Stable antenatal HIV-1 seroprevalence with high population mobility and marked seroprevalence variation among sentinel sites within Nairobi, Kenya.

Date
1999Author
Jackson, DJ
Ngugi, Elizabeth N
Plummer, FA
Kirui P.
Kariuki, C
Ndinya-Achola, JO
Bwayo, JJ
Moses, S
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
Objectives: To monitor and analyse trends in HIV-1 seroprevalence among
antenatal women in Nairobi, Kenya.
Design: Six sequential surveys were carried out among antenatal clinic attenders at
four Nairobi City Council health centres between November 1991 and April 1997.
Methods: A total of 6828 women attending for first antenatal clinic visit were
administered a standard questionnaire to obtain demographic information and were
screened for HIV-1.
Results: HIV-1 seroprevalence rose from 12.1% in the first survey to 16.2% in the
third, completed in October 1993. No rise was observed in subsequent surveys, and
seroprevalence among women under the age of 20 declined after the third survey.
Significant differences in seroprevalence (P < 0.001) were observed in all survey
rounds between women who reported that their province of origin was Nyanza
(22.4% overall), compared with those from other provinces in western Kenya
(14.1%), and the eastern group of provinces (8.9%). The rise in HIV-1
seroprevalence observed between 1991 and 1993 was almost entirely attributable to
the rising seroprevalence among women from Nyanza. There were considerable
differences in HIV-1 seroprevalence among the four health centres, partly accounted
for by differences in the proportion of clinic attenders from different provinces of
origin, which also changed significantly over time.
Conclusions: HIV-1 seroprevalence has stabilized in antenatal women attending
these health centres in Nairobi, and may be declining among women in the
youngest age group. This may reflect stabilization of HIV-1 incidence, but further
observation is required. The levels of infection among Nairobi residents reflect the
evolution of the HIV epidemic in their provinces of origin, and changing client
composition influences HIV-1 seroprevalence at different clinics. HIV sentinel
surveillance should be carried out at multiple sites in large urban centres to monitor
accurately the evolution of the HIV epidemic and the impact of control efforts in
reducing transmission.
URI
www.ncbi.nlm.nih.gov/whalecom0/pubmed/10203383http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/16224
Citation
AIDS. 1999 Apr 1;13(5):583-9Publisher
Department of Community Health, University of Nairobi, Kenya. Department of Medical Microbiology, University of Nairobi Department of Medical Microbiology and Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
Collections
- Faculty of Health Sciences (FHS) [10214]