Presented by: Dr. N Deb, Dy. Director Surveillance WEST BENGAL STATE AIDS PREVENTION AND CONTROL SOCIETY Presented by: Dr. N Deb, Dy. Director Surveillance

WEST BENGAL STATE AIDS PREVENTION AND CONTROL SOCIETY

Presented by: Dr. N Deb, Dy. Director SurveillancePresented by: Dr. N Deb, Dy. Director Surveillance

SENTINEL SURVEILLANCE IN WEST BENGAL 2005

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

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.

Sites were selected considering the different geographical locations, high risk populations & low risk populations

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

Site Type No of Sites

ANC 9

STD 12

FSW 7

IDU 4

MSM 1

Total 33

ANCANC

STDSTD

FSWFSW

IDUIDU

MSMMSM

Analytical Approach: Analytical Approach: A Few Illustrative ExamplesA Few Illustrative Examples

HIV Sentinel Surveillance Report, West Bengal :1998-2005

Round

STD ANC

No. of Sentinel

SitesNo.

TestedTotal +ve %

No. of Sentinel Sites

No. Tested

Total +ve %

1st -1998 3 750 18 2.40 3 1200 5 0.42

2nd-19984 951 12 1.26 4 1320 6 0.45

3rd-19994 819 11 1.34 4 1537 2 0.13

4th-20005 1101 19 1.73 4 1520 6 0.39

5th-20016 1493 12 0.8 8 3200 5 0.16

6th 20029 2106 47 2.23 9 3600 11 0.31

7th- 200310 2392 64 2.68 9 3425 15 0.44

8th -200410 2368 66 2.76 9 3481 15 0.43

9th -2005 12 2511 62 2.47 9 3238 29 0.90

Total (R1+R2+R3+R4+R5+R6+R7+R8+R9)

14491 311 2. 15

Total (R1+R2+R3+R4+R5+R6+R7+

R8+R9)

22521 94 0.42

HIV Sentinel Surveillance Report, West Bengal :1998-2005

Round

FSW IDU MSM

No. of Sentinel

SitesNo.

TestedTotal +ve %

No. of Sentinel Sites

No. Teste

dTotal +ve %

No. of Sentinel

Sites

No. Teste

dTotal +ve %

1st-1998 - - - - - - - - - - - -

2nd-1998

- - - - - - - - - - - -

3rd-1999

- - - - - - - - - - - -

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

Total (R1+R2+R3+R4+R5+R6+R7+R8+R

9)

4883 279 5.71(R6+R7+R8+R9)

1658 88 5.31(R8+ R9)

336 3 0.89

HIV Infection Trend-1998-2005

Percentage Prevalence of HIV Infection -STD ,ANC FSW, IDU, MSM Sites in West Bengal (1998-2005)

2.32 2.47

1.46

2.22

6.46

2.792.68

0.8

1.731.341.26

2.23

0.430.13 0.31

0.90.16

0.390.450.42 0.44

2.61

7.41

4.11

6.8

1.33

0.540

1

2

3

4

5

6

7

8

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)

