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Characterisation of particulate matter emissions from the Zimbabwe Mining and Smelting Company (ZIMASCO) Kwekwe Division (Zimbabwe): a ferrochrome smelter.

Particulate matter emissions from stack number 2 of a major ferrochrome smelter, Zimbabwe Mining and Smelting Company (ZIMASCO) were characterized and the rates at which the elements Cr, Fe, Cu and Zn and total ferrochrome dust are emitted into the atmosphere were determined. The extent of soil contamination by the dust deposited around the smelter in the generally prevailing southeasterly wind direction around the smelter was carried out. The highest concentrations of Cr and Fe occurred in the fine particulates of sizes less than 59 microm whilst that of Cu and Zn occurred in the coarse particulates of size range 70-100 microm. The emission rates from stack 2 were; total ferrochrome particulates 62.17 kg h(-1), Cr 6.217 kg h(-1), Fe 2.423 kg h(-1), Zn 42 mg h(-1) and 6 mg h(-1) for Cu. Particulate matter was emitted at a rate of 289 mg m(-3) from stack number 2. This value exceeds the legal limit of 200 mg m(-3). Chromium and iron are the metals in the largest amounts. The particles that constitute the largest proportion of the dust were in the range of 58-107.5 microm. This is a characteristic feature of the particulate matter emissions from ZIMASCO. Soils in the downwind direction from the smelter were polluted with Cr up to a distance of about 700 m outward from the perimeter of the boundary of the smelter.

Air Pollutants↗

Is fertility falling in Zimbabwe?

With an unequalled contraceptive prevalence rate in sub-Saharan Africa, of 43% among currently married women in Zimbabwe, the Central Statistical Office (1989) observed that fertility has declined sharply in recent years. Using data from several surveys on Zimbabwe, especially the birth histories of the Zimbabwe Demographic and Health Survey, this study examines fertility trends in Zimbabwe. The results show that the fertility decline in Zimbabwe is modest and that the decline is concentrated among high order births. Multivariate analysis did not show a statistically significant effect of contraception on fertility, partly because a high proportion of Zimbabwean women in the reproductive age group never use contraception due to prevailing pronatalist attitudes in the country.

Adolescent↗

The effect of child survival on fertility in Zimbabwe: a micro-macro level analysis.

The literature on the effect of fertility on child survival is extensive especially since the accumulation of data from the World Fertility, and Demographic and Health Surveys. Comparatively, empirical studies examining the other side of the relationship--the effect of child survival on fertility--are sparse although theoretical considerations suggest the interdependence of child survival and fertility. Furthermore, the relationship of child survival and fertility is often examined at the micro-level. There is growing recognition, however, that this relationship may be also influenced by macro-level factors. This study attempts to measure the effect of child survival on birth intervals in Zimbabwe using a micro-macro analytical approach based on the individual and community data from the 1988 Zimbabwe Demographic and Health Survey, and the 1989/1990 Zimbabwe Service Availability Survey, respectively. The multivariate analysis showed that there is a replacement effect in the relationship between child survival and fertility independent of individual characteristics of women in Zimbabwe. The analysis also showed that health interventions as measured by coverage and visit by a mobile family planning clinic, and access to a health service have differential impact on fertility in Zimbabwe controlling for the survival status of the previous to the last child and individual characteristics of the women.

Adolescent↗

Ranula: another HIV/AIDS associated oral lesion in Zimbabwe?

