Friday, September 08, 2006

Could we be wiped out by a virus?

Watching movies like Outbreak and Twelve Monkeys no doubt encourages such thinking.

But we have heard the fear that HIV could mutate into an infectious rather than contagious disease, or combine to form a killer combination with some other virus.

Two diseases have always been watched with caution as potential HIV disaster catalysts: Ebola and Tuberculosis.

So it is with great alarm that medical experts noted two critical alerts in KwaZulu-Natal this week:

Deadly new TB 'must be stopped'

The extreme drug-resistant tuberculosis (XDR-TB) in KwaZulu-Natal must be dealt with urgently, said international health experts here on Thursday.

"There is no time to wait before we embark on decisive action," said the World Health Organisation's Dr Ernesto Jaramillo, explaining that an epidemic could have a "deadly impact".

"It's imperative that we don't allow this to go unmitigated," said Dr Ken Castro, of the United States Centre for Disease Control.

"The emergence of XDR-TB poses a threat everywhere in the world."

More than 100 medical experts and policy-makers from around the world were meeting to discuss the XDR-TB which emerged in KZN recently.

Fifty-three cases were identified and 52 of the patients have died. The HIV/TB co-infection rate was high.

KZN's shocking HIV rates

Medical researchers are finding "unbelievable" rates of HIV and Aids infection among women in several parts of KwaZulu-Natal, with provincial prevalence levels varying between 38 and 50 percent.

Professor Gita Ramjee, of the Medical Research Council in Durban, said that in one area of the South Coast the HIV prevalence level in women was as high at 70 percent, while in the Embo area near Botha's Hill researchers found a prevalence level of more than 66 percent.



kyknoord said...

What makes it particularly interesting, is the "unbelievable" part. I wonder why they find it so difficult to believe?

ATW said...

On about page 8 of this 1999!!! journal article the following KZN stats inter alia are cited.

"Various hospitals report large numbers of HIV/AIDS illnesses; in Durban, 40% of adult medical in-patients at King-Edward VII Hospital were admitted with HIV-related conditions in 1997; the percentage of HIV-related admission in Guateng in 1997 varied between 26% and 70%; and in 1996, the Chris Hani Baragwanath Hospital in Soweto reported that about 30% of children under age 6 were HIV-positive.

A case study for a rural hospital in Hlabisa province indicated that total admissions had increased dramatically between 1991 and 1997, by 57 percent. About 55 percent of the adult medical patients surveyed were HIV positive, while 42 percent of the gynaecology patients were HIV positive, and 26 percent of the paediatric cases were HIV positive."

So I'm with the kyk on this. Why the continued disbelief?

It is the question said...

I think it's when you compare it to other countries in the world.

Brazil - 0,7% - 660 000 infected

India - 0,9% - 5,1m infected

USA - 0,6% - 950 000 infected

UK - 0,2% - 51 000 infected

Compare 360 000 dead in SA last year to 500 in Ireland.

To anybody from any other country, SA's figures beggar belief.

Triggermap said...

"the percentage of HIV-related admission in Guateng in 1997 varied between 26% and 70%;"

Does that mean at various points in time in 1997 a sample was taken and the values were between 26% and 70%? Or does that mean that if you construct a confidence interval (at say 95%) the true value of HIV-related admissions lie between 26% and 70%? The former case is frightening? The latter means very little.

The only facts I can see that are to be relied on are : (1) " admissions had increased dramatically between 1991 and 1997, by 57 percent..." (2)"360 000 dead in SA last year" (AT LEAST - you'll have to wait a while for the MRC report as they have data cleaning to do e.g. the coroner wrote cause of death as influenza, when it was clearly AIDS related)

You must also take into account the biased population they are sampling from: i.e. sick people and sexually active people. Of course those rates of HIV infected are going to be higher than for the general SA population.

That being said, even if the true HIV infection prevalence is 1 in 4 to 1 in 3, thats is frightening...