Incidence of HIV infection in stable sexual partnerships: a retrospective cohort study of 1802 couples in Mwanza Region, Tanzania.

Objective: To describe the dynamics of HIV transmission in stable sexual partnerships in rural Tanzania.

Design: Retrospective cohort study nested within community-randomized trial to investigate the impact of a sexually transmitted disease treatment program.

Methods: A cohort of 1802 couples was followed up for 2 years, with the HIV status of each couple assessed at baseline and follow-up.

Comparison of HIV prevalences in community-based and antenatal clinic surveys in rural Mwanza, Tanzania.

Objectives: First, to compare the prevalence of HIV infection among women in the general population and antenatal clinic (ANC) attenders in rural Mwanza, Tanzania, and second, to validate a method for adjusting HIV prevalence in ANC attenders to estimate the prevalence in the general female population aged 15-44 years.

Methods: A cross-sectional population survey was conducted in 12 rural communities of Mwanza Region between 1991 and 1992. From the same communities sequential ANC attenders were recruited on two occasions between 1991 and 1993.

HIV incidence and HIV-associated mortality in a cohort of factory workers and their spouses in Tanzania, 1991 through 1996.

Objective: To describe HIV incidence and HIV-associated mortality in a cohort of factory workers and their spouses with access to adequate sexually transmitted diseases (STD) treatment services and moderate exposure to sexual health interventions.

Methods: Follow-up visits at 4-month intervals and home follow-up of those who failed to keep appointments were used to estimate HIV incidence and mortality in a cohort of factory workers and their spouses in Mwanza, Tanzania, during 1991 to 1996.

Results: HIV prevalence at intake was 10.

Spread of HIV infection in a rural area of Tanzania.

Objective: To assess the spread of HIV into rural areas.

Methods: Since 1994 a demographic surveillance system (with 5-monthly rounds) and open adult cohort study have been established in a rural ward in Tanzania. Two sero-surveys of all resident adults aged 15-44 and 15-46 years were conducted in 1994 1995 and 1996-1997 respectively.

HIV-associated adult mortality in a rural Tanzanian population.

Objective: To measure HIV-associated adult mortality in a rural population in Tanzania. To record the signs and symptoms associated with deaths of HIV-positive adults.

Design: Prospective cohort study conducted in the context of a randomized controlled trial to evaluate the impact of a sexually transmitted disease treatment programme.

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.

Sexual behaviour patterns and other risk factors for HIV infection in rural Tanzania: a case-control study.

Objective: To examine the association between HIV infection and patterns of sexual behaviour and other risk factors in a rural Tanzanian population in a case-control study, nested within a randomized trial of improved sexually transmitted disease treatment.

Methods: All HIV-positive patients from the baseline survey of the randomized trial were eligible as cases. Cases (n = 338) and controls (a random sample of one in eight HIV-negative persons; n = 1078) were interviewed about risk factors for HIV infection using a structured questionnaire.

Impact of improved treatment of sexually transmitted diseases on HIV infection in rural Tanzania: randomised controlled trial.

A randomised trial was done to evaluate the impact of improved sexually transmitted disease (STD) case management at primary health care level on the incidence of HIV infection in the rural Mwanza region of Tanzania. HIV incidence was compared in six intervention communities and six pair-matched comparison communities. A random cohort of about 1000 adults aged 15-54 years from each community was surveyed at baseline and at follow-up 2 years later.

HIV-1 incidence and HIV-1 associated mortality in a cohort of urban factory workers in Tanzania.

Objective: To determine HIV-1 incidence and HIV-1 associated mortality in a prospective cohort study. To determine whether the cohort is suitable for studies aiming to determine the impact of interventions on HIV-1 incidence.

Methods: The study population was a cohort of 1772 urban factory workers (1478 men and 294 women) in northwest Tanzania.

A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Baseline survey results.

Objectives: To determine baseline HIV prevalence in a trial of improved sexually transmitted disease (STD) treatment, and to investigate risk factors for HIV. To assess comparability of intervention and comparison communities with respect to HIV/STD prevalence and risk factors. To assess adequacy of sample size.

Reducing the cost of HIV-testing through use of the IgG antibody captured particle adherence test (GACPAT) in district hospitals.

Though the World Health Organization (WHO) has acted to reduce the price of anti-HIV assays for developing countries, the cost of the large-scale testing to be done may still be prohibitive to the health budget of these countries. GACPAT, a modified commercial particle assay, is ten times cheaper than the WHO price of ELISAs. In this study GACPAT was introduced in three district hospital laboratories (DHL) in Tanzania, and the results compared with those on the same sera in a reference laboratory (RL).

