Evaluation of the work of the Institut Pasteur de Madagascar in detecting HIV seropositivity in the country

A 1985 screening for HIV antibodies conducted in Antananarivo by the Institute Pasteur of Madagascar among 42 male homosexuals 58 prostitutes and 43 male and 31 female heterosexuals with multiple partners including 4 subjects with Kaposis sarcoma did not reveal any seropositive individuals. The Institute conducted a subsequent screening in 1987 on a larger sample of 1075 blood donors in Antananarivo and 1131 subjects considered at high risk in the 4 main port cities of Madagascar. 2 diagnostic laboratories were planned for initial screening for HIV in Madagascar and the Institute Pasteur was designated the reference center that would confirm positive test results for Madagascar. No seropositive blood donors were identified but there were 4 false positive or 3.72/1000 with the ELAVIA test. 1 seropositive case among the 1131 high risk subjects was confirmed with western blot. The case concerned a prostitute from the countrys 2nd largest port. There were 10 false positives for a rate of 8.8/1000. In 1987 an individual with dual French and Madagascan citizenship resident in Madagascar was also diagnosed with AIDS. Another screening program was initiated in April 1988 among women with multiple partners from 9 areas of the country. 269 samples have been obtained but not processed pending receipt of laboratory materials. The Institute Pasteur has tested 14 serums found positive with the ELAVIA test with the western blot procedure. All were negative; the rate of false positives was 6.9/1000. Among over 5000 samples tested only 1 was found positive in a subject from Madagascar.