The Bhutanese Leading the way.
The Ministry of Health has detected 29 new HIV positive cases from 1st December 2014 to June 2015.Of the 29 new cases 16 are female and 13 are male.
As of now the total detected cases in the country since 1993 stands at 432 cases. 217 of them are males and 215 are females.
31.03% of the new cases are in the age range of 20-29, where females are mostly infected and the reaming 31.03% are aged above 30 where males are mainly infected.
The demographic characteristics of the new cases, shows that majority of the male and female are all married and falls in a reproductive age group of 20-49.
The CD4 count of the male above 30 years of age is much lower than that of female aged 20-29. Therefore, it is more likely that younger females are being infected more recently than that of elderly men.
In 2014 out of 45,808 tests being conducted only 58 positive cases were detected and a similar trend have been observed in the past years.
A CD4 count is a lab test that measures the number of CD4 cells in a sample of blood. It is an important indicator of how well the immune system is working. The CD4 cells or T-cells are a type of white blood cells that play a major role in protecting the body from infection. They send signals to activate the body’s immune response when they detect “intruders,” like viruses or bacteria.
So a less the CD4 count means the weaker the immune system. The recommended normal CD 4 count ranges from 500 – 1000 cells/mm3.
Of the new cases 15 cases (8 males and 7 females) are eligible for treatment and as of now 13 clients were put on treatment and remaining 02 will be enrolled for treatment within the month of August, 2015. The CD4 count tests for the remaining 10 cases are still in the process of follow-up and counseling for enrollment into the CD4 count test.
Over all deaths related to HIV infection accounts to 83 including 26 who died on treatment. The longest surviving PLHA on treatment is now 50 years old (detected in 1994) and is living with HIV for the last 20 years. Currently there are 190 people on Anti-retroviral (ART) treatment.
Since 2006 no less than 25 cases have been detected every year and in the last three years the average yearly detection had been 42.Of the total reported cases approximately 75% were reported from 2004 onwards due to a stronger effort by the government.
The dominate mode of HIV transmission (90%) is through the sexual route followed by Mother to child transmission (07%) and other modes constitute only 3 %.
Bhutan is one of the few countries in South Asia that continue to experience a low adult (15-49 years) HIV prevalence, which is below 0.2 percent (0.1-0.6%). Out of 432 cases detected since 1993, 329 of them are currently living with HIV in the country.
The Ministry of Health is re-strategizing its approach to intensify the case finding though micro-stratification of the population, identifying the most at risk population and comprehensive risk assessment of individuals.
In a resource constrained country like Bhutan with low prevalence the MOH said it would be more viable to focus and prioritized testing services for the more vulnerable sections of the population.
Among the 29 cases 9 of them were detected through the voluntary counseling and testing services, another 9 through medical screening, 7 of them through contact tracing, 2 through active surveillance and 1 each from mother to child transmission (MTCT) and through blood donor.
Although there seems a progressive increase in the number of cases every year, Bhutan still has a case detection gap of 60.7% to reach the 2013 UNAIDS estimation of 1100 cases. As per the modeling exercise of UNAIDS the estimated new cases in 2014 is 172.