Perc

en

tag

e P

revale

nce

STD ANC IDU FSW MSM

% Prevalence 2003 ………..2005

2.68 2.792.47

0.44 0.43

0.9

6.46

4.11

6.8

2.612.22

7.41

1.33

0.54

0

1

2

3

4

5

6

7

8

STD ANC FSW IDU MSM

2003 2004 2005

% Prevalence District wise in West Bengal-2004-2005

1

0 . 6 5

0 . 5

0

0 . 5

0

1 . 2 5

2 . 2 5

0

1 . 5

0 . 2 5

0 . 2 6

2 . 2 5

0

0

0 . 8 4

0 . 5

1 . 2 5

0 0 . 5 1 1 . 5 2 2 . 5

B u r d w a n

S o u th 2 4P G S

U t ta rD i n a j p u r

P u r b aM e d i n i p u r

P u r u l i a

M a l d a h

D a r j e e l i n g

K o o c h b e h a r

K o l k a ta

% P r e v a l e n c e

2 0 0 5

2 0 0 4

0 . 8 2

2 . 4 6

0

0 . 4 1

1 . 6 5

0 . 8 2

0 . 9 4

3 . 2 4

2 . 0 4

4 . 8

1 . 6

1 . 5 1

2 . 2 7

0

4 . 8

0 . 9 3

3 . 0 2

3 . 4

1 . 1 9

0

1 9 . 7 4

1 . 2

0 5 1 0 1 5 2 0 2 5

S o u th 2 4 P g s

B u r d w a n

K o l k a ta

E a s t M e d i n i p u r

B a n k u r a

D a k s h i nD i n a j p u r

J a l p a i g u r i

M u r s h i d a b a d

N a d i a

H o w r a h

H o o g l y

P a s c h i mM e d i n i p u r


ANCANC

STDSTD

% Prevalence District wise in West Bengal-2004-2005

4 . 4

2 . 8

5 . 6

2

8

6 . 8

6 . 6 7

8

6

2 . 5 4

9 . 6

1 . 6

0 2 4 6 8 1 0 1 2

S o u th 2 4P g s

B u r d w a n

K o l k a ta

P u r b aM e d i n i p u r

J a l p a i g u r i

M u r s h i d a b a d


2 0 0 5

2 0 0 4

FSWFSW

ANC Sites - 2005

HIV VDRL

S.No District Name Site Name Number Tested

Number Positive

% Positive

Number Positive

% Positive

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

Total 3238 29 0.90 90 2.78

STD Sites-2005

HIV VDRL


Number Positive

% Positive

Number Positive

% Positive

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

Total 2511 62 2.47 127 5.06

FSW Sites-2005

HIV VDRL


Number Positive

% Positive

Number Positive

% Positive

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

Total 1383 94 6.80 160 11.57

IDU & MSM Sites-2005

HIV VDRL


Number Positive

% Positive

Number Positive

% Positive

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

Total 998 74 7.41 45 4.51

IDUIDU

HIV VDRL


Number Positive

% Positive

Number Positive

% Positive

1 Kolkata Manas Bangla 186 1 0.54 2 1.08

Total 186 1 0.54 2 1.08

MSMMSM

ANC Sites-2005ANC Sites-2005 No. of Sites-9No. of Sites-9

Sample Tested-Sample Tested-3238 3238

Found Positive -29Found Positive -29 Percentage Prevalence-0.90%Percentage Prevalence-0.90%

Age, Locale, Migration & Literacy Distribution-ANC Sites

H I V P r e v a l e n c e b y A g e G r o u p

0 . 8 30 . 9 5

0 . 5 1

00 .0 0

0 .2 0

0 .4 0

0 .6 0

0 .8 0

1.0 0

15 - 19 2 0 - 2 9 3 0 - 4 4 4 5 - 4 9

A g e G r o u p

HIV

%

Pre

vale

nce

H I V P r e v a l e n c e b y L o c a l i t y

1 . 2 5

0 . 5 5

0 .0 00 .2 00 .4 00 .6 00 .8 01.0 01.2 01.4 0

U r b a n R u r a l

L o c a l i t y

HIV

%

Pre

vale

nce

H I V P r e v a l e n c e b y M i g r a t i o n

0 . 9

0 . 8 9

0 .8 9

0 .8 9

0 .9 0

0 .9 0

0 .9 1

Y e s N o

M i g r a t i o n

HIV

%

Pre

vale

nce

H I V P r e v a l e n c e b y L i t e r a c y

1 . 1 7 1 . 0 10 . 7

00 .0 0

0 .5 0

1.0 0

1.5 0

Illite ra te L ite ra te &t ill 5 th

T ill 12 th G ra d u a te& a b o v e

E d u c a t i o n

HIV

%

Pre

vale

nce

Occupation of Spouse -ANC

H IV P r e v a le n c e b y O c c u p a t io n ( S p o u s e )

1 . 8 8

1 . 11 . 2 9

0

0 . 3 8

1 . 3 1

0 . 7

2 . 0 8

0 .0 0

0 .5 0

1 .0 0

1 .5 0

2 .0 0

2 .5 0

Agr

i/Uns

kille

dw

orke

r

Tru

ck/A

uto/

Tax

iD

river

Indu

st./

Fac

tory

wor

kers

Hot

el S

taff

Ser

vice

Cla

ssP

eopl

e

Bus

ines

s

Une

mpl

oyed

Stu

dent

O c c u p a t io n

HIV

% P

reva

len

ce

STD Sites-2005STD Sites-2005

No. of Sites-12 No. of Sites-12 Sample Tested- Sample Tested-2511 2511

Found Positive -62 Found Positive -62 Percentage Prevalence-2.47%Percentage Prevalence-2.47%

