HIV infection and sexual behaviour among women with infertility in Tanzania: a hospital-based study.

BACKGROUND: Infertility is common in Africa, but virtually no data exist on HIV prevalence among infertile women. Mainly anthropological studies in Africa have shown that infertile women have higher risks of marital instability and possibly also have more sexual partners than fertile women. METHOD: This study was conducted in a hospital in northwest Tanzania during 1994 and 1995. Women presenting themselves with infertility problems to the outpatient clinic were interviewed, examined and blood was drawn. Women who came to deliver in the hospital, excluding primiparae, were taken as a control group. The analysis was limited to women > or = 24 years. In total 154 infertile and 259 fertile women were included in the study. RESULTS: HIV prevalence was markedly higher among infertile women than among fertile women: 18.2% and 6.6% respectively (adjusted odds ratio [OR] for age, residence and occupation 2.7; 95%-confidence interval [CI]: 1.4-5.3). Data on past sexual behaviour showed that infertile women had more marital breakdowns, more lifetime sexual partners and a higher level of exposure to sexually transmitted diseases (STD). CONCLUSION: Women with fertility problems appear to have higher HIV prevalence, which justifies more attention for such women in the context of AIDS programmes. In addition, caution is needed when using sentinel surveillance data from antenatal clinics to monitor HIV prevalence.

PIP: Infertility is common in Africa. Anthropological studies conducted on the continent have found infertile women to have higher risks of marital instability and possibly more sex partners than fertile women. Findings are reported from a study conducted during 1994 and 1995 in a hospital in northwest Tanzania to determine the prevalence of HIV infection among infertile women. Women presenting with infertility problems to the outpatient clinic were interviewed, examined, and blood was drawn. Women who came to deliver in the hospital, excluding primiparae, comprised the control group. A total of 154 infertile and 259 fertile women were included in the study, all age 24 years and older. 18.2% of infertile women and 6.6% of fertile women were infected with HIV. Data on past sex behavior indicated that infertile women had more marital breakdowns, more lifetime sex partners, and a higher level of exposure to sexually transmitted diseases.

Occupational exposure to the risk of HIV infection among health care workers in Mwanza Region, United Republic of Tanzania.

During 1993, we collected data on knowledge of human immunodeficiency virus (HIV) transmission, availability of equipment, protective practices and the occurrence of prick and splash incidents in nine hospitals in the Mwanza Region in the north-west of the United Republic of Tanzania. Such incidents were common, with the average health worker being pricked five times and being splashed nine times per year. The annual occupational risk of HIV transmission was estimated at 0.27% for health workers. Among surgeons, the risk was 0.7% (i.e. more than twice as high) if no special protective measures were taken. Health workers' knowledge and personal protective practices must therefore be improved and the supply of protective equipment supported. Reduction of occupational risk of HIV infection among health workers should be an integral part of acquired immunodeficiency syndrome (AIDS) control strategies.

PIP: An investigation of occupational exposure to human immunodeficiency virus (HIV) among health workers in hospitals in Tanzania's Mwanza region raised serious concerns about a lack of protective measures against such risk. Data, including questionnaires and direct observation, were collected during May-September 1993 in 9 hospitals in the region. Among the 403 hospital workers who completed an acquired immunodeficiency syndrome (AIDS)-related questionnaire, 71% had adequate knowledge scores. On the other hand, observation of hospital wards revealed insufficient measures to reduce the risk of HIV transmission (e.g., non-functioning water taps, lack of plastic bags for disposal of soiled linen, widespread shortage of gloves). 9.2% of 623 nurses and 1.3% of 118 doctors and medical assistants interviewed had pricked themselves in the preceding week; 22% of nurses working in labor wards and 25% of those working in operating theaters had pricked themselves in the previous month. Among the 50 laboratory technicians interviewed, 25% had been pricked in the previous month. In addition, more than half of nursing and medical personnel has been splashed, largely by blood and amniotic fluid, in the preceding month. Assuming an HIV prevalence of 20% among hospital patients in Mwanza, the estimated annual incidence of HIV infection due to occupational exposure is 0.27%, with percutaneous exposure contributing 93% of this risk. Among surgeons, this risk is even higher: 0.7% per year. Prevention of pricking accidents through use of double gloving, forceps to remove syringes, and appropriate containers for needle disposal should be a priority to reduce the risk of occupational HIV exposure.

Fibrodysplasia (myositis) ossificans progressiva in Dominica.

Fibrodysplasia (myositis) ossificans progressiva is a rare but severely disabling disease in which ossification forms within muscle and leads to progressive restriction of the movements of the jaw, neck, shoulders and hips. Shortening of the big toes is usually present. It is important to recognise this disease as avoidance of intra-muscular injections, surgery and trauma reduces the risk of further ossification.

Fibrodysplasia (myositis) ossificans progressiva in Dominica

Fibrodysplasia (myositis) ossifcans progressiva is a rare but severely disabling disease in which ossification forms within muscle and leads to progressive restriction of the movements of the jaw, neck, shoulders and hips. Shortening of the big toes is usually present. It is important to recognise this disease as avoidance of intra-muscular infections, surgery and trauma reduces the risk of further ossification (AU)

Fibrodysplasia (Myositis) ossificans progressiva in Dominica

Fibrodysplasia (myositis) ossificans progressiva is a rare but severely disabling disease in which ossification forms within muscle and leads to progressive restriction of the movements of the jaw, neck, shoulders and hips. Shortening of the big toes is usually present. It is important to recognise this disease as aboidance of intra-muscular injections, surgery and trauma reduces the risk of further ossification