AIM: To show that sublingual ranula is associated with HIV/AIDS and as such should be considered an HIV/AIDS associated oral lesion in Zimbabwe. OBJECTIVES: To retrospectively study the prevalence, age and gender distribution, the HIV serostatus of ranula patients and the trend in prevalence of ranula and Kaposi's sarcoma (KS) in patients at the two largest referral Oral and Maxillofacial Surgery specialist centres in Harare, Zimbabwe. To use this information to infer an association between ranula and HIV/AIDS in Zimbabwe. DESIGN: Descriptive study with a retrospective and prospective component. SETTING: Oral and Maxillofacial Surgical clinics at specialist referral hospitals, Harare Central Hospital and Parirenyatwa Government Hospital, Harare, Zimbabwe. SUBJECTS: Eighty-three cases of ranula were studied: 45 cases retrospectively and 38 consecutively. A total of 231 cases of KS were studied retrospectively. METHODS: Histopathologic records of patients who presented with ranula and KS during the period January 1981 to September 2003 were studied. Gender and age were recorded for each case. Thirty-eight ranula patients studied consecutively during the period June 1999 to September 2003 were consented for HIV testing. RESULTS: There were 83 cases of ranula; 43.4% male and 56.6% female. There were 231 cases of KS, 61.2% male and 38.8% female. Male to female ratio was 1:1.3 for ranula and for KS was 1:0.6. Ranula was predominant in the 0-10 year age group (73.5%) while KS was most common in the 21-40 year age group (76.4%). Ranula and KS both had a marked rise in prevalence from 1992 to 2003. A total of 88.5% of the ranula cases tested HIV positive with 95% in the 0-10 year age group. CONCLUSION: There was a rising prevalence of ranula which mirrors that of KS (an HIV/AIDS associated oral lesion) and that 88.5% of ranula patients were HIV positive with 95% of them in the 0-10 year age group. Sublingual ranula should thus be considered another HIV/AIDS associated lesion in Zimbabwe, especially in children.

AIDS-Related Opportunistic Infections↗

Understanding women's attitudes towards wife beating in Zimbabwe.

OBJECTIVE: To investigate the factors associated with attitudes towards wife beating among women in partnerships in Zimbabwe in order to assist public health practitioners in preventing intimate partner violence (IPV). METHODS: A nationally representative survey of 5907 women of reproductive age (15-49 years) was conducted in Zimbabwe. Women were asked about their attitudes towards wife beating in five situations. The survey included sociodemographic characteristics, partnership characteristics, and household decision-making. FINDINGS: Over half of all women in Zimbabwe (53%) believed that wife beating was justified in at least one of the five situations. Respondents were most likely to find wife beating justified if a wife argued with her spouse (36%), neglected her children (33%), or went out without telling her spouse (30%). Among women in partnerships (n=3077), younger age, living in rural areas, lower household wealth, schooling at a lower level than secondary, and lower occupational status were associated with women reporting that wife beating is justified. Women who reported that they make household decisions jointly with their partners were less likely to say that wife beating is justified. CONCLUSIONS: Zimbabwe has a long way to go in preventing IPV, particularly because the younger generation of women is significantly more likely to believe that wife beating is justified compared with older women. Given the current social and political climate in Zimbabwe, finding means to negotiate rather than settle conflict through violence is essential from the household level to the national level.

Adolescent↗

Factors affecting the distributions of the ticks Amblyomma hebraeum and A. variegatum in Zimbabwe: implications of reduced acaricide usage.