Sex Distribution-STD Sites

H I V P r e v a l e n c e b y S e x

3 . 4 5

1 . 8

0 .0 0

1.0 0

2 .0 0

3 .0 0

4 .0 0

M a l e F e m a l e

S e x

HIV

%

Pre

va

len

ce

Age Distribution-STD Sites


1 . 31 . 9 2 1 . 7 5

2 . 2 21 . 4 5

2 . 7 92 . 2 9 2 . 4

1 . 8 9

4 . 3 6

2 . 9 2 2 . 5

0 .0 0

1.0 0

2 .0 0

3 .0 0

4 .0 0

5 .0 0

15 - 19 2 0 - 2 9 3 0 - 4 4 4 5 - 4 9

A g e G r o u p

HIV %

Pr

evale

nce

M a l e

F e m a l e

T o t a l

Locale Distribution-STD Sites


2 . 0 7 1 . 6 6

2 . 8 72 . 2 1

3 . 8 33 . 1 6

0 .0 0

1.0 0

2 .0 0

3 .0 0

4 .0 0

5 .0 0

U r b a n R u r a l

L o c a l i t y

HIV

%

Pre

va

len

ce

M a l e

F e m a l e

T o t a l

Status of Migration-STD Sites


2 . 7 31 . 7 3

5 . 0 7

2 . 1 2

6 . 4 5

2 . 7 8

0 .0 01.0 0

2 .0 03 .0 04 .0 05 .0 06 .0 07 .0 0

Y e s N o

M i g r a t i o n

HIV

%

Pre

vale

nce

M a l e

F e m a l e

T o t a l

Literacy Status-STD Sites


1.1

0

2 .0 3

0

4 .7 63 .7 1

3 .13

0

2 .0 22 .3 2

2 .7 23 .0 3

0 .0 01.0 0

2 .0 03 .0 04 .0 05 .0 0


T ill 12 th G ra d u a te &a b o v e

E d u c a t i o n

HIV

%

Pre

va

len

ce

M a l e

F e m a l e

T o t a l

Self Occupation –STD Sites

H I V P r e v a l e n c e b y O c c u p a t i o n

2 . 6 73 . 3

0

2 . 0 8

0

5 . 2 2

0 0

5 . 7 1

0 0 0 0

3 . 6 7 3 . 9 2

1 . 9 6

2 . 9 6

0

1 . 3 9

3 . 5 9 3 . 7 74 . 4 4

5 . 1 3

1 . 5 2

3 . 9 2

5 . 4 1

1 . 5 2

0 . 0 01 . 0 02 . 0 03 . 0 04 . 0 05 . 0 06 . 0 0

A g r i / U n s k i l le dw o r k e r

T r u c k / A u t o / T a x iD r iv e r

In d u s t ./ F a c t o r yw o r k e r s

H o t e l S t a ff S e r v ic e C la s sP e o p le

B u s in e s s U n e m p lo y e d S t u d e n t H o u s e w if e

O c c u p a t i o n

HIV %

Pre

valen

ce

M a le

F e m a le

T o t a l

Clinical Diagnosis-STD Sites

C l i n i c a l D i a g n o s t i c s

7 8 .6 2

4 7 .14 3 7 .6 7

6 .6 1 711.6 27 .3 5

2 .2 72 5 .9 7

6 2 .0 9

7 .0 5 4 .180 . 0 0

2 0 . 0 04 0 . 0 06 0 . 0 08 0 . 0 0

1 0 0 . 0 0G

enit

al U

lcer

s

Ure

thra

l/C

ervi

cal

Dis

char

ge

Gen

ital

Ulc

ers

&D

isch

arge

Gen

ital

War

t

T y p e o f S T D s

Pe

rce

nta

ge

M a l e

F e m a l e

T o t a l

FSW Sites-2005FSW Sites-2005 No. of Sites-No. of Sites- 77

Sample Tested-Sample Tested-13831383


Age, Locale, Migration & Literacy Distribution-FSW Sites


3 . 4 8

8 . 6 4

6 . 0 2

2 . 4 4

0 .0 0

2 .0 0

4 .0 0

6 .0 0

8 .0 0

10 .0 0

15 - 19 2 0 - 2 9 3 0 - 4 4 4 5 - 4 9

A g e G r o u p

HIV

%

Pre

val

ence


7 . 5 95 . 9 5

0 .0 0

2 .0 0

4 .0 0

6 .0 0

8 .0 0

U r b a n R u r a l

L o c a l i t y

HIV

%

Pre

vale

nce


7 . 4 1

6 . 3

5 .5 0

6 .0 0

6 .5 0

7 .0 0

7 .5 0

Y e s N o

M i g r a t i o n

HIV

%

Pre

vale

nce


6 . 1 48 . 4

6 . 3 7

00 .0 02 .0 04 .0 0

6 .0 08 .0 0

10 .0 0



E d u c a t i o n

HIV

%

Pre

vale

nce

Clinical Diagnosis-FSW Sites


2 . 1

2 8 . 1

1 . 9 0 . 70 .0 05 .0 0

10 .0 015 .0 0