Secondary school students: a safer blood donor population in an urban with high HIV prevalence in east Africa.

We evaluated the enrollment of secondary school students as voluntary unremunerated blood donors in a city where the HIV-1 prevalence among the adult population is 11.8%. Between 1st July, 1992 and 1st December, 1993, consecutive blood donors were screened for anti-HIV-1, TPHA, HBsAg and anti-HBc.

Intake of a cohort study of urban factory workers in northwest Tanzania. Risk factors for HIV-1 infection.

A cohort study has been started of urban factory workers and their spouses in Tanzania, in order to 1) identify risk factors for HIV-1 seroconversion, and 2) document changes over time in risk behaviour, in particular condom use and partner change, and determine whether these are associated with a reduced incidence of HIV-1 and other sexually transmitted diseases. We report findings at intake from October 1991 to March 1992. Study participants were interviewed, examined, and screened for HIV-1 and syphilis.

A population-based study of syphilis and sexually transmitted disease syndromes in north-western Tanzania. 2. Risk factors and health seeking behaviour.

Objective: To determine risk factors for syphilis and sexually transmitted disease (STD) syndromes, and to study health seeking behaviour among those with STD syndromes, in the population of Mwanza Region, North-Western Tanzania.

Methods: A population-based random cluster sample survey, stratified by rural, roadside or urban residence, of 4173 individuals aged 15-54 years was performed in 1990-91. The seroprevalence of syphilis and the prevalence and incidence of self-reported genital ulcer syndrome (GUS) and genital discharge syndrome (GDS) are reported in the accompanying paper.

A population-based study of syphilis and sexually transmitted disease syndromes in north-western Tanzania. 1. Prevalence and incidence.

Objective: To determine the prevalence of syphilis and the prevalence and incidence of self-reported STD syndromes in the population of Mwanza Region, North-Western Tanzania.

Methods: A population-based random cluster sample survey, stratified by rural, roadside or urban residence, of 4173 individuals aged 15-54 years was performed in 1990-91. The seroprevalence of syphilis (using TPHA and RPR) and the prevalence and incidence of self-reported genital ulcer syndrome (GUS) and genital discharge syndrome (GDS) were determined.

HIV-1 infection as a risk factor for leprosy; a case-control study in Tanzania.

A case-control study was carried out in Tanzania to determine the relative risk of those with HIV-1 infection for getting leprosy. Cases were 93 consecutively diagnosed patients with leprosy aged 15-54 years from the Mwanza Region. Controls were a representative population sample of 4161 people drawn from a stratified cluster sample from urban areas, roadside settlements, and rural villages.

HIV-1 infection as a risk factor for the development of tuberculosis: a case-control study in Tanzania.

A population-based case-control study was carried out in Mwanza Region, Tanzania, to determine the relative and population attributable risk of human immunodeficiency virus type 1 (HIV-1) infection for developing active tuberculosis. Cases were 441 consecutively diagnosed patients with tuberculosis (all types), aged 15-54 years. Controls were a representative population sample of 4161 people, drawn in a stratified cluster sample from urban areas, roadside settlements, and rural villages.

Sentinel surveillance for HIV-1 among pregnant women in a developing country: 3 years' experience and comparison with a population serosurvey.

Objectives: To establish unlinked, anonymous sentinel surveillance for HIV-1 among pregnant women attending an antenatal clinic, to determine age-specific seroprevalences, to monitor trends and to compare seroprevalence with that detected by a population serosurvey. To establish the sustainability and costs of surveillance.

Design: Sentinel surveillance for HIV through serial collection of unlinked, anonymous seroprevalence data from antenatal care; comparison of sentinel data with those from a population serosurvey; financial and general audit of the sentinel surveillance.

Sentinel surveillance for HIV-1 infection: how representative are blood donors, outpatients with fever, anaemia, or sexually transmitted diseases, and antenatal clinic attenders in Mwanza Region, Tanzania?

Objective: To assess the validity of extrapolation from sentinel data by comparing the HIV-1 prevalence of various sentinel groups with that of the general population in Mwanza Region, Tanzania.

Methods: In a population survey, 4161 individuals were selected in a stratified random cluster sample. Sentinel groups (all in the age group 15-54 years) included blood donors (n = 1090); patients examined at district hospitals for the presence of malaria parasites (n = 1488), anaemia (n = 1339), or syphilis (n = 33); and antenatal clinic attenders (n = 1193).