...
This presentation is the property of its rightful owner.
Sponsored Links
1 / 35

HIV/AIDS GLOBAL, INDIAN & STATE SCENARIO AND ACTIVITIES OF DSACS PowerPoint PPT Presentation


  • 39 Views
  • Uploaded on
  • Presentation posted in: General

Download Presentation

HIV/AIDS GLOBAL, INDIAN & STATE SCENARIO AND ACTIVITIES OF DSACS

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Hiv aids global indian state scenario and activities of dsacs

Dr. A. K.Gupta Additional Project Director Delhi State AIDS Control Society

HIV/AIDS GLOBAL, INDIAN & STATE SCENARIO

AND ACTIVITIES OF DSACS


Hiv aids global indian state scenario and activities of dsacs

TIME LINE

  • 1981- Cases of unusual immune deficiency identified

  • in USA

  • 1982- Acquired Immune Deficiency Syndrome (AIDS)

  • defined for the first time

  • 1983-The Human Immune Deficiency Virus (HIV)

  • identified as the cause of AIDS

  • 1983-In Africa, a heterosexual AIDS epidemic is revealed

  • 1985-The first HIV antibody test becomes available

  • 1987-The WHO launches the Global AIDS Programme


Hiv aids global indian state scenario and activities of dsacs

TIME LINE (contd)

  • 1988-The first therapy for AIDS – zidovudine, or AZT

  • approved for use in the USA

  • 1994- Highly Active Antiretroviral Treatment launched

  • 1996- First treatment regimen to reduce mother-to-child

  • transmission of HIV

  • 1997-Brazil becomes the first developing country to

  • provide antiretroviral therapy through its public

  • health system

  • 2001-Global Fund to fight AIDS, Tuberculosis and Malaria

  • launched

  • 2003-Launch of "3 BY 5" initiative -goal of reaching 3

  • mill people in developing world with ART by 2005


Hiv aids global indian state scenario and activities of dsacs

Global estimates for adults and children, 2008

  • People living with HIV33.4 million[31.1 – 35.8 million]

  • New HIV infections in 20082.7 million [ 2.4 – 3.0 million]

  • Deaths due to AIDS in 20082.0 million[1.7 – 2.4 million]


Hiv aids global indian state scenario and activities of dsacs

Adults and children estimated to be living with HIV, 2008

Eastern Europe & Central Asia

1.5 million

[1.4 – 1.7 million]

Western &

Central Europe

850 000

[710 000 – 970 000]

North America

1.4 million

[1.2 – 1.6 million]

East Asia

850 000

[700 000 – 1.0 million]

Middle East&North Africa

310 000

[250 000 – 380 000]

Caribbean

240 000

[220 000 – 260 000]

South & South-East Asia

3.8 million

[3.4 – 4.3 million]

Sub-Saharan Africa

22.4 million

[20.8 – 24.1 million]

Latin America

2.0 million

[1.8 – 2.2 million]

Oceania

59 000

[51 000 – 68 000]

Total: 33.4 million (31.1 – 35.8 million)


Hiv aids global indian state scenario and activities of dsacs

Over 7400 new HIV infections a day in 2008

  • More than 97% are in low- and middle-income countries

  • About 1200 are in children under 15 years of age

  • About 6200 are in adults aged 15 years and older,

  • of whom:

    • almost 48%are among women

    • about 40% are among young people (15–24)


Indian scenario

Indian Scenario

First case: 1986, Estimates 2007: 2.31 million PLHAs,

86.5% -15-49 years age group (27.9 % in 15-29 and 58.6% in 30-49 age groups)

Epidemic concentrated in H.R.Gs; Spreading From : H.R.Gs to the general population & Urban to Rural areas

Feminization (39.3% - women) of epidemic

7,50,500 HIV +VE Regd. In HIV Care At ART Centers

3,50,000 Initiated on ART

2,60,000 alive and on treatment


Hiv aids global indian state scenario and activities of dsacs

1998

2001

2002

1986

1990

1994

HIV Prevalence reaches over 5% amongst high risk group in Maharashtra and Manipur

