Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2014-10-17T12:52:33Z No. of bitstreams: 2 Tese - Helen de Lima 2013.pdf: 9777714 bytes, checksum: cc6650482217d50ed3a20d235b2fe54a (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Jaqueline Silva (jtas29@gmail.com) on 2014-10-17T20:38:40Z (GMT) No. of bitstreams: 2 Tese - Helen de Lima 2013.pdf: 9777714 bytes, checksum: cc6650482217d50ed3a20d235b2fe54a (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2014-10-17T20:38:40Z (GMT). No. of bitstreams: 2 Tese - Helen de Lima 2013.pdf: 9777714 bytes, checksum: cc6650482217d50ed3a20d235b2fe54a (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2013-09-17 / Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG / The aim of this study was to analyze the prevalence and distribution of mortality hospitalizations and costs for non-communicable chronic diseases (cardiovascular diseases, cancer, chronic respiratory diseases and diabetes mellitus ) in the State of Goiás, from 2006-2012 about the epidemiological dimension and proposed strategic actions. Methodological procedures included descriptive statistics with frequency analysis, absolute and percentage, and frequency conversion rate of deaths per 10 000 inhabitants, for all of the municipalities and their distribution in the large and small regions of health. We used the databases of deaths and hospitalizations from national health information by selecting admissions frequently occurring above 100 in 2011, according to the International Classification of Diseases (ICD-10). Copied these databases. It was created an environment tab, using TabWin Exploratory Analysis applicative, version 3.6. The process of extracting the data consisted in taking some filters so that the extracted data were only and exclusively of non-communicable chronic diseases and disabled residents in the state of Goiás and only during the selected period. The findings show that, for the variable death, the most frequent cause was the circulatory system diseases. Struck both sexes in the age groups in their extreme stratification. These diseases are also prevalent when analyzing hospital admissions, and the majority occur in women. When assessing the cost of hospital admissions, there is a growing expense, in general, for all causes. The large region health, the Midwest has the highest death rates and higher expenses, R$ 182.84 million in the period. The causes cancer affects men more than 60 years of age or above with the death rate was 3.6 cases per 10 000 inhabitants. Chronic respiratory diseases and diabetes mellitus occur respectively in men aged 70 and above and women 50 years of age or above. The study also revealed that, for large region health, death rates had great variation. The highest rate corresponds to the large region Midwest, which has characteristics of great development. The study revealed the presence of significant and diverse death rate in the large regions of health. The findings indicate the need for consideration of the possibilities and limits of punctual interventions, compensatory cyclical character, and the importance of intersectoral interventions, integral for amending the conditions of life of the whole population. It also demonstrates the importance of the adoption of public policies and intersectoral actions guided by the community – based approach, amplifying the reach of intervention of public agencies in the prevention and control of NCDs, one of the large, if not the biggest, challenge for the public health of the XXI century. / O objetivo deste trabalho foi analisar a prevalência e distribuição da mortalidade, das internações e dos custos por doenças crônicas não transmissíveis (doenças do aparelho circulatório, câncer, doenças respiratórias crônicas e diabetes mellitus) no Estado de Goiás, no período de 2006 a 2012 no tocante a dimensão epidemiológica e a propostas de ações estratégicas. Os procedimentos metodológicos incluíram estatística descritiva com análise de frequência, absoluta e percentual, e conversão da frequência em taxa de óbitos para cada 10 mil habitantes, para o conjunto de municípios e a distribuição destes nas macrorregiões e microrregiões de saúde. Foram utilizadas as bases de dados de óbitos e de internações hospitalares dos sistemas