The ticks Amblyomma hebraeum and A. variegatum are the main vectors of heartwater, a disease of ruminants caused by Cowdria ruminantium, in the agricultural areas of Zimbabwe. At present, A. hebraeum is widely distributed in the dry southern lowveld, and occurs in at least seven foci in the higher rainfall highveld. Amblyomma variegatum occurs in the Zambezi valley and surrounding dry lowveld areas in the northwest. The distribution of A. hebraeum has changed considerably over the past 70 years, while that of A. variegatum appears to have remained fairly static. The distribution patterns of both species in Zimbabwe display anomalous features; the ticks occur in areas of lowest predicted climatic suitability for survival and development and in areas where the densities of cattle, the most important domestic host, are lowest. The only factor favouring the survival of the species in the lowveld habitats in which they occur is the presence of alternative wildlife hosts for the adult stage. Their absence from more climatically favourable highveld habitats appears to have been the result of intensive acaricide treatment of cattle over a long period and a historic absence of significant numbers of wildlife hosts. Eradication of A. hebraeum and A. variegatum by intensive acaricide treatment of cattle can be achieved in the absence of significant numbers of alternative hosts, because of the long attachment and feeding periods of the adults of these tick species. However, eradication becomes impossible when alternative hosts for the adult stage are present, because a pheromone emitted by attached males attracts the unfed nymphal and adult stages to infested hosts. The unfed ticks are not attracted to uninfested hosts, such as acaricide-treated cattle. Regular acaricide treatment of cattle is expensive and so, for economic reasons, the Government of Zimbabwe is no longer enforcing a policy of strict tick control. It is likely that reduced tick control will result in the spread of Amblyomma ticks to previously uninfested areas. Added to this, recent introductions of various wildlife species to highveld commercial farming areas have created conditions in which the ticks could become established in higher rainfall areas. Amblyomma hebraeum is more likely to spread than A. variegatum, because its adults parasitize a wider range of wildlife hosts (warthogs, medium to large-sized antelope, giraffe, buffalo and rhinoceros), whereas adults of A. variegatum appear to be largely restricted to one wildlife species (buffalo) in Zimbabwe, the distribution of which is now confined to very limited areas of the country, as part of foot and mouth disease control measures.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Prevalence of hearing loss in primary school children in Zimbabwe.

OBJECTIVE: The objective of the study was to determine the prevalence of significant hearing impairment in children attending primary school in the country of Zimbabwe. METHODS: A cross-sectional study of the prevalence of hearing impairment in primary school children was undertaken as part of The Rotary Hearing Health Care Program in Zimbabwe. The sampling unit was primary schools in Manicaland, a province of Zimbabwe. All students in selected schools were screened. In total, 5528 students were screened for significant hearing impairment defined as greater than 30 dB HL at 1, 2 and 4 kHz in a quiet classroom. RESULTS: Overall, 135 students (2.4%, 95% CI 2.0-2.8) were identified as having a hearing threshold of greater than 30 dB in at least one ear and for at least one of the test frequencies. A conductive hearing loss was found in 79 students, or 1.4% of the total, and a sensorineural hearing loss was found in 56 students or 1.0% of the total. Disabling hearing impairment was found in 0.9% of children. CONCLUSIONS: The prevalence of hearing impairment in children in Zimbabwe is significant, even as a conservative measure amongst children attending school. Hearing impairment challenges the academic, career and social potential of young children. Regular screening, such as this could help target preventative measures that may improve the hearing impaired child's potential in terms of social interaction, academic achievement, and work opportunities.

Adolescent↗

Prospects for tobacco control in Zimbabwe: a historical perspective.

Using a historical and political economy perspective, this paper explores the prospects for tobacco control in Zimbabwe, the world's sixth largest producer and third largest tobacco exporter. Tobacco production, which first began in the former Rhodesia in the early 1900s, is closely associated with colonial history and land occupation by white settlers. The Zimbabwe (formerly Rhodesia) Tobacco Association was formed in 1928 and soon became a powerful political force. Although land redistribution has always been a central issue, it was not adequately addressed after independence in 1980, largely due to the need for Zimbabwe to gain foreign currency and safeguard employment. However, by the mid-1990s political pressures forced the government to confront the mainly white, commercial farmers with a new land acquisition policy, but intense national and international lobbying prevented its implementation. With advent of global economic changes, and following the start of a structural adjustment programme in 1991, manufacturing began to decline and the government relied even more on the earnings from tobacco exports. Thus strengthening tobacco control policies has always had a low national and public health priority. Recent illegal occupation of predominantly white owned farms, under the guise of implementing the former land redistribution policy, was politically motivated as the government faced its first major challenge at the general elections in June 2000. It remains unclear whether this will lead to long term reductions in tobacco production, although future global declines in demand could weaken the tobacco lobby. However, since Zimbabwe is only a minor consumer of tobacco, a unique opportunity does exist to develop controls on domestic cigarette consumption. To achieve this the isolated ministry of health would need considerable support from international agencies, such as the World Health Organisation and World Bank.