First case of HIV detected in Chennai

> 1 % antenatal women

> 5 % high risk groups

< 5 % high risk groups


Hiv aids global indian state scenario and activities of dsacs

TIME LINE –INDIAN ACTIVITIES

  • 1990-1992-AIDS Task Force (ICMR), National AIDS

  • Committee , Medium Term Plan (1990-1992)

  • 1992- NACP I

  • 1997-VCTC SERVICES

  • 1999-NACP PHASE II

  • 2002- NATIONAL PMTCT PROGRAMME

  • 2004- NATIONAL ART PROGRAMME

  • 2004- COMPREHENSIVE PPTCTC PROGRAMME

  • 2006- REVISED WHO ART GUIDELINES

  • 2007-NACP III LAUNCHED


Characteristics of indian epidemic

Characteristics of Indian Epidemic

  • Heterogeneous epidemic

  • A wide variation in HIV prevalence between districts and intra districts even within the states

  • A concentrated epidemic, focused in HRGs (CSWs,MSMs,IDUs)

  • < 1% Prevalence

HIV & Nephrology 23-08-07


Hiv aids global indian state scenario and activities of dsacs

DELHI SCENARIO

  • Total population - 16 million, First case-

  • 1988

  • Estimated PLHAs (2007)- 32,000

  • Low prevalence state (Prevalence in Gen.

  • population- 0.22%)

  • Highly vulnerable state- (Migrant labour-

  • 0.88 million, Truckers stationed/day-35000)

  • Total high risk population ->1.00 Lakh

  • (FSW-61261, MSM- 28999, IDU- 17173)

  • PLHAs detected at ICTCs/VCTCs since 2002- 34,759

  • HIV +VE Regd. In HIV Care At ART Centers : 33,473

  • No. Currently Alive & on ART-9624

  • LFU (7%), DIED (8%) OR TRANSERRED OUT TO ART CENTRES (21%) OF

  • OTHER STATES.


Hiv aids global indian state scenario and activities of dsacs

DELHI STATE AIDS CONTROL SOCIETY- 1ST NOVEMBER, 1998 HAVING A STAFF OF 56 PROGRAMME OFFICERS & SUPPORT STAFF & HEADED BY PROJECT DIRECTOR.

SERVICE OUTLETS – 93 ICTC CENTRES, 17 STI/RTI CLINICS, 9 ART CENTRES, 4 CCCs, 57DICs, 85 T.I PROJECTS FOR HRGs RUN BY NGOs, 21 BLOOD BANKS & 10 BSC, QA -4 SRLs.

FUNDED BY NACO, GOI

SOCIETY & ECCHAIRED BY CHIEF SECY, GNCT OF DELHI

DELHI STATE AIDS COUNCIL CHAIRED BY HON’BLE C.M. OF DELHI

GENERAL BODY – PRESIDENT HON’BLE HM


Hiv aids global indian state scenario and activities of dsacs

HIV Prevalence : States Classified


Categorization of districts in delhi

CATEGORIZATION OF DISTRICTS IN DELHI


Hiv aids global indian state scenario and activities of dsacs

  • Categories of Districts In Delhi

HIV & Nephrology 23-08-07


Dynamics of hiv transmission

Dynamics of HIV Transmission

High Risk Population

GENERAL POPULATION

GENERAL POPULATION

0.22%

0.22%

(2.6 -11%)

Bridging Population

Clients, Truckers, migrant population etc.


