Innovative Biotech LtdInnovative Biotech LtdNigeriaNigeria

Dr Simon Agwale

General overview (1)General overview (1)General overview (1)General overview (1)

Nigeria is the tenth largest country in the world and the most populous in Africa. It is situated within sub Saharan Africa which harbors about 67% of the world HIV/AIDS burden

It has an estimated population of 120 million (1999), representing over one fifth of the total population of the African continent

It is a democratic Federal Republic consisting of 36 states and the Federal Capital Territory (FCT)

The literacy level is estimated to be 55%

Ever since HIV was reported in the country in 1996, the infection rate has continued to rise steadily from less than 0.1% in 1987, to 1.8% in 1991, to 5.8% in 2001, with a slight decrease in 2003 sentinel survey to 5.0%

The HIV prevalence rates in the two States chosen for the study are 12% for Benue and 9% for Nasarawa. Most of the female sex workers have low literacy rates

Presently, no study has effectively addressed the incidence of the disease among this group till date

General overview (2)General overview (2)General overview (2)General overview (2)

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PREVALENCE

HIV prevalence in Nigeria (1)HIV prevalence in Nigeria (1)HIV prevalence in Nigeria (1)HIV prevalence in Nigeria (1)

According to the National survey, HIV prevalence rate among female sex workers in Nigeria has remained high, and is on the increase from 17.5% in 1991 through 22.5%(1993), to 35.6% in 1995

Female sex workers constitutes an important core group of HIV transmission to the general population

HIV prevalence in Nigeria (2)HIV prevalence in Nigeria (2)HIV prevalence in Nigeria (2)HIV prevalence in Nigeria (2)

Innovative Biotech Ltd (IBL) is a company registered in Nigeria

Investigators have experience with clinical research

Current research at IBL includes: Development of HIV candidate vaccines Subtyping of HIV 1 and 2 in Nigeria HIV drug resistance Surveillance in Nigeria Prevalence of co-infection of HIV with Hepatitis B & C Subtyping of Hepatitis C virus in Nigeria Cross-sectional HIV incidence study among female

sex workers based at brothels in Nasarawa and Benue states

Site overviewSite overviewSite overviewSite overview

Site locationsSite locationsSite locationsSite locations

Interim study findings ( Feb. 07- April Interim study findings ( Feb. 07- April 11, 2006)11, 2006)Interim study findings ( Feb. 07- April Interim study findings ( Feb. 07- April 11, 2006)11, 2006)

Total number of brothels 28

Total number recruited 266

Total number HIV positive 192

Total number of HIV negative 74

Total number of co-infection (HIV-1 and 2) 12

Number of HIV-1alone 180

Number of HIV-2 Nil

HIV prevalence so far 72%

Prevalence of co-infection 4.5%

Challenges Challenges Challenges Challenges

Subjects being skeptical of our intention- such trials are relatively new in the area Not comfortable with staff leaving with their blood

samples Some think their blood will be used for ritual purpose

Resistance sometimes from their male clients Brothel owners not being cooperative in some

places Outright refusal to grant us entrance in some

brothels Resistance to the ideal of someone witnessing

after signing the informed consent form

Current infrastructureCurrent infrastructureCurrent infrastructureCurrent infrastructure

DNA sequencer-DNA analyses Real time PCR for Viral load quantification Facs count for CD4/8 measurement ELISA washer and reader Chemistry analyzer Vaccine administration and post-vaccination

surveillance Training and capacity building for health workers,

organizations and the general public Treatment services for HIV an other tropical infectious

diseases Internet and Data entry/analyses Pharmacy Counselling unit

Reception Reception Reception Reception

Data entry and processing Data entry and processing Data entry and processing Data entry and processing

Serology lab Serology lab Serology lab Serology lab

Lab equipment Lab equipment Lab equipment Lab equipment

IT EquipmentIT EquipmentIT EquipmentIT Equipment

IBL Boardroom IBL Boardroom IBL Boardroom IBL Boardroom