nacionais de informação em saúde, selecionando-se as internações com frequência de ocorrência acima de 100 no ano de 2011, segundo a Classificação Internacional de Doenças (CID-10). Copiadas essas bases de dados, criou-se um ambiente de tabulação, com o uso do aplicativo de Análise Exploratório TabWin, versão 3.6. O processo de extração dos dados consistiu em assumir alguns filtros de forma que os dados extraídos fossem únicos e exclusivamente de doenças crônicas não transmissíveis e os enfermos residentes no Estado de Goiás e apenas no período selecionado. Os achados demonstram que, para a variável óbito, a causa de maior ocorrência foi doenças do aparelho circulatório. Acometeu ambos os sexos nas faixas etárias em seus extremos de estratificação. Esses agravos também predominam quando da análise das internações, sendo a maior ocorrência em mulheres. Ao avaliar o custo das internações, observa-se um crescente gasto, de forma geral, para todas as causas. A macrorregião de saúde, Centro Oeste, tem as maiores taxas de óbitos e os maiores gastos, R$ 182,84 milhões, no período. A causa câncer acomete mais homens de 60 anos de idade ou acima com taxa de óbito de 3.6 casos por 10 mil habitantes. As doenças respiratórias crônicas e o diabetes mellitus ocorrem, respectivamente, em homens de 70 anos ou acima e mulheres de 50 anos de idade ou acima. O estudo revelou ainda que, por macrorregião de saúde, as taxas de óbito tiveram grande variação. A maior taxa corresponde à macrorregião Centro Oeste, que tem característica de grande desenvolvimento. O estudo evidenciou a presença relevante e diversificada de taxa de óbitos nas microrregiões de saúde. As conclusões indicam a necessidade de ponderação acerca das possibilidades e limites das intervenções pontuais, de caráter conjuntural e compensatório, bem como a relevância de intervenções intersetoriais, integrais que visem modificar as condições de vida do conjunto da população. Demonstra ainda a importância da adoção de políticas públicas e ações intersetoriais orientadas pela abordagem de base comunitária amplificando a capilaridade de intervenção dos órgãos públicos na prevenção e controle das DCNT um dos grandes, senão o maior, desafio para a saúde pública do século XXI.

A Organização Mundial da Saúde estima que 3.9 bilhões de pessoas, em 128 países, vivem atualmente em áreas de risco para contrair dengue em todo o mundo, e que anualmente, 390 (284-528) milhões de infecções ocorrem, sendo apenas 96 (67-136) milhões de casos com manifestações clínicas. Estima-se que 500.000 casos de dengue hemorrágica aconteçam por ano, muitos deles em crianças, causando milhares de mortes (Bhatt et al., 2013; WHO, 2015a). A urbanização, a superpopulação, aglomeração, a pobreza, a infra-estrutura de saúde pública enfraquecida, além das mudanças demográficas globais, são fatores que interferem na incidência da dengue e contribuem para a perpetuação e o crescente número de casos da doença (Farmer, 1996; Guzmán and Kouri, 2002). Além destes fatores, as viagens internacionais também implicam no aumento da incidência da dengue, porque o viajante ajuda a introduzir novas estirpes de diferentes partes do mundo ao chegar doente em seu destino, ou ao voltar para casa portando a doença (Wilder-Smith and Schwartz, 2005). O Brasil sediou em 2014 a Copa do Mundo da FIFA e, em 2016, recebeu os Jogos Olímpicos de Verão, no Rio de Janeiro, dois dos maiores eventos esportivos da atualidade, e por isso esperava receber centenas de milhares de turistas em cada um dos eventos. Embora exista uma vacina contra a dengue, sua eficácia não é suficiente para a prevenção ampla, e a curto prazo, da população suscetível e, por estas razões, este trabalho pretende, através da modelagem matemática, estimar o risco de contágio de dengue para turistas não imunes no Brasil no período da Copa do Mundo da FIFA 2014, em cada uma das 12 cidades-sede do evento e também estimar o risco de contágio de dengue para turistas não imunes no Brasil no período dos Jogos Olímpicos Rio 2016. Para a Copa do Mundo da FIFA, o risco obtido variou de 3,61x10-6 no melhor cenário a 8,33x10-4, no pior. Já para os Jogos Olímpicos, o pior risco individual obtido foi igual a 5.84x10-5 (IC 95%: 5.21x10-5 - 6.47x10-5) / The World Health Organization