Hiv trend among ante natal cases

HIV Trend Among Ante Natal Cases


Hiv aids global indian state scenario and activities of dsacs

PERINATAL

OTHERS

I.D.Us

BLOOD TRANSFUSION

SEXUAL


Risk of transmission

RISK OF TRANSMISSION

  • TRANSFUSION OF INFECTED BLOOD / BLOOD PRODUCTS-> 90%

  • PERINATAL TRANSMISSION- 25-30%

  • SEXUAL ROUTE-(ORAL- 0.01%, VAGINAL -0.1%, ANAL-0.5%)

  • PERCUTANEOUS NEEDLE STICK- 3: 1000 (0.3%)


Hiv aids global indian state scenario and activities of dsacs

1. Prevention

Of New Infection

2. Care,

Support &

Treatment

3. Institutional

Strengthening

Capacity

building

4. Strategic

Management

Information

system

  • Targeted intervention-85

  • STI Diagnosis & treatment-17

  • Condom promotion

  • Blood Safety-53

  • ICTC-93

  • IEC and social mobilisation

  • AEP- launched

  • PEP- all govt hospitals

  • Mainstreaming-7 departments

  • COE for ART-LNH

  • Model Blood bank -DDUH

  • Regional STD Lab-MAMC

  • TSU for DSACS & Parivar Sewa for PPP STI clinics

  • Training

  • EQAS-4 SRLs

  • Operational Research

  • ART Centres-9

  • CCCs-4

  • DICs-7

  • Holistic Approach-

  • Widow pension & jobs for PLHAs

  • Programme management (CMIS & CPFMS)

  • Surveillance-20 sites

  • M & E

  • Computerization of ICTCs & STI clinics

  • Common National reporting format


Prevelance of hiv positivity

PREVELANCE OF HIV POSITIVITY

  • GENERAL POPULATION- INDIA : 0.36%, DELHI-0.22% ( SENTINEL SURVEILLANCE ANC DATA 2007)

  • HIGH RISK GROUPS- 2.64% to 11.73%

  • STI ATTENDACE: 4.38%

  • VULNERABLE POPULATION ATTENDING ICTC: 3.5%

  • TB PATIENTS HIV POSITIVE: 5%

  • TRUCKERS - 2.5% (TCI)


Natural history of hiv infection

Natural History of HIV Infection

Initial Infection (lasting 4–8 weeks),

Acute HIV Syndrome (lasting 1 week–3 months),

HIV-Specific Immune Response (1–2 weeks),

Clinical Latency (10 years, median),

AIDS-Defining Illnesses (2 years on average),and

Death


Natural history of hiv 1 infection prior to treatment

Natural History of HIV-1 InfectionPrior to treatment

Seroconversion

Death

Initial Infection

Asymptomatic

Symptomatic

AIDS

1000

CD4+

Cells/L

500

ARS

0

Up to 12 years

4-8 wks

2-3 years

W.P.


Hiv aids global indian state scenario and activities of dsacs

10%

60%

30%


Characteristic viral load cd4 cd8 changes over time in cases with hiv infection

Characteristic Viral Load ,CD4 & CD8 Changes Over Time In Cases with HIV Infection

CD8 COUNT

P24 Ag

CD4 COUNT

VIRAL LOAD


Hiv aids global indian state scenario and activities of dsacs

CD 4 COUNT & OPPORTUNISTIC INFECTIONS

500

200

50


The changing natural history of hiv aids in the haart era

The Changing Natural History Of HIV/AIDS In The 'HAART' Era

Dramatic reductions in the incidence of

1. Opportunistic Infections

2. HIV-related Malignancies

3. Kaposi's Sarcoma

4. Deaths in advanced AIDS cases


Impact of anti retroviral treatment delhi statistics

IMPACT OF ANTI-RETROVIRAL TREATMENT (DELHI STATISTICS)


Who clinical staging hiv infection

WHO Clinical Staging HIV Infection

Clinical Stage I:

  • Asymptomatic

  • Persistent Generalized lymphadenopathy (PGL)


Who clinical stage ii

WHO CLINICAL STAGE II

  • Moderate unexplained weight loss (< 10% of body weight).

  • Recurrent bacterial upper respiratory tract infections (current event plus one or more in last six-month period).

