The Sorry Saga of Bhutan's North

The Sorry Saga of Bhutan's North
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Friday, July 23, 2010

Alarming rise in cases

10 July, 2010 - It was as though one Bhutanese was detected being HIV positive a week within the last seven months.
Health records showed that between December 1, 2009 and July 1 this year, 32 new HIV positive cases were detected, the highest the country ever saw since its first detection in 1993.

From 19 cases in 2008, the number increased to 25 last year.

So far, the total cases detected stands at 217 of which 43 have died. Today, the country has 174 people living with HIV.

Except for one, where the infection was passed from the mother to child, the rest 31 were infected through sexual contact or heterosexual route as it is normally known in medical terms.

Of the equal division between 16 infected males and 16 females, ten are housewives, another ten employees of corporate and private firms, and eight belonging to business community. The rest comprise a civil servant, a farmer, a minor and a trainee.

All 32 infected, health officials said, were between five and 49.

The minor is below five years, 12 are between 30 and 39, nine between 25 and 29, seven between 20 and 27 and three between 40 and 49 years.

Of the 32, 15 were diagnosed through contact tracing, where identification and diagnosis of persons, who may have come into contact with an infected person, was done. Eleven were detected through voluntary testing, five through medical check up or screening, and one through mother to child.

All 32 cases were detected with CD4 count of 356, CD4 being marker of disease progression and 356 the defense mechanism. That means the victims were infected about eight to nine years ago.

“A normal person has a CD4 count of 1,200,” the HIV program official said. “We monitor the defense mechanism of the body every six months; and, if the count goes below 200 in an HIV infected person, then we put them on anti-retroviral drug.”

From the total 217 infected thus far, 110 were males and 107 females.

Since the first HIV case was reported in 1993, 46 are on anti-retroviral drug, a medicine, which boosts the immune system of the body and prolongs life. The rest 128, health officials said, were healthy and being monitored under the HIV program.

While increased awareness and access to testing facilities enhanced detection of HIV infection, it is estimated that Bhutan would have 500 HIV cases, deduced from the reported cases.

Although the 2006 general population survey found that 99 percent have heard about condoms and 84.4 percent use condoms when in contact with sex workers, Bhutan should halve the spread of HIV and begin to reverse the trend by 2015.

To achieve this, the health ministry would aggressively campaign and create awareness on STI/HIV to most-at-risk population, improve HIV testing, provide counselling and treatment facilities, promote and make condoms easily available, and request Bhutanese to practise safe sex.

By Sonam Pelden

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