estimates that 3,9 billion people in 128 countries currently live in areas at risk of dengue worldwide, and that 390 (284-528) million infections occur annually, of which 96 (67 -136) million cases with clinical manifestations. It is estimated that 500,000 cases of dengue hemorrhagic occur annually, many of them in children, causing thousands of deaths (Bhatt et al., 2013; WHO, 2015a). Urbanization, overpopulation, agglomeration, poverty, weakened public health infrastructure, and global demographic changes are factors that interfere with the incidence of dengue and contribute to the perpetuation and increasing number of cases of the disease (Farmer, 1996; Guzmán and Kouri, 2002). In addition to these factors, international travel also increase in the incidence of dengue, because an infected traveller may introduce new strains from different parts of the world when they arrive at their destination, or when they return home with the disease (Wilder-Smith and Schwartz, 2005). Brazil hosted the 2014 FIFA World Cup and hosted the 2016 Summer Olympics in Rio de Janeiro, two of the biggest modern sporting events, and it was predicted that each event would receive hundreds of thousands of tourists in each of events. Although a vaccine against dengue exists, its efficacy is not sufficient for the broad and short-term prevention of the susceptible population. As a result, this work intends, through mathematical modelling, to estimate the risk of contagion of dengue for non-immune tourists in Brazil during the period of 2014 FIFA World Cup in each of the 12 host cities of the event and also estimate the risk of contagion of dengue for non-immune tourists in Brazil during the period of Rio 2016 Olympic Games. During the FIFA World Cup, the risk obtained ranged from 3,61x10-6 in the best scenario up to 8,33x10-4 in the worst case scenario. For the Olympic Games, the worst individual risk was 5.84x10-5 (IC 95%: 5.21x10-5 - 6.47x10-5)

Objetivo - Avaliar o sono, ritmos biológicos e metabolismo de trabalhadores de uma comunidade amazônica do Acre, segundo diferentes graus de urbanização das residências. Métodos - Foram executados três sub-estudos distintos. No primeiro estudo foram feitas análises de dados referentes às características sociodemográficas, medidas antropométricas, hábitos de vida, características do sono e morbidades referidas de trabalhadores da reserva extrativista de Xapuri, Acre. Para o segundo estudo foi executada uma análise de dados alimentares de recordatório de 24 horas para obtenção de padrões alimentares e suas associações possíveis para variáveis de sono e sonolência em trabalhadores. Para o último estudo foram realizadas coleta e análise de dados alimentares, antropométricos, variáveis metabólicas, relacionados ao sono e aos hábitos de vida de trabalhadores residentes nas regiões rurais e urbanas de Xapuri. Resultados - Foram produzidos três manuscritos que representaram os três sub-estudos distintos que compõe este trabalho múltiplo. O primeiro estudo avaliou os efeitos do tipo de trabalho (elevado ou baixo esforço físico) e o estilo de vida sobre o sono dos trabalhadores da reserva amazônica. O segundo estudo propôs uma nova abordagem na avaliação do consumo alimentar e suas relações com o sono e sonolência de trabalhadores, envolvendo a investigação dos padrões alimentares. O terceiro estudo apresentou os principais achados comparando trabalhadores rurais e urbanos da reserva amazônica no que tange estilo de vida, sono, exposição à luz, aspectos metabólicos, estado nutricional e consumo alimentar. Conclusão - No que tange aos aspectos metabólicos, destaca-se alta prevalência de sobrepeso e obesidade entre trabalhadores urbanos, bem como marcadores alterados para doenças metabólicas. No que se refere ao sono, trabalhadores rurais apresentam um alta prevalência de distúrbios de sono; entretanto, entre os residentes urbanos destacam-se uma redução da duração de sono, horário de sono tardio e menor exposição à luz. O estudo de padrões alimentares demonstrou-se possível e eficaz eficaz na avaliação de desfechos relacionados à alimentação e ritmos biológicos, em especial o sono. / Aim - To evaluate the sleep, biological rhythms and metabolism of workers of an Amazonian community of Acre, according