The estimated burden of HIV/AIDS in Uganda, 2005-2010.
OBJECTIVE
To estimate the burden of HIV disease in Uganda and the effect of HIV/AIDS control programmes to mitigate it.


METHODS
Mathematical modelling and projecting using surveillance and census data.


METHODS
Using antenatal clinic surveillance (1986-2002) and a recent population-based survey (2004-2005) data, we modelled the adult national HIV prevalence over time (1981-2004), and kept prevalence constant at 6.4% for the years 2004-2010. Using Spectrum software and census data, we estimated the national burden of HIV disease and the effect of selected HIV-related prevention and treatment programmes.


RESULTS
In 2005, we estimated that there were 135,300 new HIV infections (adult HIV incidence 0.96%), 691,900 asymptomatic prevalent infections, 88 100 AIDS cases, and 76 400 AIDS deaths. An estimated 647,000 (80%) HIV-infected adults were unaware of their infection; one third of all adult deaths were HIV related. As a result of population growth, by 2008 a similar number of people will be HIV infected (1.1 million) as during the peak of the epidemic in 1994. Although antiretroviral therapy (ART) coverage is expected to rise from 67,000 (2005) to 160,000 (2010), the number of persons needing but not receiving ART will decrease only slightly from 127,600 (2005) to 111,100 (2010). The use of single-dose in 2005 nevirapine probably averted only 4% of the estimated 20 400 vertical infections.


CONCLUSIONS
HIV/AIDS continues to be a leading cause of adult disease and death in Uganda. Universal ART access is probably unachievable. With the absolute burden of HIV disease approaching the historic peak in the early 1990s, more effective prevention programmes are of paramount importance.
Hladik
Wolfgang
W
Global AIDS Program, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, US Centers for Disease Control and Prevention, Entebbe, Uganda. wfh3@cdc.gov
Musinguzi
Joshua
J
Kirungi
Wilford
W
Opio
Alex
A
Stover
John
J
Kaharuza
Frank
F
Bunnell
Rebecca
R
Kafuko
Jessica
J
Mermin
Jonathan
J
D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D002648:Child; D017281:Cost of Illness; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014454:Uganda / Q000453:epidemiology
D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination