[Seroprevalence of HIV among pregnant women in the ten regions of the Ivory Coast].
Ivory Coast, a sub-Saharan African country, has 14 million inhabitants. Two AIDS cases were reported to the WHO in 1985. By December 31st 1996, there were a total of 37,878 AIDS cases in Ivory Coast, 6,727 of which were new cases reported in 1996. Heterosexual transmission is the predominant means of HIV infection in Africa and women of childbearing age account for a substantial proportion of the individuals infected. The aim of this study was to follow the progression of infection in the various regions of the country by comparing data from two time periods: Period I: 1986 to 1989; Period II: 1994 to 1996.


METHODS



METHODS
Samples were taken in regional maternal and child protection centers. Recruitment method: Women were recruited anonymously, during their antenatal care. BIOLOGICAL ANALYSIS: Period I (1986 to 1989), 2,604 pregnant women. Anti-HIV antibodies were detected with: Abbott HIV-1 EIA Recombinant (Chicago) used initially, for 1,200 sera; Abbott HIV-1/HIV-2 Recombinant (Chicago) used later for the remaining sera. There was no commercially available test for HIV-2 during this first period, so all samples with Rm0.8 (R = optical density/cut-off) were also tested by western blotting. Period II (1994 to 1996), 2,935 pregnant women. All sera were tested with Enzygnost HIV-1-2 and Enzygnost HIV-1-2 Plus, produced by Behring (Germany). All sera testing positive in EIA were also tested by western blotting.


RESULTS
The prevalence of HIV infection was 4.23% for Period I and 12.53% for Period II. No region of Ivory Coast was completely free of these 2 viruses after the mid-1980s. Women aged 20 to 29 years of age were the most likely to be infected, for both periods. The highest prevalence of HIV-2 was that for women aged between 20 and 29 years and HIV-2 infection occurred mostly in the South, Southwest and West regions.


CONCLUSIONS
The prevalence of HIV infection is now at least 10% in each region of the country. Abidjan is no longer the city with the highest levels of infection, as shown by the results for Period II. The East and West have the highest levels of HIV infection, and the prevalence of HIV in these areas is significantly higher than that for Abidjan (p = 0.007 for the East and p = 0.009 for the West).
Laboratoire des rétrovirus, Institut Pasteur, Abidjan, Côte d'Ivoire.
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Sangaré
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Coulibaly
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Ehouman
D000328:Adult; D007560:Cote d'Ivoire / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D015528:HIV Seroprevalence; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D015995:Prevalence