to different degrees of urbanization of the residences. Methods - Three different sub-studies were performed. In the first study, data were analyzed regarding socio-demographic characteristics, anthropometric measurements, lifestyle, sleep characteristics and referred morbidity of workers from the Xapuri Extractive Reserve, Acre. For the second study, a 24 hour recall data analysis was performed to obtain dietary patterns and their possible associations for sleep and sleepiness variables in workers. For the last study were collected and analyzed food data, anthropometric, metabolic variables, related to sleep and living habits of workers residing in the rural and urban regions of Xapuri. Results - Three manuscripts were produced that represented the three distinct sub-studies that compose this multiple work. The first study evaluated the effects of the type of work (high or low physical effort) and the sleep lifestyle of the workers of the Amazon reserve. The second study proposed a new approach in the evaluation of food consumption and its relationships with sleep and drowsiness of workers, involving the investigation of dietary patterns. The third study presented the main findings comparing rural and urban workers in the Amazon Reserve in relation to lifestyle, sleep, light exposure, metabolic aspects, nutritional status and food consumption. Conclusion - Regarding the metabolic aspects, there is a high prevalence of overweight and obesity among urban workers, as well as altered markers for metabolic diseases. As far as sleep is concerned, rural workers have a high prevalence of sleep disorders; however, among urban residents, there is a reduction in sleep duration, late sleep time and less light exposure. The study of dietary patterns has proved to be possible and effective in evaluating outcomes related to diet and biological rhythms, especially sleep.

Abstract not available

In the pre-contact era, Huron women were relatively powerful. They were active participants in the political, economic, and cultural activities of pre-contact Huronia. After contact with Europeans, however, epidemic disease swept through the Huron country. As a virgin soil population, the Hurons were devastated by contagious disease. Beginning in 1634, they witnessed epidemic outbreaks of diseases such as measles, scarlet fever, influenza, and smallpox. The epidemics had a harsh physical toll on all Hurons, particularly pregnant and breast-feeding women. The incidence of disease was high and the mortality rate was at least fifty percent. The epidemics also had cultural consequences. As a result of epidemic disease, the Hurons witnessed changes to their political processes, economic activities, cultural practices, and spiritual beliefs. Two of the most significant cultural consequences of contagious disease were warfare with the Five Nations and the loss of faith in traditional beliefs. Each of the cultural changes instigated by contagious disease affected the power and prestige of Huron women. The impact of contagious disease on Huron women was overwhelmingly negative.

In the pre-contact era, Huron women were relatively powerful. They were active participants in the political, economic, and cultural activities of pre-contact Huronia. After contact with Europeans, however, epidemic disease swept through the Huron country. As a virgin soil population, the Hurons were devastated by contagious disease. Beginning in 1634, they witnessed epidemic outbreaks of diseases such as measles, scarlet fever, influenza, and smallpox. The epidemics had a harsh physical toll on all Hurons, particularly pregnant and breast-feeding women. The incidence of disease was high and the mortality rate was at least fifty percent. The epidemics also had cultural consequences. As a result of epidemic disease, the Hurons witnessed changes to their political processes, economic activities, cultural practices, and spiritual beliefs. Two of the most significant cultural consequences of contagious disease were warfare with the Five Nations and the loss of faith in traditional beliefs. Each of the cultural changes instigated by contagious disease affected the power and prestige of Huron women. The impact of contagious disease on Huron women was overwhelmingly negative.

