Jia Yujiang, Sun Jiangping, Fan Lu, Song Duan, Tian Shuming, Yang Yuecheng, Jia Manhong, Lu Lin, Sun Xinhua, Zhang Sanguo, Kulczycki Andrzej, Vermund Sten H
Institute for Global Health, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
Int J Epidemiol. 2008 Dec;37(6):1287-96. doi: 10.1093/ije/dyn196. Epub 2008 Oct 14.
Dehong Prefecture in Yunnan Province, China, borders Myanmar. Its proximity to the 'Golden Triangle', one of the world's largest illicit drug production and distribution centre, contributes to drug trafficking and ready availability of heroin. Dehong's 1.1 million people confront a serious HIV problem fuelled by injection drug use. The aim of this study is to improve the 2005 estimates of the true status of the HIV/AIDS epidemic in Dehong Prefecture.
We estimated the HIV prevalence by synthesizing the results from several data sources (HIV/AIDS case reports, surveys, surveillance activities and epidemiological studies). We applied three different statistical procedures for estimations: (i) The Workbook method, adapted to meet the estimation needs in Dehong Prefecture; (ii) An estimate based on antenatal clinical data; and (iii) a dynamic model based on the local epidemic pattern.
We estimated that the population prevalence for HIV infections in Dehong Prefecture is 1.3% (likely range from low/high of three estimates: 0.9-1.7%) such that 13 500 people were living with HIV/AIDS in Dehong Prefecture (likely range: 8,200-18,300) in 2005. Infections remain concentrated among injection drug users, female sex workers and their clients with an uneven geographical distribution of estimated cases.
More reliable estimates of HIV prevalence can be made by synthesizing multiple data sources using several procedures. Current HIV prevention, care and treatment challenges are judged substantial in Dehong Prefecture, regardless of what modelling strategy is used.
中国云南省德宏州与缅甸接壤。由于靠近世界最大的非法毒品生产和分销中心之一“金三角”，德宏州毒品走私猖獗，海洛因随处可得。德宏州110万人口面临着因注射吸毒导致的严重艾滋病问题。本研究旨在改进2005年德宏州艾滋病毒/艾滋病流行真实状况的估计。
我们通过综合多个数据源（艾滋病毒/艾滋病病例报告、调查、监测活动和流行病学研究）的结果来估计艾滋病毒流行率。我们应用三种不同的统计程序进行估计：（i）适用于德宏州估计需求的工作簿方法；（ii）基于产前临床数据的估计；（iii）基于当地流行模式的动态模型。
我们估计德宏州艾滋病毒感染的人群流行率为1.3%（三个估计值的低/高可能范围：0.9 - 1.7%），因此2005年德宏州有13500人感染艾滋病毒/艾滋病（可能范围：8200 - 18300人）。感染仍集中在注射吸毒者、女性性工作者及其客户中，估计病例的地理分布不均衡。
通过使用多种程序综合多个数据源，可以对艾滋病毒流行率做出更可靠的估计。无论采用何种建模策略，目前德宏州在艾滋病毒预防、护理和治疗方面面临的挑战都相当大。
