %
Prevalence
12.00
10.00
8.00
6.00
4.00
2.00
0.00
HIV Prevalence by Locality
10.91
9.09
4.66
15-19
20-29
30-44
2.63
HIV %
Prevalence
HIV Prevalence by Age Group
15.00
10.00
5.00
0.00
10.82
1.39
Urban
45-49
Locality
Age Group
20.83
7.08
Yes
No
Migration
HIV Prevalence by Literacy
HIV %
Prevalence
HIV %
Prevalence
HIV Prevalence by Migration
25.00
20.00
15.00
10.00
5.00
0.00
Rural
40.00
30.00
20.00
10.00
0.00
37.5
7.11
5.6
6.11
Illiterate Literate & Till 12th Graduate
till 5th
& above
Education
Self Occupation -IDU
17.86
14.29
10.67
10.45
8.05
6.67
Occupation
Housewife
Student
Unemployed
2.73
Business
Service Class
People
Hotel Staff
4
Indust./Factory
workers
3.96
Truck/Auto/Taxi
Driver
20.00
18.00
16.00
14.00
12.00
10.00
8.00
6.00
4.00
2.00
0.00
Agri/Unskilled
worker
HIV % Prevalence
HIV Prevalence by Occupation
MSM Sites
No. of Sites-1
Sample Tested-186
Found Positive -1
Percentage Prevalence-0.54
Age,Locale,Migration & Literacy
Distribution-MSM Sites
10.00
8.00
6.00
4.00
2.00
0.00
HIV Prevalence by Locality
8.33
0
0
15-19
20-29
0
30-44
HIV %
Prevalence
HIV %
Prevalence
HIV Prevalence by Age Group
1.11
1.20
1.00
0.80
0.60
0.40
0.20
0.00
0
45-49
Urban
0.60
0.50
0.40
0.30
0.20
0.10
0.00
Locality
HIV Prevalence by Migration
0.57
0
Yes
No
Migration
HIV Prevalence by Literacy
HIV %
Prevalence
HIV %
Prevalence
Age Group
R ural
4.00
3.00
2.00
1.00
0.00
3.33
0
0
Illiterate Literate & Till 12th
till 5th
Education
0
Graduate
& abov e
HIV % Prevalence
4.00
3.50
3.00
2.50
2.00
1.50
1.00
0.50
0.00
Agri/Unskilled
worker
0
Truck/Auto/Taxi
Driver
0
Indust./Factory
workers
0
0
Service Class
People
Hotel Staff
0
Occupation
Business
0
Student
Unemployed
3.57
0
Percentage
40.00 32.26
30.00
20.00
10.00
0.00
Urethral/Cer
vical
Discharge
3.23
Genital
Ulcers &
Discharge
0.54
Type of STDs
8.06
Genital Wart
HIV Prevalence by Occupation
Genital
Ulcers
Occupation & Clinical Diagnosis- MSM Sites
Clinical Diagnostics
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