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Zambia: cases and investigations

Unexpected infections in children. 1991-93: In 1991-93, WHO’s Global Programme on AIDS arranged for hospitals to test children aged 6-59 months (1/2 to 5 years old) admitted to pediatric care and their mothers in 4 cities in Africa: Kigali, Rwanda; Dar es Salaam, Tanzania; Kampala, Uganda; and Lusaka, Zambia. Out of 5,593 child-mother pairs, 61 (1.1%)  children were HIV-positive with HIV-negative mothers. Reports from this study do not give any breakdown by country. The authors conclude (incredibly!): “The risk of nosocomial and non-perinatally acquired HIV infection appears low among these populations.” This shows a double-standard for Africa; if 1% of inpatient Europeans had unexpected HIV infections, such a conclusion would be unacceptable. Source: Hitimana D, Luo-Mutti C, Madraa B, et al. A multicentre matched case control study of possible nosocomial HIV-1 transmission in infants and children in developing countries. 9th Int Conf AIDS, Berlin 6-11 June 1993. Abstract no. WS-C13-2. Available at: http://ww1.aegis.org/aidsline/1993/nov/M93B3075.html  (accessed 31 August 2012).

Unexpected infections in young adults, 1997-98: In a 1997-98 survey among young adults aged 15-24 years in Ndola city, 7.6% (8/106) of women who said they were virgins were HIV-positive vs 34.9% (119/341) of sexually active women. Among men who said they were virgins, 4.8% (3/63) were HIV-positive vs 10.4% (19/182) of sexually active men. The source that reports these data asserts that men and women “misreported their sexual activity.” Is that so? For that matter, the high percentages of sexually active young adults with HIV are hard to explain by sex (with 1 transmission in 1,000 coital acts). A lot of HIV infections among Ndola’s sexually active young adults may have come from blood exposures: sexually active men and/or women get injections for birth control, treating sexual sores, and vaccinations to prevent neo-natal tetanus. Source: Buve A, Lagarde E, Carael M, et al. Interpreting sexual behavior data: validity issues in the multicentre study on factors determining the differential spread of HIV in four African cities. AIDS 2001; 15 (suppl 4): S117-S126. Abstract available at: http://www.ncbi.nlm.nih.gov/pubmed/11686460 (accessed 27 January 2012).

Unexpected infections in young adults, 2007: Among young adults aged 15-24 years, a random sample national survey in 2007 found that 3.4% of women who said they were virgins were HIV-positive compared to 8.5% of all young adult women. Among young adult men, 3.5% of those who said they were virgins were HIV-positice vs. 6.5% of all young adult men. Source: Table 14.8 in: Central Statistical Office (CSO), Ministry of Health (MOH), Tropical Diseases Research Centre (TDRC), University of Zambia, and Macro International Inc. 2009. Zambia Demographic and Health Survey 2007. Calverton, Maryland, USA: CSO and Macro International Inc. Available at: http://measuredhs.com/pubs/pdf/FR211/FR211[revised-05-12-2009].pdf (accessed 19 January 2012).

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