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  • Title: Nationwide community-based serological survey of HIV-1 and other human retrovirus infections in a Central African country.
    Author: Dunn D.
    Journal: WHO AIDS Tech Bull; 1989 Sep; 2():143-4. PubMed ID: 12282458.
    Abstract:
    In December, 1986, a nationwide serological survey was done in Rwanda, Central Africa. The sampling method was a modification of the cluster sampling technique developed for assessing immunization coverage. 60 clusters ("cells" of 50-150 households) were randomly selected. Only 1 person per household was chosen for inclusion in the study. Serum was collected and tested for antibodies to human immunodeficiency virus (HIV)-1, HIV-2, and HTLV-1 for 1870 urban and 742 rural residents. ELISA and Western blotting techniques were used. The overall prevalence in the urban sample was 17.8%. The lowest prevalence (4.2%) occurred in the 6-15 year age group; the highest (30%) in the 26-40 year group. The prevalence in women (21%) significantly exceeded the figure for men (14.6%). In the rural sample, 10 individuals were HIV-1 seropositive; a prevalence of 1.3%. The number of seropositives was inadequate to determine any effect of age or sex. Antibodies to HIV-2 were not found. HTLV-1 seroprevalence was 0.2% in the urban and 0.3%, rural. Information on risk factors for HIV infection was collected in the survey but not considered in this report. The strength of this study is the representativeness of the general population. The study was done nearly 3 years ago. The HIV-1 seroprevalence rate may not be true today; an HIV-2 epidemic may have begun. A questionable aspect of study design is the inclusion of only 1 individual per household. The correct procedure is to include all members of sampled households. A curious finding is that of the 33 rural serum samples found HIV-1 seropositive by ELISA, 23 were indeterminate by Western blot. Only 15 of 347 urban samples were indeterminate by Western blot after a positive ELISA. Although one would expect a higher false-positive rate in a low prevalence community, one would not expect the absolute number to be larger in view of the larger urban sample size.
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