This study was undertaken to investigate the relationship between Natural Killer cells and HLA-G at the placental barrier in HIV-I infected pregnant women and to establish the significance, if any, to in utero infection. Fifty-five HIV -I infected pregnant women were recruited into the study after consent was obtained. Blood samples were collected from both mothers and babies for viral loads and CD4+ cell counts. Placental samples were obtained from pregnancies at delivery and examined by immunoperoxidase immunohistochemistry methods using monoclonal antibodies to p24 antigens and Natural Killer (CD56+) cells. HLA-G expression was quantified using real-time polymerase chain reaction. Analysis of viral loads and CD4+ cell counts were undertaken in categories. No significant association was observed between the viral load of mothers and their CD4+ cell counts. Eighteen percent of the women in this study population had 5 log viral loads with a transmission rate of 0.27(95% Cl, 0.15 - O. 39). Maternal viraemia was significantly associated with transmission of infection to babies (p = 0.047). The odds ratio indicated that for every 1 log increase in maternal viral load the babies were 3.1 times more likely to acquire the infection (Exp (B) = 3.137 (95%CI, 1.015-9.696). Furthermore, the study found that a higher number of female babies were infected than males. Although not statistically significant the odds ratio indicated that female babies were 3.1 times more likely to become infected than males (Exp (B) = 3.110 (95%CI, 0.819-11.808). We report here the results of immunohistochemistry for p24 antigens and NK (CD56+) cells and compare them to the immunological responses of both mothers and babies at birth. HIV-1 antigens were detected in 94.5% of all placentas by immunohistochemistry. Infiltration of CD56+ was found in 98% of placental tissue. The analysis revealed that the presence of p24 antigens in placental tissue was not influenced by maternal viral load or CD4+ cell counts. Lower median NK cell values were observed in placentas of mothers with infected babies as compared with the uninfected cluster. Although not statistically significant, the risk of vertical transmission was increased 3.4 times more in placentas which had lower NK cell values. According to the odds ratio, babies CD4+ counts were affected by every 1 log increase in mother's viral load. Overall, maternal viral load emerged as a strong predictor for risk of infection from infected mothers to their infants. Our analysis indicated that female babies were 3.7 times more likely to acquire the infection than males. Using data obtained from real-time PCR we investigated the relationship between maternal viral load and the quantity of HLA-G expression (p = 0.045; 95%CI 1.029- 11.499). Logistic regression models revealed that mother's viral load was the strongest risk factor for vertical transmission. No statistically significant correlation was noted with HLA-G and viral transmission. However, the odds ratio indicated that the risk of infection increased by 1.3 with every 1 fold increase in HLA-G expression. An analysis of mother-to-child transmission rates by gender revealed that the odds ratio for transmission was 3.4 times more in female babies than in males. We then investigated the relationship between maternal viraemia and HLA-G expression. A positive correlation between maternal viral load and placental HLA-G was observed (p = 0.038). When gender susceptibility to HLA-G expression was explored a statistically significant association was observed in placental tissue of mothers with infected and uninfected male babies and HLA-G expression (p = 0.013). To conclude, the analysis found that HLA-G was up regulated 3.95 times more in placental tissue of mothers with infected babies than in mothers with uninfected babies. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2007.

Background: Although the prevalence of pneumonia in pregnancy is reported to be less than 1%, the pregnant state and risk factors associated with the development of pneumonia adversely influence the outcome of pregnancy. KwaZulu-Natal is at the epicenter of the dual epidemics of tuberculosis and HIV-1 and the impact of these diseases occurring concurrently in pregnant women at King Edward VIII hospital (KEH), South Africa have been described previously. The impact of antenatal pneumonia in HIV-1 infected and uninfected women however has not been described in the study population and was investigated. Methods: Pregnant women with clinical and radiological evidence of pneumonia were recruited from the antenatal clinic and labour ward at KEH. The study was conducted prospectively between January and December 2000. The clinical profile of these women and the causative organisms were determined. In addition the impact of HIV-1 infection, maternal immunosuppression and maternal pneumonia on obstetric and perinatal outcomes were evaluated. Mothers diagnosed with tuberculosis and multi drug resistant tuberculosis were hospitalised at King George V hospital until delivery. Results: Twenty nine women were diagnosed with antenatal pneumonia (study arm) with Mycobacterium tuberculosis the only causative organism isolated. A control arm of 112 pregnant women was also studied. Maternal and perinatal mortality was restricted to the study arm with a maternal mortality ratio of 99 per 100 000 live births and a perinatal mortality rate of 240 per 1000 births. Pneumonia was significantly associated with a negative overall obstetric outcome in the presence of HIV- l infection, antenatal care, anaemia and second trimester booking status. In addition, the presence of pneumonia was significantly associated with maternal mortality. There was a highly significant association between exposure to pneumonia and poor neonatal outcome. Maternal pneumonia, maternal HIV infection and the presence of medical and obstetric conditions were significantly associated with low birth weight and neonatal pneumonia. Further, maternal pneumonia (p <0.001) and concurrent HIV infection (p=0.002) was significantly associated with neonatal death. Conclusion: The presence of pneumonia in the antenatal period impacts negatively on maternal and neonatal morbidity and mortality. Health care providers must maintain a high degree of suspicion when managing a pregnant woman with unresolving upper respiratory tract symptoms and refer timeously for further investigation. Pneumonia and in particular pulmonary tuberculosis associated with HIV co- infection in pregnancy is a threat to mother and baby. Therefore in areas endemic for TB and HIV infection, it may be prudent to screen HIV positive pregnant women for symptoms suggestive of pneumonia and thereby identify women requiring further investigations such as sputummicroscopy and cultures, and a screening chest radiograph. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2007.