Agriculture↗

Population density and spatial differentials in child mortality in Zimbabwe.

Large regional variations in under-five mortality exist within many sub-Saharan countries. Population density as a potential explanatory factor for these regional variations has seldom been considered despite it being implicated as a determinant of mortality at other spatial scales. In Zimbabwe, the "Ndebele provinces"-Matabeleland North and South-have significantly lower levels of under-five mortality than the other ("Shona") provinces. This regional differential is explored using the Zimbabwe Demographic and Health Survey and census data. Factors other than population density that may contribute to the differential are examined. After controlling for the effects of potentially confounding socio-economic, demographic and environmental variables using Cox regression models children aged 1-4 yr living in the Ndebele provinces continued to have a level of mortality 45% lower than their counterparts in the Shona provinces. The possibility that regional variations in health care provision and/or cultural factors contribute to the mortality differential is also examined and rejected. Population densities in the Ndebele provinces are of a far lower order than in the Shona provinces. The main causes of child mortality in Zimbabwe in the time period under consideration were diarrhoea, ALRI, measles and malaria. How population density may affect the transmission of these infections and, hence, mortality is discussed. It is suggested that population density may provide an explanation for the spatial variation in child mortality in Zimbabwe. The implications of changing population densities for child health in urban and rural sub-Saharan Africa are briefly considered.

Cause of Death↗

Microsatellite analysis of Pinus taeda L. in Zimbabwe.

Deducing the origin of early 20th century introductions of Pinus taeda into Zimbabwe is possible given microsatellite markers and clear population differentiation in ancestral U.S. populations. This study was designed to determine whether P. taeda introductions into Zimbabwe came from one U.S. region or whether the present-day population is an admixture of introductions from east and west of the Mississippi River Valley. Principal components analysis, Cavalli-Sforza and Edwards' chord distances and presence of diagnostic alleles each indicate that the Zimbabwe population is an admixture. There were five novel alleles in the Zimbabwe population not represented in the indigenous U.S. populations, possibly because of de novo mutation, introgression with other introduced North American pines or sampling error.

Alleles↗

DNA relatedness of Leptospira strains isolated from beef cattle in Zimbabwe.

The DNA relatedness of 17 Leptospira strains isolated from beef cattle in Zimbabwe was determined using the hydroxyapatite method. Similarly to previously speciated African strains, all Zimbabwe isolates belonged to either Leptospira borgpetersenii or Leptospira kirschneri. All serovars within serogroups Pyrogenes (kwale, mombe and a strain closely related to serovar nigeria), Hebdomadis (marondera and mhou), Tarassovi (ngavi) and Sejroe (balcanica and hardjo) were L. borgpetersenii. L. kirschneri contained all strains in serovars of serogroups Icterohaemorrhagiae (zimbabwe), Australis (fugis), Bataviae (paidjan) and Pomona (a strain closely related to mozdok). The species designations of the Zimbabwe fugis and paidjan strains were different from those of the reference strains of these two serovars, both of which belong to Leptospira interrogans.

Animals↗

The burden of disease in Zimbabwe in 1997 as measured by disability-adjusted life years lost.