  • Herpes zoster

  • Angular cheilitis

  • Recurrent oral ulcerations (two or more episodes in last six mths.

  • Papularpruritic eruption

  • Seborrhoeic dermatitis

  • Fungal nail infections.


Who clinical stage iii

WHO CLINICAL STAGE III

  • Unexplained severe weight loss (> than 10% of body wt)

  • Unexplained chronic diarrhoea for longer than one month.

  • Unexplained persistent fever > one month

  • Oral candidiasis

  • Oral hairy leukoplakia.

  • Pulmonary tuberculosis (current).

  • Severe bacterial infection for example, pneumonia, meningitis, empyema, pyomyositis, bone or joint infection, bacteraemia or severe pelvic inflammatory disease.

  • Acute necrotizing ulcerative gingivitis or necrotizing

    ulcerative periodontitis.

  • Unexplained anaemia, neutropenia or chronic (more than one month) thrombocytopenia


Who clinical stage iv

WHO CLINICAL STAGE IV

  • HIV wasting syndromei

  • Pneumocystiscarinii pneumonia

  • Recurrent bacterial pneumonia.

  • Chronic herpes simplex virus (HSV) infection (orolabial, genital or anorectal) of more than one month, or visceral of any duration.

  • Oesophageal candidiasis.

  • Extra Pulmonary tuberculosis

  • Kaposi’s sarcoma.

  • Cytomegalovirus disease (other than liver, spleen or lymph node).

  • Central nervous system toxoplasmosis.

  • HIV encephalopathy.

  • Extrapulmonarycryptococcosis (including meningitis)

  • Disseminated nontuberculousmycobacteria infection.

  • Progressive multi focal leukoencephalopathy (PML).

  • Cryptosporidiosis (with diarrhoea lasting more than one month).

  • Disseminated mycosis (coccidiomycosis, histoplasmosis, penicilliosis)

  • Cerebral or non hodgkins Lymphoma, invasive cervical Carcinoma,

  • Recurrent non salmonella typhoid

  • HIV cardiomyopathy, nephropathy


Socio economic profiling of plhas

SOCIO-ECONOMIC PROFILING OF PLHAs

A STUDY WAS UNDERATKEN IN COLLABORATION WITH ILO AT TWO ART CENTRTERS (RML & LNH)

SALIENT FEATURES:

SAMPLE SIZE: 1171 PLHAs (816 MALES, 333 FEMALES & 22 TS/TG

LNH: 584 PLHAs, RML:587 PLHAs

90.9% PLHAs BELONG TO 16-45 YRS AGE GROUP

SEX COMPOSITION: MALES 70%, FEMALES-28%, TS/TG-2%

MARITAL STATUS: MARRIED-72%, WIDOW-12%, SINGLE-16%

STATUS OF RESIDENCE: 62% FROM DELHI,

38% ARE MIGRANTS (UP,HARYANA)

EDUCATIONAL STATUS: MAJORITY (61%)- LOW EDUCATION STATUS: 25%-ILLITERATE, 36% PRIMARY SCHOOL. ONLY 29%-SEC SCHOOL & 10% COLLLEGE GRADIATE

EMPLOYMENT STATUS: > 51% -UNEMPLOYED(90% WOMEN, 50% TS/TG & 35% MEN); 12% DAILY WAGE, 37% REGULAR EMPLOYMENT

OCCUPATIONAL BREAKUP OF EMPLOYED : SELF EMPLOYED/BUISENSS-34%, PVT SECTOR-35%, GOVT -8%, LABOUR-14%, FARMER-5%, HAWKERS-4%

MONTHLY HOUSLEHOLD INCOME: 46.9% < RS. 2000/PM; 79.2% < RS. 4000/PM;18.2% BETWEEN 4000-10,000/PM; 2.6% . > RS. 10,000/PM


Hiv aids global indian state scenario and activities of dsacs

THANK YOU


  • Login