2 0 .0 02 5 .0 03 0 .0 0

Ge

nita

l

Ulc

ers

Ure

thra

l/Ce

r

vic

al

Dis

ch

arg

e

Ge

nita

l

Ulc

ers

&

Dis

ch

arg

e

Ge

nita

l Wa

rt

T y p e o f S T D s

Pe

rce

nta

ge

IDU Sites-2005IDU Sites-2005 No. of Sites-No. of Sites- 44

Sample Tested-Sample Tested-998998


Age, Locale, Migration & Literacy Distribution-IDU Sites


9 . 0 91 0 . 9 1

4 . 6 62 . 6 3

0 .0 02 .0 04 .0 06 .0 08 .0 0

10 .0 012 .0 0

15 - 19 2 0 - 2 9 3 0 - 4 4 4 5 - 4 9

A g e G r o u p

HIV

%

Prev

alen

ce


1 0 . 8 2

1 . 3 9

0 . 0 0

5 . 0 0

1 0 . 0 0

1 5 . 0 0

U r b a n R u r a l

L o c a l i t y

HIV

%

Pre

va

len

ce


2 0 . 8 3

7 . 0 8

0 .0 0

5 .0 0

10 .0 0

15 .0 0

2 0 .0 0

2 5 .0 0

Y e s N o

M i g r a t i o n

HIV

%

Pre

vale

nce


7 .11 5 .6 6 .11

3 7 .5

0 .0 0

10 .0 0

2 0 .0 0

3 0 .0 0

4 0 .0 0

Illit e ra te L ite ra te &t ill 5 th


E d u c a t i o n

HIV

%

Pre

vale

nce

Self Occupation -IDU


1 0 . 4 5

2 . 7 3

1 0 . 6 7

1 4 . 2 9

1 7 . 8 6

8 . 0 5

3 . 9 6 4

6 . 6 7

0 . 0 02 . 0 04 . 0 06 . 0 08 . 0 0

1 0 . 0 01 2 . 0 01 4 . 0 01 6 . 0 01 8 . 0 02 0 . 0 0

Ag

ri/U

nsk

illed

wo

rker

Tru

ck/A

uto

/Tax

iD

rive

r

Ind

ust

./Fac

tory

wo

rker

s

Ho

tel S

taff

Ser

vice

Cla

ssP

eop

le

Bu

sin

ess

Un

emp

loye

d

Stu

den

t

Ho

use

wif

e

O c c u p a t i o n

HIV

% P

reva

len

ce

MSM SitesMSM Sites

No. of Sites-1No. of Sites-1Sample Tested-186Sample Tested-186

Found Positive -1Found Positive -1 Percentage Prevalence-0.54Percentage Prevalence-0.54

Age,Locale,Migration & Literacy Distribution-MSM Sites


0 0

8 . 3 3

00 .0 0

2 .0 0

4 .0 0

6 .0 0

8 .0 0

10 .0 0

15 - 19 2 0 - 2 9 3 0 - 4 4 4 5 - 4 9

A g e G r o u p

HIV

%

Pre

va

len

ce


0

1 . 1 1

0 .0 00 .2 00 .4 00 .6 00 .8 01.0 01.2 0

U r b a n R u r a l

L o c a l i t y

HIV

%

Pre

va

len

ce


0

0 . 5 7

0 .0 00 .10

0 .2 00 .3 0

0 .4 00 .5 00 .6 0

Y e s N o

M i g r a t i o n

HIV

%

Pre

vale

nce


00

3 . 3 3

00 . 0 0

1 . 0 0

2 . 0 0

3 . 0 0

4 . 0 0

I l l i t e r a t e L i t e r a t e &

t i l l 5 t h

T i l l 1 2 t h G r a d u a t e

& a b o v e

E d u c a t i o n

HIV

%

Pre

va

len

ce

Occupation & Clinical Diagnosis- MSM Sites


0 0

3 . 5 7

00 0 0 00 . 0 00 . 5 01 . 0 01 . 5 02 . 0 02 . 5 03 . 0 03 . 5 04 . 0 0

Agri/

Uns

kille

dw

orke

r

Truc

k/Au

to/T

axi

Driv

er

Indu

st./F

acto

ryw

orke

rs

Hot

el S

taff

Serv

ice

Cla

ssPe

ople

Busi

ness

Une

mpl

oyed

Stud

ent

O c c u p a t io n

HIV

% P

reva

lenc

e


3 2 .2 6

3 .2 3 0 .5 48 .0 6

0 . 0 01 0 . 0 02 0 . 0 03 0 . 0 04 0 . 0 0

Gen

ital

Ulce

rs

Uret

hral/

Cer

vical

Disc

harg

e

Gen

ital

Ulce

rs &

Disc

harg

e

Gen

ital W

art

T y p e o f S T D s

Perc

enta

ge

THANK YOU

Documents

Presented by: Dr. N Deb, Dy. Director Surveillance WEST BENGAL STATE AIDS PREVENTION AND CONTROL SOCIETY Presented by: Dr. N Deb, Dy. Director Surveillance