Transcript Қазақстан Республикасы Денсаулық сақтау министрлігі. Мемлекеттік мекеме ЖИТС-тың алдын алу және оған қарсы күрес жөніндегі республикалық орталық The Ministry of Health of the.

Қазақстан Республикасы Денсаулық сақтау министрлігі. Мемлекеттік мекеме
ЖИТС-тың алдын алу және оған қарсы
күрес жөніндегі республикалық орталық
The Ministry of Health of the Republic of Kazakhstan. Government Agency
Republican Center
of prevention and fight against AIDS
AIDS Service in the Republic of
Kazakhstan
Tukeyev M.S. – Director General of AIDS RC
The HIV/AIDS situation
As of 01.01.2012. (cumulatively) are registered:
 17763 of HIV infected (86,8 per 100 thousand), including among children under
14 – 369; The maximum rate of prevalence of PLHA in Almaty city (214,7),
Pavlodar oblast (180,5), Karaganda oblast (153,0).
 The prevalence of HIV infection among total population - 0,107%  The prevalence in age group of 15-49 years old - 0,185%
 In the structure of diagnosed cases the citizens of the RoK – 93,9%, foreign
citizens – 6,1%, the part of diagnosed in the places of imprisonment - 26,4%
 1480 of AIDS patients, including 76 children under 14
 3447 of HIV infected died, among them by reason related to HIV infection 1127 patients on AIDS stage (32,7%), including children under 14 – 7 years old
 The sex distribution: male – 12444 (70,1%), female – 5319 (29,9%)
 The distribution by transmission route: sexual - 28,6%, parenteral -63,4%
 In the social and professional structure 71% makes non-workers; 17,5% workers
 “D” registered -11359 of PLHA (79,3%), including -312 of children
 1830 of PLHA take ARM therapy.
The number of registered cases of HIV infection in the
RoK by year (2000- 2011)
20000
17763
18000
15771
16000
13874
14000
11725
12000
9390
10000
7411
8000
5666
6000
4003
4000
2000
2522
1347 1175
347
4702
3257
735
746
699
964
2335 2081 1988 2006
1745 1979
0
2000г. 2001г. 2002г. 2003г. 2004г. 2005г. 2006г. 2007г. 2008г.
Количество вновьзарегистрированных случаев
2009г. 2010г. 2011г.
Кумулятивное количество случаев
3
The extension rate of HIV infection
per 100 thousand of population (1987-2011)
250.0
214.7
200.0
180.5
153.0
150.0
122.4
107.1
100.0
РК-86,8
80.4
64.9 63.5
50.0
53.8 51.7 49.2
39.3
25.3 20.0
17.0
0.0
8.1
The distribution by transmission route (2006-2011)
100%
90%
Не установлен
80%
19%
25%
29%
70%
35%
42%
51%
60%
Нозокомиальный
Вертикальный
50%
Гомосексуальный
40%
30%
66%
64%
60%
Гетеросексуальный
56%
52%
44%
20%
10%
0%
2006г.
(1745)
2007г.
(1979)
2008г.
(2335)
2009г.
(2081)
2010
(1988)
2011
(2006)
Внутривенное
употребление
наркотиков
The distribution of HIV infection cases by gender
structure 2006 –2011 (in %)
100
90
25
30
27
71
73
2007г.
2008г.
28
80
37
39.6
63
60.4
2010г.
2011г.
70
60
50
40
75
72
30
20
10
0
2006г.
муж.
2009г.
жен.
The distribution of HIV infection cases by transmission
route in the gender aspect (%, 1987-2011)
Female HIV infection
transmission route
Male HIV infection transmission
route
Other;
4%
Sexual
hetero;
16%
Other; 5%
Parenteral
; 32%
Parenteral
80%
Sexual
hetero;
62%
Proportion of sexual and parenteral routes of HIV infection
transmission by year (2006 - 2011.%).
70
66
64
60
60
(1159)
55,5
(1258)
(1410)
(1155)
50
40
(1043)
52,5
52
43
44
(830)
(876)
36,5
30
29,1
25
20
20
10
(1046)
(502)
(739)
(692)
(331)
0
2006
2007
2008
2009
ВВП
Половой
2010
2011
8
The distribution by social and professional groups
(%,1987-2011)
preschool
age children;
1,8
unknown; 1,8
students of Dual
Educat.Inst.and pensioners; 0,2
HEIs; 1,0
military personnel;
0,07
school children;
0,6
foreigners; 6,1
prisoners; 26,4
workers and
employees; 17,5
non-workers; 44,6
HIV infection extension among patrol groups (2006-2011)
4.5%
4.2%
3.9%
4.0%
3.8%
3.4%
3.2%
3.5%
2.9%
3.0%
2.5%
2.5%
2.4%
2.3%
2.6%
2.0%
1.5%
3.0%
1.4%
2.0%
1.3%
1.0%
2.8%
1.5%
1.0%
1.5%
1.0%
1.0%
0.5%
0.3%
0.2%
0.2%
0.3%
2006
2007
2008
2009
0.0%
ПИН
РС
заключенные
2010
МСМ
2011
10
Mortality among PLHA (2006-2010 per 1000)
70
65
60
52
51
50
50
45
47.9
40
30
24
17
20
16
14
16
14.4
10
0
2006г.