OBJECTIVE: To rank health problems contributing most to the burden of disease in Zimbabwe using disability-adjusted life years as the population health measure. METHODS: Epidemiological information was derived from multiple sources. Population size and total number of deaths by age and sex for the year 1997 were taken from a nationwide census. The cause of death pattern was determined based on data from the Vital Registration System, which was adjusted for under-reporting of human immunodeficiency virus (HIV) and reallocation of ill-defined causes. Non-fatal disease figures were estimated based on local disease registers, surveys and routine health service data supplemented by estimates from epidemiological studies from other settings if no Zimbabwean sources were available. Disease and public health experts were consulted about the identification of the best possible sources of information, the quality of these sources and data adjustments made. RESULTS: From the information collected, HIV infection emerged as the single most serious public health problem in Zimbabwe responsible for 49% of the total disease burden. A quarter of the total burden of disease was attributed to morbidity rather than premature mortality. The share of the disease burden was similar in females and males. CONCLUSION: Using local sources of information to a large extent, it was possible to develop plausible estimates of the size and the relative significance of the major health problems in Zimbabwe. The disease pattern of Zimbabwe differed substantially from regional estimates for sub-Saharan Africa justifying the need for countries to develop their own burden of disease estimates.

Adolescent↗

Prevention of mother to child transmission of HIV: evaluation of a pilot programme in a district hospital in rural Zimbabwe.

PROBLEM: Zimbabwe has one of the highest rates of HIV seroprevalence in the world. In 2001 only 4% of women and children in need of services for prevention of mother to child transmission of HIV were receiving them. DESIGN: Pilot implementation of the first programme for prevention of mother to child transmission of HIV in rural Zimbabwe. SETTING: 120 bed district hospital in Buhera district (285,000 inhabitants), Manicaland, Zimbabwe. KEY MEASURES FOR IMPROVEMENT: Programme uptake indicators monitored for 18 months; impact of policy evaluated by assessing up-scaling of programme. STRATEGIES FOR CHANGE: Voluntary counselling and testing services for HIV were provided in the hospital antenatal clinic. Women identified as HIV positive and informed of their serostatus and their newborn were offered a single dose antiretroviral treatment of nevirapine; mother-child pairs were followed up through routine health services. Nursing staff and social workers were trained, and community mobilisation was conducted. EFFECTS OF CHANGE: No services for prevention of mother to child transmission of HIV were available at baseline. Within 18 months, 2298 pregnant women had received pretest counselling, and the acceptance of HIV testing reached 93.0%. Of all 2137 women who had an HIV test, 1588 (74.3%) returned to collect their result; 326 of the 437 HIV positive women diagnosed had post-test counselling, and 104 (24%) mother-child pairs received nevirapine prophylaxis. LESSONS LEARNT: Minimum staffing, an enhanced training programme, and involvement of district health authorities are needed for the implementation and successful integration of services for prevention of mother to child transmission of HIV. Voluntary counselling and testing services are important entry points for HIV prevention and care and for referral to community networks and medical HIV care services. A district approach is critical to extend programmes for prevention of mother to child transmission of HIV in rural settings. The lessons learnt from this pilot programme have contributed to the design of the national expansion strategy for prevention of mother to child transmission of HIV in Zimbabwe.

Ambulatory Care↗

Zimbabwe's success story in education and health: will it weather economic structural adjustment?

The beginning of the 1980s saw the birth of Zimbabwe as a result of a protracted liberation war. It coincided with global interest in primary health care, the concept of universal primary school education and, unfortunately, moves towards economic stabilization and structural adjustment programmes. Economic structural adjustment was adopted by several sub Saharan African countries with dire consequences for the poor and vulnerable. Zimbabwe's commitment to social justice and to equitable distribution of resources demonstrated a practical move away from the culture of rhetoric so characteristic of many governments and non-governmental organisations and agencies. This commitment has been translated into impressive improvements in health and education. Current evidence shows that education has had a positive impact on health and related areas like contraceptive use, child mortality and the nutrition status of children. Conversely nutrition and health conditions among school children are important determinants of educational outcomes. Hitherto Zimbabwe's economy has been sufficiently strong to avoid excessive dependence on the International Monetary Fund, the World Bank and other foreign financial institutions. Unfortunately, however, the current economic recession together with economic structural adjustment programmes are beginning to have a negative impact on health and education. Will true synergism between health and education weather these structural problems? It seems that the people and government of Zimbabwe have the capacity and resolve to weather such a storm.

