ABSTRACT
HIV surveillance and screening programs were established at Khartoum Teaching Hospital (KTH) following the first identified HIV case diagnosed in a hemophiliac boy in November 1987. As of December 1995, 15 cases of symptomatic HIV infection have been observed in Sudanese children (< or = 16 years) at KTH. An HIV seroprevalence rate of 35.7% was documented in a group of 28 patients (adults and children) with various congenital coagulation defects. The postulated mode of transmission was through contaminated factor concentrate. Screening of 52,000 volunteer male blood donors (March, 1987-1989) showed an HIV-seroprevalence rate of 0.05%. Selected groups, including 1118 children admitted to KTH during the period 1985-1995, were screened for HIV infection. These included aseptic meningitis/encephalitis group (n = 52), high-risk group (n = 523), children with various chronic and malignant diseases (n = 181), and chronic blood recipients (n = 330). A group of 32 displaced homeless children who survived on the streets were also included. Overall, an HIV seroprevalence rate of 1.2% was established. Among the 15 children with symptomatic HIV infection, tuberculosis accounted for the majority of admissions (33.3%) followed by admission for recurrent infections (20.0%). Of the 13 children with nonparental mode of HIV transmission, a vertical mode was documented in 61.5%. The pattern of HIV infection in Greater Khartoum is similar to that in North Africa and the Middle East. However, the geographic influence of high endemicity in neighboring sub-Saharan countries might change it in the future.
Subject(s)
HIV Infections/epidemiology , Adolescent , Blood Coagulation Disorders/complications , Blood Coagulation Disorders/congenital , Blood Donors , Central Nervous System Infections/complications , Child , Child, Preschool , Female , HIV Infections/complications , HIV Infections/prevention & control , HIV Seroprevalence , Ill-Housed Persons , Humans , Infant , Male , Neoplasms/complications , Nutrition Disorders/complications , Risk Factors , Sudan/epidemiologyABSTRACT
A serosurvey was conducted in Port Sudan and Suakin, Sudan in October and March 1987 to determine the prevalence and risk factors associated with the transmission of hepatitis B, human immunodeficiency virus type 1 (HIV-1), and syphilis among sexually active heterosexuals on the coast of Sudan. A total of 536 subjects, including 202 female prostitutes, 95 long-distance truck drivers, 103 soldiers, 72 Ethiopian refugees, and 54 Sudanese outpatients, were enrolled in the study. Seventy-eight percent (202/259) of the female study subjects were engaged in prostitution, and 57% (157/277) of the men admitted to prior sexual relations with prostitutes. Serologic markers for hepatitis B and syphilis were detected in 68% and 17% of the entire study population, respectively. In contrast, antibody to HIV-1 was detected in none of the 536 sera tested. Risk factors found to be independently predictive of hepatitis B infection by multivariate analysis included prostitution, positive serology for syphilis, and a history of anti-schistosomal therapy. The absence of HIV-1 infection among the prostitutes enrolled in this study is in marked contrast to the current AIDS epidemic in neighboring sub-Saharan countries, suggesting that HIV-1 has not been widely introduced on the coast of Sudan. The high prevalence of serologic markers to hepatitis B and syphilis, however, indicates a potential for HIV-1 in this region.