2007г.
2008г.
Общая смертность
2009г.
2010г.
2011г.
Смертность от СПИД
11
ART coverage over the RoK
(in % and absolute number)
90
83,3 (1860)
80
70
74,5(1336)
66 (1035)
60
50
40
30
20
10
0
2009
2010
2011
The principal directions on HIV/AIDS in the State Program
“Salamatti Kazakhstan” for 2011 – 2015
The prevention of HIV infection in population groups, which are key for HIV
infection epidemic;
The cure of HIV infected and AIDS patients;
The support of non-governmental HIV/AIDS organizations, including in the
places of imprisonment;
Provision of AIDS Service with laboratory equipment and test systems;
Provision of opioid-addicted injecting drug users with replacement therapy;
Development of epidemiological surveillance over HIV infection.
The mechanisms for HIV/AIDS measures
implementation:
 The unified coordination mechanism – Country
Coordination Committee;
 Specialized AIDS Service within the Republican Center
and 20 regional and town centers;
 Availability of specialized laboratories equipped with
modern equipment;
 The normative legal base of AIDS Service;
 The unified system of screening and registration of HIV
infection cases;
 The stable system of monitoring and evaluation of
implementable measures of HIV prevention;
 The electronic tracking system of HIV infection cases;
 The system of patrol epidemiological surveillance over
HIV extension, VHC and syphilis among vulnerable
populations;
 The adequate support of civil society.
14
AIDS Services activity
 Organization and coordination of arrangements on
prevention, diagnostics and treatment of HIV
infection and AIDS;
 Organization and carrying out of epidemiological
surveillance and epidemiology;
 Organization and carrying out of laboratory
diagnostic of HIV and AIDS associated diseases;
 Monitoring
of
treatment
examinations for HIV;
and
performed
 Preventive medical examination and medical care
for
HIV
infected,
carrying
post-contact
antiretroviral preventive care;
 Training of medical professionals on prevention,
diagnostic and treatment of HIV infection and
AIDS.
Laboratory service
 The HIV and AIDS diagnostic is carried out in 28 laboratories, including
in 14 regional, 8 town AIDS centers and in 6 laboratories under central
regional hospitals.
 All AIDS centers are equipped with two sets of diagnostic equipment for
carrying out enzyme multiplied immunoassay.
- 13 laboratories are equipped with flow cytometers for identification
of immune status of HIV infected.
- 6 laboratories are equipped with PCR equipment for identification of
viral load.
Laboratory service
The tree-stage HIV diagnostic system is developed, which allows
to obtain correct interpretation of the results of laboratory assessment
carried out in primary AIDS laboratories.
All laboratories carry out the researches on HIV infection
diagnostic applying laboratory quality control, that is complying with
the requirements of ST RK ISO15189-2008.
External laboratory quality control is carried out at the international,
republican, regional levels. Seven laboratory chiefs obtained the
international certificate of Voluntary Certification System in
laboratory science.
International collaboration
UN organizations
U.S. government organizations
International non-governmental organizations
The Global Health
Research Center
in Central Asia
New lines of activity of AIDS Service
 The diagnostic laboratory of AIDS RC carries out researches on
identification of proviral HIV DNA of newborn infants that allows to
reduce the terms of dispensary observation of children born by HIV
infected mothers from 3 to 1 year old, and carry out establishing
diagnosis within first 3 months after the birth.
 Strategy and tactics of carrying out serologic stage of patrol
epidemiological surveillance by dried blood spot method is developed,
the test systems adaptation to this method is carried out.
 Diagnostics of HIV, VHC, syphilis and quality control of performed
researches is carried out by verification of 10% of negative samples.
 All laboratories carry out monitoring of antiretroviral therapy
efficiency by identification of CD4 cells and viral load of HIV infected.
 The genetic typing of the revealed HIV-1 variants and determination
of virus resistance to antivirals-inhibitors of viral anionic proteins is
carried out in AIDS RC.
The electronic HIV infection cases tracking base is implemented over
the whole territory of Kazakhstan.
Strategic lines of development of AIDS Service for
2011-2015
1.
2.
3.
4.
5.
6.
7.
Enhancement of preventive programs among the population, including
the youth through mass media, the Internet, mobile network operators,
etc..
Laying the emphasis on enhancement of monitoring of controllable
transmission routes of HIV infection – vertical and transfusion routes.
The further work on programs of harm reduction with the vulnerable
populations, including in the places of imprisonment.
Improvement of antiretroviral therapy compliance, ensuring access to
treatment, strengthening of multi disciplinary approach in treatment,
social service of people living with HIV and monitoring of
antiretroviral therapy.
Mortality reduction among people living with HIV.
Enhancement of interdepartmental interaction on HIV/AIDS matters.
Creation of the genetic material bank of HIV diagnosed in
Kazakhstan.
Thank for kind attention!!!
84, Auezov str., Almaty
050000, Republic of Kazakhstan,
Tel. 2699481
Fax 2699481
[email protected]