Economics↗

Effects of the Zimbabwe Defence Forces training programme on body composition and reproductive hormones in male army recruits.

OBJECTIVES: To investigate the effects of a four month endurance training programme on body composition and reproductive hormone levels. DESIGN: PRE and POST training comparative study. SETTING: Zimbabwe Military Academy, Gweru, Zimbabwe. SUBJECTS: 77 male recruit volunteers participating in the Zimbabwe Defence Forces cadet training programme. MAIN OUTCOME MEASURES: Percent body fat, fat free mass, body mass index, total serum testosterone, luteinising hormone (LH) and follicle stimulating hormone (FSH) compared using the paired t-test. RESULTS: There was a significant decrease in all parameters measured after four months of endurance training. Decreases in body composition parameters were 54% in percent body fat, 6% in fat free mass, and 13% in body mass index. There was a dramatic 58% drop in testosterone, 60% drop in LH and 15% drop in FSH after four months of endurance training. CONCLUSIONS: The Zimbabwe Defence Forces cadet training programme, an endurance training programme induces a state of negative energy balance in trainees. This results in a decrease in % body fat and body mass index due to utilisation of fat stores as a source of energy and a decrease in fat free mass due to gluconeogenic utilisation of muscle protein as energy source for muscle activity. There is impaired hypothalamic-pituitary-testicular axis function as evidenced by the state of hypogonadal-hypogonadism (low testosterone, LH and FSH). This may be attributed to: 1. gonadotrophin releasing hormone pattern generator malfunction due to the stress of intense physical activity and 2. withdrawal of energy expenditure from reproductive machinery as a way of conserving energy for more vital processes in the prevailing state of energy starvation.

Adolescent↗

Comparative evaluation and assessment of the diagnostic usefulness of four commercial HIV-1/HIV-2 antibody assays using two well-characterized serum panels from Blood Transfusion Service and the National Health Laboratory Services in Zimbabwe.

OBJECTIVE: To evaluate four Enzyme Linked Immunosorbent Assay (ELISA) HIV kits for possible use as a combination at the National Health Laboratory Services (NHLS) in Zimbabwe. DESIGN: Laboratory evaluation, sensitivity, specificity and cost effectiveness of HIV diagnostic kits. SETTING: Blood Transfusion Service (BTS) and Parirenyatwa Hospital in Zimbabwe. SUBJECTS: A total of 346 samples from 245 patients referred to Parirenyatwa Hospital and 101 blood donors at BTS. MAIN OUTCOME: The main goal was to come out with the best combination of ELISA kits in terms of sensitivity, specificity and cost effectiveness for use in diagnosis of HIV infection in Zimbabwe. RESULTS: The best combination kit was the Murex/Innotest with 100% sensitivity and 98.9% specificity, being slightly superior to the Genelavia/Vironostika combination kits in current use at NHLS. In addition, the Murex/Innotest combination has the shortest assay running time and requires fewer internal controls thereby increasing the number of test specimens per run. CONCLUSION: We recommend the use of the Murex/Innotest kits as a suitable combination for HIV infection diagnosis in Zimbabwe. The combination has a relatively low number of discordant results, drastically reducing the cost of running a third confirmatory test to resolve the discordant results. Most importantly, this combination maximizes HIV infection diagnosis by its ability to detect antibodies to HIV-1 groups M and O as well as HIV-2.

Cost-Benefit Analysis↗

A preliminary study of stress levels among first year medical students at the University of Zimbabwe.

