Age- and sex-specific HIV-1 prevalence in the urban community setting of Addis Ababa, Ethiopia

SUMMARYA community-based seroepidemiological survey of Addis Ababa, Ethiopia was conducted in 1994 to inform on the transmission dynamics and control of hepatitis B virus (HBV) infection. Venous blood from 4736 individuals under 50 years of age from 1262 households, selected using stratified cluster-sampling, was screened for HBV markers using commercial ELISAs. HBsAg prevalence was 7% (95 % CI 6-8), higher in males (9 % ; 7-10) than females (5 %; 4-6). HBeAg prevalence in HBsAg positives was 23 % (18-29), and less than 1 % of women of childbearing age were HBeAg positive. Overall HBV seroprevalence (any marker), rose steadily with age to over 70 % in 40-49 year olds, indicating significant childhood and adult transmission. Estimated instantaneous incidence was 3-4/100 susceptibles/year, higher in males than females in 0-4 year olds, and peaking in early childhood and young adults. The age at which 50 % had evidence of infection was around 20 years, and the herd immunity threshold is approximated at 63-77%. Addis Ababa is of intermediate-high HBV endemicity, with negligible perinatal transmission. Our main findings are the identification of a significant difference between males and females in the age-acquisition of HBV infection, and marked differences between age groups in HBV incidence rates. These results should target future research studies of underlying risk factors. Furthermore, we generate a crude estimate of the level of coverage of HBV vaccine that would be required to eliminate the virus from the study population.

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“…Further details on the characteristics of the surveyed population are found in other publications [29,30].…”

Section: Resultsmentioning

confidence: 99%

“…Emphasis is given to details not presented in previous related publications [29,30]. Ethical approval was obtained from authorities in Ethiopia (Ethical Committee of the Ethiopian Health and Nutrition Research Institute) and the United Kingdom (St Mary's Research Ethics Committee, London University).…”

Section: Methodsmentioning

confidence: 99%

Seroepidemiology of hepatitis B virus in Addis Ababa, Ethiopia: transmission patterns and vaccine control

et al. 2003

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“…Of the 4675 individuals with adequate serology and questionnaire information, 9 were excluded because of missing data on age. The characteristics of the sample in comparison to the census data for Addis Ababa have been presented in detail elsewhere [9] ; in general, adult men were under-represented.…”

Section: Resultsmentioning

confidence: 99%

“…Full details of the sample design and composition are given elsewhere [9], and only briefly outlined here. Addis Ababa, the capital of Ethiopia, had an estimated population in 1994 of approx.…”

Section: Methodsmentioning

confidence: 99%

“…In our analyses of seroprevalence account was taken of the survey design using STATA (V6n0) svy commands following the procedure described in detail elsewhere [9]. In brief, first, we applied probability weights to each measurement to account for the different population size in the inner and outer city strata, and the variation in the number of households from each cluster (kebele) who participated, and second, variance estimation took into account the degree of inter-versus intra-cluster variability (i.e.…”

Section: Accounting For Sur Ey Designmentioning

confidence: 99%

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Sero-epidemiology of rubella in the urban population of Addis Ababa, Ethiopia

et al. 2000

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SUMMARYWe conducted a community-based cluster sample survey of rubella sero-epidemiology in Addis Ababa, Ethiopia in 1994. Among 4666 individuals for whom complete data were available, rubella antibody prevalence was 91 % (95 % confidence interval : 90, 92). On multivariable analysis, seroprevalence was lower among individuals who were resident in Addis Ababa for 1 year or less. Approx. 50 % seroprevalence was attained by age 4 years, and the estimated average age at infection was 5n2 years. The highest age-specific force of infection was estimated to occur in 5-to 9-year-olds. The early age at infection corresponded with a low estimated incidence of congenital rubella syndrome (CRS) of 0n3 per 1000 live births, equivalent to nine cases of CRS in 1994. The predicted critical level of immunity for elimination of rubella via vaccination was 85-91 %, requiring 89-96 % coverage with a vaccine of 95 % effectiveness. Unless very high coverage of rubella vaccine could be guaranteed, the introduction of childhood vaccination could increase the incidence of CRS in Addis Ababa.

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Higher prevalence of anti‐HCV antibodies among HIV‐positive compared to HIV‐negative inhabitants of Addis Ababa, Ethiopia

Ayele

Nokes

Abebe

et al. 2002

Journal of Medical Virology

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Serum samples (n = 4,593) collected in 1994 as part of a representative household community survey of the population of Addis Ababa who were 0-49 years old were tested for hepatitis C (HCV) antibodies. A third generation ELISA was used for primary screening and a line immunoblot assay for confirmation. HCV antibody prevalence was 0.9% (95% CI, 0.6-1.2%) and higher among HIV-positive compared to HIV-negative individuals (4.5% vs. 0.8%, respectively, P < 0.001). Similar higher prevalence of HCV antibodies was seen among HIV-positive compared to HIV-negative antenatal care attenders (2.9% vs. 0.8%, respectively, P = 0.003, n = 1,725), and sex workers (5.3% vs. 1.3%, respectively, P = 0.02, n = 383). Such association between HCV and HIV infection has not been described previously in Africa. After stratification by HIV status, HCV prevalence among women of the general population was identical to that of sex workers, suggesting that HCV sexual transmission is not common in this population and that HIV infection does not enhance susceptibility to HCV sexual transmission.

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Age- and sex-specific HIV-1 prevalence in the urban community setting of Addis Ababa, Ethiopia

Abstract: By 1994, a substantial proportion of the adult population of Addis Ababa was infected with HIV. Promotion of behavioural changes and the control of sexually transmitted diseases should be strongly supported to limit the spread of the HIV epidemic in Ethiopia.

Cited by 78 publications

References 11 publications

Seroepidemiology of hepatitis B virus in Addis Ababa, Ethiopia: transmission patterns and vaccine control

Seroepidemiology of hepatitis B virus in Addis Ababa, Ethiopia: transmission patterns and vaccine control

Sero-epidemiology of rubella in the urban population of Addis Ababa, Ethiopia

Higher prevalence of anti‐HCV antibodies among HIV‐positive compared to HIV‐negative inhabitants of Addis Ababa, Ethiopia

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