Presented by: Dr. N Deb, Dy. Director Surveillance WEST BENGAL STATE AIDS PREVENTION AND CONTROL SOCIETY Presented by: Dr. N Deb, Dy. Director Surveillance SENTINEL SURVEILLANCE IN WEST BENGAL 2005

Definition HIV surveillance can be defined as “A collection of epidemiological information of sufficient accuracy and completeness regarding the distribution and spread of HIV infection to be relevant to the planning and implementation of HIV / AIDS prevention and control programme activities”.

Objectives  Determine the geographical spread of HIV infection  Monitor the trends of HIV epidemic  Know the prevalence of the infection in high risk group like Sexually transmitted disease (STD) clinic attendees  Measure the prevalence of the HIV infection in the general population through testing the antenatal clinic attendees.  Measure the prevalence of the infection in the targeted intervention groups of Female Sex Workers (FSW), Men Having Sex with Men (MSM) & Injecting Drug Users (IDU)  Provide information for estimates and future projections of HIV/AIDS in the country;  Use such data to mobilize the national political and social leaders as well as to generate external support for the programme;  Provide useful data for appropriate planning of health and medical care services

Site Selection & Sample Size: ANC, STD, FSW, IDU & MSM Sites   400 samples collected from each ANC sentinel site in a period of 3 month- Sentinel group is the ANC attendees / pregnant women attending the clinic for the first time during this period.   In the case of STD clinic the sample size is 250 of them 150 from STD clinic & 100 from Gyno clinic of same institution.   250 samples collected from identified TI clinic for FSW, IDU, MSM in a period of 3 months- sentinel groups are FSW, IDU, MSM Samples were collected (a) Maintaining consecutiveness, (b) Following inclusion criteria Testing done at (a) Pre-designated testing centers at Microbiology/ Virology units of teaching institutions in a unlinked anonymous manner. Sites were selected considering the different geographical locations, high risk populations & low risk populations

Sentinel Sites  1998 (R-1): 6 Sites (3ANC+3STD)  1998 (R-2): 8 Sites (4ANC+4STD)  1999 (R-3): 8 Sites (4ANC+4STD)  2000 (R-4): 9 Sites (4ANC+5STD)  2001 (R-5): 14 Sites (8ANC+6STD)  2002 (R-6): 19Sites(9ANC+9STD+1IDU)  2003 (R-7): 27 Sites(9ANC+10STD+1IDU+7FSW)  2004 (R-8): 28 Sites (9ANC+10STD+1IDU+7FSW+1MSM)  2005 (R-9): 33 Sites (9ANC+12STD+4IDU+7FSW+1MSM)

New STD & IDU Sites-2005 STD Sites:   Hoogly DH   Medinipur Medical College & Hospital IDU Sites:   SCIR-Siliguri   SCIR-Lalgola   Kripa Foundation-Darjeeling

Sentinel Surveillance Sites:2005 Site TypeNo of Sites ANC9 STD12 FSW7 IDU4 MSM1 Total33 ANCSTDFSWIDUMSM

Analytical Approach: A Few Illustrative Examples

HIV Sentinel Surveillance Report, West Bengal : Round STDANC No. of Sentinel Sites No. TestedTotal +ve% No. of Sentinel Sites No. Tested Total +ve% 1 st nd rd th th th th th th Total (R1+R2+R3+R4+R 5+R6+R7+R8+R9) Total (R1+R2+R3+R 4+R5+R6+R7 +R8+R9)

HIV Sentinel Surveillance Report, West Bengal : Round FSW IDUMSM No. of Sentinel Sites No. Tested Total +ve% No. of Sentine l Sites No. Teste d Total +ve% No. of Sentinel Sites No. Teste d Total +ve% 1 st nd rd th th th th th th Total (R1+R2+R3+R4+ R5+R6+R7+R8+ R9) (R6+ R7+R 8+R9 ) (R8+ R9)

HIV Infection Trend

% Prevalence 2003 ………..2005

% Prevalence District wise in West Bengal ANC STD

FSW

ANC Sites HIVVDRL S.NoDistrict NameSite NameNumber Tested Number Positive % Positive Number Positive % Positive 1KolkataAbinash Dutta Maternity Home Uttar DinajpurRaiganj District Hospital MaldahMalda District Hospital South 24 PGSBijaygarh State General Hospital CoochbeharCoochbehar District Hospital (MJN) DarjeelingDarjeeling District Hospital BurdwanDurgapur SD Hospital PuruliaPurulia District Hospital Purba Medinipur Tamluk District Hospital Total

STD Sites-2005 HIVVDRL S.NoDistrict NameSite NameNumber Tested Number Positive % Positive Number Positive % Positive 1NadiaKrishnagar Sadar Hospital HooglyHoogly District Hospital MurshidabadBerhampur District Hospital Purba MedinipurHaldia SD Hospital Paschim Medinipur Mednipur Medical College Hospital BurdwanBurdwan Medical College Hospital Dakshin DinajpurBalurghat Sadar Hospital KolkataKolkata Medical College & Hospital BankuraBankura Sammilani Medical College Hospital JalpaiguriJalpaiguri District Hospital South 24 PGSM R Bangura Hospital HowrahHowrah District Hospital Total

FSW Sites-2005 HIVVDRL S.NoDistrict NameSite NameNumber Tested Number Positive % Positive Number Positive % Positive 1South 24 PGSDiamond Harbour TI Project KolkataKolkata SHIP TI Project BurdwanDurgapur 9 RLA TI project Purba Medinipur Haldia (VES) TI project JalpaiguriJalapaiguri TI Project KolkataKolkata DMSC TI project MurshidabadBerhampur TI project Total

IDU & MSM Sites-2005 HIVVDRL S.NoDistrict NameSite NameNumber Tested Number Positive % Positive Number Positive % Positive 1KolkataSCIR_Kolkata MurshidabadSCIR-Lalgola DarjeelingSCIR-Siliguri DarjeelingKirpa Foundation,Darjeeling Total IDU HIVVDRL S.NoDistrict NameSite NameNumber Tested Number Positive % Positive Number Positive % Positive 1KolkataManas Bangla Total MSM

ANC Sites-2005 No. of Sites-9 Sample Tested-3238 Found Positive -29 Percentage Prevalence-0.90%

Age, Locale, Migration & Literacy Distribution-ANC Sites

Occupation of Spouse -ANC

STD Sites-2005 No. of Sites-12 Sample Tested-2511 Found Positive -62 Percentage Prevalence-2.47%

Sex Distribution-STD Sites

Age Distribution-STD Sites

Locale Distribution-STD Sites

Status of Migration-STD Sites

Literacy Status-STD Sites

Self Occupation –STD Sites

Clinical Diagnosis-STD Sites

FSW Sites-2005 No. of Sites- 7 Sample Tested-1383 Found Positive -94 Percentage Prevalence-6.80%

Age, Locale, Migration & Literacy Distribution-FSW Sites

Clinical Diagnosis-FSW Sites

IDU Sites-2005 No. of Sites- 4 Sample Tested-998 Found Positive -74 Percentage Prevalence-7.41%

Age, Locale, Migration & Literacy Distribution-IDU Sites

Self Occupation -IDU

MSM Sites No. of Sites-1 Sample Tested-186 Found Positive -1 Percentage Prevalence-0.54

Age,Locale,Migration & Literacy Distribution-MSM Sites

Occupation & Clinical Diagnosis- MSM Sites

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