Injection Drug User, Female Sex Workers & Combined Male Sex Workers/Hijra (Transgender) Sex Workers per 1000 Adult Men in Six Cities in Pakistan

Background

Considerable HIV transmission occurs among injection drug users (IDUs) in Pakistan and recently the HIV prevalence has been increasing among male (MSW), hijra (transgender; HSW) and female (FSW) sex workers. We describe past and estimate future patterns of HIV emergence among these populations in several cities in Pakistan.

Methods

The density of these key populations per 1000 adult men was calculated using 2011 mapping data from Karachi, Lahore, Faisalabad, Larkana, Peshawar and Quetta, and surveillance data were used to assess bridging between these key populations. We used the UNAIDS Estimation and Projection Package model to estimate and project HIV epidemics among these key populations in Karachi, Lahore, Faisalabad and Larkana.

Results

The density and bridging of key populations varied across cities. Lahore had the largest FSW population (11.5/1000 adult men) and the smallest IDU population (1.7/1000 adult men). Quetta had the most sexual and drug injection bridging between sex workers and IDUs (6.7%, 7.0% and 3.8% of FSW, MSW and HSW, respectively, reported injecting drugs). Model evidence suggests that by 2015 HIV prevalence is likely to reach 17–22% among MSWs/HSWs in Karachi, 44–49% among IDUs in Lahore and 46–66% among IDUs in Karachi. Projection suggests the prevalence may reach as high as 65–75% among IDUs in Faisalabad by 2025. HIV prevalence is also estimated to increase among FSWs, particularly in Karachi and Larkana.

Conclusions

There is a need to closely monitor regional and subpopulation epidemic patterns and implement prevention programmes customised to local epidemics.

Full article at:   http://goo.gl/gGnKI6

By:   Tahira Reza,1 Dessalegn Y Melesse,2 Leigh Anne Shafer,3 Momina Salim,1 Arshad Altaf,1 Altaf Sonia,1 Gayatri C Jayaraman,4 Faran Emmanuel,1,2 Laura H Thompson,2 and James F Blanchard2

¹Canada-Pakistan HIV/AIDS Surveillance Project, Islamabad, Pakistan

²Department of Community Health Sciences, Centre for Global Public Health, University of Manitoba, Winnipeg, Canada

³Department of Internal Medicine, Faculty of Medicine, University of Manitoba, Winnipeg, Canada

⁴Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada

Correspondence to Dr James F Blanchard, Department of Community Health Sciences, Centre for Global Public Health, University of Manitoba, R070-771 McDermot Ave, Winnipeg, Canada R3E 0T6; Email: ac.abotinamu@drahcnalb_semaj

 

More at:  https://twitter.com/hiv_insight

And: http://twitter.com/Prison_Health

Identification of Risk Factors for Hepatitis B and C in Peshawar, Pakistan

Hepatitis B and C need immediate worldwide attention as the infection rates are too high. More than 240 million people have chronic (long-term) liver infections. Every year, about 600,000 people die globally due to the acute or chronic consequences of hepatitis B and more than 350,000 people die from hepatitis C-related liver diseases.

Our study was designed as a case-control, descriptive study. It was conducted through formal interviews by using structured questionnaires. A total of 100 cases were included, with four controls for each case.

This study confirms household contact, history of dental work, history of surgery, sexual contact, and history of transfusion (blood and its components) as the main risk factors which are responsible for the increased prevalence of hepatitis.

The important risk factors, responsible for the high prevalence of hepatitis B and C in our society are household contact, history of dental work, history of surgery, sexual contact, and history of transfusion (blood and its components). The odds ratio of probability for these risk factors are: 4.2 for household contact history, 4.1 for history of dental work, 3.9 for sexual contact, 2.7 for history of surgery, and 2.1 for history of transfusion. Associations of other predictor variables (diabetes status, education level, profession, contact sports, intravenous drug abuse, residence, immunosuppression, and skin tattoos) were not statistically significant.

Below:  Profession versus hepatitis status

Below:  Sexual contact history versus hepatitis status

Below: Injection drug abuse history versus hepatitis status

Below:  Skin tattoos versus hepatitis status

Read more at:  http://ht.ly/Sa0aK 

By: Muhammad Shafiq, Muhammad Nadeem, Zeeshan Sattar, Sohaib Mohammad Khan, Sheikh Muhammad Faheem, Irfan Ahsan, Rabia Naheed,6 Tahir Mehmood Khattak,2 Shahzad Akbar,7 Muhammad Talha Khan, Muhammad Ilyas Khan, and Muhammad Zubair Khan

1Department of Internal Medicine, Khyber Teaching Hospital, University Town, Peshawar, Pakistan

2Department of General Surgery, Nishtar Medical College and Hospital, Dera Ghazi Khan, Punjab, Pakistan

3Department of Internal Medicine, Khyber Medical College, University Campus, Peshawar, Pakistan

4Department of Neurology, King Edward Medical University, Anarkali, Lahore, Pakistan

5Department of Internal Medicine, Mayo Hospital, Phoenix, AZ, USA

6Department of Internal Medicine, Fatima Memorial Hospital, Lahore, Pakistan

7Department of Internal Medicine, Lady Reading Hospital, Andar Shehr, Peshawar, Pakistan

8Department of Internal Medicine, Hayatabad Medical Complex, Hayat Abad, Pakistan

Correspondence: Muhammad Nadeem, Nishtar Medical College and Hospital, House 277, B-C, Block 17, Dera Ghazi Khan, Punjab, Pakistan