1. 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

2. 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”.

3. 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

4. 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. 1. 1.Samples were collected (a) Maintaining consecutiveness, (b) Following inclusion criteria. 2. 2.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

5. 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)

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

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

8. Analytical Approach: A Few Illustrative Examples

9. HIV Sentinel Surveillance Report, West Bengal :1998-2005 Round STDANC No. of Sentinel Sites No. TestedTotal +ve% No. of Sentinel Sites No. Tested Total +ve% 1 st -1998 3750182.403120050.42 2nd-1998 4951121.264132060.45 3rd-1999 4819111.344153720.13 4th-2000 51101191.734152060.39 5th-2001 61493120.88320050.16 6th 2002 92106472.2393600110.31 7th- 2003 102392642.6893425150.44 8th -2004 102368662.7693481150.43 9th -2005 122511622.4793238290.90 Total (R1+R2+R3+R4+R 5+R6+R7+R8+R9) 144913112. 15 Total (R1+R2+R3+R 4+R5+R6+R7 +R8+R9) 22521940.42

10. HIV Sentinel Surveillance Report, West Bengal :1998-2005 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-1998 ------------ 2nd-1998 ------------ 3rd-1999 ------------ 4th-2000 ------------ 5th-2001 ------------ 6th 2002 ----120531.46---- 7th- 2003 717501136.46123062.61---- 8th -2004 71750724.11122552.22115021.33 9th -2005 71383946.804998747.41118610.54 Total (R1+R2+R3+R4+ R5+R6+R7+R8+ R9) 48832795.71 (R6+ R7+R 8+R9 ) 1658885.31 (R8+ R9) 33630.89

11. HIV Infection Trend-1998-2005

12. % Prevalence 2003 ………..2005

13. % Prevalence District wise in West Bengal-2004-2005 ANC STD

14. FSW

15. ANC Sites - 2005 HIVVDRL S.NoDistrict NameSite NameNumber Tested Number Positive % Positive Number Positive % Positive 1KolkataAbinash Dutta Maternity Home 40092.2520.50 2Uttar DinajpurRaiganj District Hospital 40020.50194.75 3MaldahMalda District Hospital 40010.25225.50 4South 24 PGSBijaygarh State General Hospital 8922.2533.37 5CoochbeharCoochbehar District Hospital (MJN) 39110.2661.53 6DarjeelingDarjeeling District Hospital 35930.8492.51 7BurdwanDurgapur SD Hospital 40051.255 8PuruliaPurulia District Hospital 40061.50102.50 9Purba Medinipur Tamluk District Hospital 39900.00143.51 Total 3238290.90902.78

16. STD Sites-2005 HIVVDRL S.NoDistrict NameSite NameNumber Tested Number Positive % Positive Number Positive % Positive 1NadiaKrishnagar Sadar Hospital 21520.9362.79 2HooglyHoogly District Hospital 14753.4064.08 3MurshidabadBerhampur District Hospital 250124.8052.00 4Purba MedinipurHaldia SD Hospital 25041.60166.40 5Paschim Medinipur Mednipur Medical College Hospital 8411.1933.57 6BurdwanBurdwan Medical College Hospital 24552.042610.61 7Dakshin DinajpurBalurghat Sadar Hospital 17642.2710.57 8KolkataKolkata Medical College & Hospital 250124.80249.60 9BankuraBankura Sammilani Medical College Hospital 19931.51199.55 10JalpaiguriJalpaiguri District Hospital 24900.0062.41 11South 24 PGSM R Bangura Hospital 24783.248 12HowrahHowrah District Hospital 19963.0273.52 Total 2511622.471275.06

17. FSW Sites-2005 HIVVDRL S.NoDistrict NameSite NameNumber Tested Number Positive % Positive Number Positive % Positive 1South 24 PGSDiamond Harbour TI Project 250208.0052.00 2KolkataKolkata SHIP TI Project 2502610.405120.40 3BurdwanDurgapur 9 RLA TI project 250176.803915.60 4Purba Medinipur Haldia (VES) TI project 250208.00249.60 5JalpaiguriJalapaiguri TI Project 5036.001326.00 6KolkataKolkata DMSC TI project 21552.33146.51 7MurshidabadBerhampur TI project 11832.541411.86 Total1383946.8016011.57

18. IDU & MSM Sites-2005 HIVVDRL S.NoDistrict NameSite NameNumber Tested Number Positive % Positive Number Positive % Positive 1KolkataSCIR_Kolkata25072.807 2MurshidabadSCIR-Lalgola24820.81156.05 3DarjeelingSCIR-Siliguri2504016.0020.80 4DarjeelingKirpa Foundation,Darjeeling 2502510.00218.40 Total998747.41454.51 IDU HIVVDRL S.NoDistrict NameSite NameNumber Tested Number Positive % Positive Number Positive % Positive 1KolkataManas Bangla18610.5421.08 Total18610.5421.08 MSM

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

20. Age, Locale, Migration & Literacy Distribution-ANC Sites

21. Occupation of Spouse -ANC

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

23. Sex Distribution-STD Sites

24. Age Distribution-STD Sites

25. Locale Distribution-STD Sites

26. Status of Migration-STD Sites

27. Literacy Status-STD Sites

28. Self Occupation –STD Sites

29. Clinical Diagnosis-STD Sites

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

31. Age, Locale, Migration & Literacy Distribution-FSW Sites

32. Clinical Diagnosis-FSW Sites

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

34. Age, Locale, Migration & Literacy Distribution-IDU Sites

35. Self Occupation -IDU

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

37. Age,Locale,Migration & Literacy Distribution-MSM Sites

38. Occupation & Clinical Diagnosis- MSM Sites

39. THANK YOU