OBJECTIVE: To assess stress levels among first year medical students at the University of Zimbabwe. DESIGN: A cross sectional study using two questionnaires. SETTING: Department of Anatomy, Faculty of Medicine, University of Zimbabwe, Mount Pleasant, harare, Zimbabwe. SUBJECTS: First year medical students aged between 18 and 24 years who have spent about seven months in the medical school. RESULTS: A total of 109 out of 123 first year medical students were used in the study. The two questionnaires produced similar results with an average of about 35.5% normal and an average of 64.5% of the students being at various levels of stress and or depression. About 11% reported very high levels of stress while the majority of the stressed students fell within the middle bracket. The number of affected students decreased as the level of stress and depression increased and demonstrates the differences in the stress threshold of the individual students. Estimation of suicide tendencies from both questionnaires showed that about 12% of the students were at serious risk and about 20% at lesser risk of psychological and emotional depression. The stratification of group 2 of SRQ-20 was valuable in isolating those students seriously stressed and/or depressed. CONCLUSION: This study has demonstrated that a number of first year medical students of the University of Zimbabwe were at various levels of stress and/or depression. Those students in the extreme stress or depression group need serious attention. This state of psychological and emotional distress in the subsequent years of medical training and during the professional years may lead to serious social consequences. A system of identifying students with low stress threshold early in their training is recommended as well as a means of helping them to deal with the stress and its causes.

Adolescent↗

AIDS prevention is thicker than blood. Zimbabwe.

Usually, giving blood is generous. Sometimes, however, it is lethal. In countries such as the US, India and Brazil, where blood donors can get paid by the pint, drug addicts, street dwellers and others who have little to sell except their bodies flock to for-profit blood centers. Many of these people carry the AIDS virus. A survey in the Indian state of Maharashtra revealed that 27% of blood donors tested positive for AIDS antibodies--a slightly higher rate than the same survey found among prostitutes. If 1 private blood bank tests for AIDS antibodies and turns HIV-positive volunteers away--forget about treating them--those poor and desperate enough can often find another, less scrupulous clinic. Or a clinic that doesn't do the testing properly. Although the 1988 Brazilian constitution banned the sale of blood, private clinics continue to flourish and nobody knows whose veins the blood is flowing from. The inevitable result is a frightening rate of contamination. An estimated 85% of Brazilian hemophiliacs have become infected with the HIV virus by contaminated blood or blood products. Even in countries that eschew blood sales and rely on donated supplies, the danger of HIV contamination is still present. HIV infection often does not generate antibodies for weeks; sometimes months or even years. In many 3rd World communities without adequate equipment, blood storage is impossible. The cost of testing emergency donations is so high that the choice may be narrowed--either go without testing or do without blood. Despite all these obstacles, Zimbabwe has shown that a 3rd World country where public health care takes precedence over private profit can make the blood supply network a force for reducing the spread of AIDS rather than increasing it. All blood donations in Zimbabwe were voluntary even before AIDS became an issue. When AIDS was accorded recognition as a serious issue, the country had no clinic for HIV testing. Concerned with the rapid spread of AIDS among the general population, the National Blood Transfusion Service (NBTS) began testing in 1985. Zimbabwe was the 3rd country in the world to begin routine testing. The NBTS is a nonprofit organization headed by representatives from the ministry of health, the Red Cross, and private donors. Because the NBTS was the only group in the country testing blood, many people who suspected they might be infected volunteered to donate blood just so they could have the test. Unfortunately, their suspicions were often justified. The service has found that regular donors now have a far lower incidence of HIV-positive since 1989, when alternative testing services were opened. Analysts believe much of the credit goes to the AIDS counseling given before each blood donation. Each individual is interviewed by a nurse who takes a comprehensive medical history. The education session also includes how AIDS might be contracted. The NBTS quickly discovered that the incidence of HIV antibodies was far lower among students aged 17-19. Since then, the service has thrown much of its resources into school blood campaigns. The service has also opened 5 new collection branches, 1 in each province. Samples from each donation are sent to 1 of the 2 national centers for testing. AIDS is still spreading in Zimbabwe, but thanks to the efforts of NBTS, hospital patients can feel secure.

Acquired Immunodeficiency Syndrome↗