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Abstract
BackgroundThe occurrence of HIV-1 and syphilis infections during pregnancy poses major health risks to the foetus due to mother-to-child transmission. We conducted surveillance of HIV and syphilis infections among pregnant women attending antenatal clinics (ANCs) in Mainland Tanzania in 2011.MethodsThis surveillance was carried out in 133 ANCs selected from 21 regions in Tanzania. In each region, six ANC sites were selected, with urban, semi-urban, and rural areas contributing two each. All pregnant women who were attending selected sentinel ANC sites for the first time at any pregnancy between September and December 2011 were enrolled. Serial ELISA assays were performed to detect HIV infection in an unlinked anonymous manner using dried blood spot (DBS) after routine syphilis testing. Data analysis was conducted using Stata v.12 software.ResultsA total of 39,698 pregnant women representing 2.4 % of all pregnant women (1.68 million) attending ANCs in the Mainland Tanzania were enrolled. The overall HIV prevalence was found to be 5.6 % (95 % CI: 5.4–5.8 %). The risk for HIV infection was significantly higher among women aged 25–34 (cOR = 1.97, 95 % CI: 1.79–2.16; p < 0.05), older than 35 years (cOR = 1.88, 95 % CI: 1.62–2.17; p < 0.05) and those having 1–2 and 3–4 previous pregnancies. HIV infection was less prevalent among women attending rural ANC clinics (cOR = 0.46, 95 % CI 0.4–0.52; p < 0.05).The overall syphilis prevalence was 2.5 % (95 % CI: 2.3, 3.6). The risk for syphilis infection was significantly higher among women attending semi-urban and rural clinics and those having 3–4, and 5 previous pregnancies (p < 0.05). Marital status and level of education were not statistically significant with either of the two infections. HIV and syphilis co-infections occurred in 109 of 38,928 (0.3 %).ConclusionThe overall prevalence of HIV infection (5.6 %) and syphilis (2.5 %) found among pregnant women attending ANC clinics in Tanzania calls for further strengthening of current intervention measures, which include scaling up the integration of prevention of mother to child transmission (PMTCT) services in Reproductive and Child Health (RCH) clinics.
Highlights
The occurrence of HIV-1 and syphilis infections during pregnancy poses major health risks to the foetus due to mother-to-child transmission
The upper part of the surveillance data collection form that contained the woman’s clinic card number was torn up and discarded in order to ensure de-linking of the client identifier from the respective HIV data that was documented on the surveillance data collection form
Among 39,698 pregnant women enrolled in the surveillance, majority (87 %) were married and nearly half (48.7 %) were aged between 15–24 years
Summary
The occurrence of HIV-1 and syphilis infections during pregnancy poses major health risks to the foetus due to mother-to-child transmission. In many developing countries, including Tanzania, estimates on the magnitude of and trends on the HIV epidemic are obtained through HIV seroprevalence surveys conducted over a period of time [1] These surveys are primarily conducted using sentinel and general population. In Tanzania the most frequently used sentinel populations are women attending antenatal clinics (ANCs) and persons attending clinics for routine diagnosis and treatment of sexually transmitted infections (STIs) [5,6,7]. Apart from these surveys, the country has conducted household surveys to monitor HIV infection and behavioral risks factors in general population [8,9,10]. Results from various surveys have reported varying trends of both HIV and other sexual transmission diseases [8, 11, 12]
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