Background: Lifestyle related non-communicable diseases are now the biggest cause of death and burden of disease in Thailand. NANDA is an evidence- based classification system of nursing diagnosis. Aim: The purpose of the study was to identify and describe the nursing needs of a patient group from a low socio-economic background located in an urban primary health-care setting in Thailand by using NANDA. Method: The study is a structured observation study with a quantitative approach. The study was conducted at a health- center in Bangkok, Thailand. Result: 42 different NANDA diagnoses were identified in the observed group. In total 609 nursing diagnoses were distributed among 96 patients of which 76 were women. The most frequent nursing need diagnosis found was; Imbalanced nutrition; more than body requirement. The most frequent nursing risk diagnosis identified was: Risk for decreased cardiac tissue perfusion. Conclusion: The nursing needs observed in the patient group were mainly related to non- communicable diseases. The disease panorama observed in the patient group coherent with findings in international modern research. Significant relationships and patterns between nursing needs could be identified which strengthens the idea of using an instrument such as NANDA. In conducting the study it was evident that some nursing problems did not match with any diagnosis in the NANDA taxonomy. Clinical impact: The study shows the nursing needs among a patient group with low-socio economic backgrounds in an urban primary health care setting in Bangkok. NANDA is a good tool to systematize nursing care in the nursing profession. It can be beneficial for students in similar situations to use a tool like NANDA to categorize their assessments and impressions. / Bakgrund: Livsstil relaterade icke-smittsamma sjukdomar är numera den största dödsorsaken och sjukdomsbördan i Thailand. NANDA är en evidensbaserad klassificeringssystem av omvårdnad diagnos. Syfte: Syftet med studien var att beskriva och identifiera omvårdnadsbehov hos en patientgrupp med låg socioekonomisk bakgrund inom primärvården i Bangkok genom att använda NANDA. Metod: Studien är en strukturerad observationsstudie med en kvantitativ ansats. Studien genomfördes på en primärvårsinstans i Bangkok. Resultat: 42 olika NANDA diagnoser identifierades i den observerade gruppen. Totalt fördelades 609 diagnoser på 96 patienter, varav 76 var kvinnor. Vanligaste omvårdnadnadsdiagnosen var Obalanserad kost, mer än kroppsbehovet. Den vanligaste omvårdnads riskdiagnosen identifierad var Risk för minskad hjärtvävnads perfusion. Slutsats: Omvårdnads behovet i den observerade patient gruppen var främst relaterat till icke smittsamma livsstilsrelaterade sjukdomar. Sjukdomspanoramat i den observerade patientgruppen var i överensstämmelse med resultat i internationell modern forskning. Att använda NANDA visade sig vara använbart för att organisera och systematisera observationer och data oavsett sammanhang. Signifikanta samband och mönster mellan olika omvårdnadsbehov kunde identifieras. Ett antal identifierade omvårdnadproblem matchade inte med någon diagnos i NANDA taxonomin. Klinisk betydelse: Studien visar på omvårdnadsbehovet hos en patientgrupp med låg socioekonomisk bakgrund i en urban primärvårdsinstans i Bangkok. NANDA är ett bra verktyg för att systematisera omvårdnad i sjuksköterskeyrket. Det kan vara fördelaktigt för studenter i liknande situationer att använda ett verktyg som NANDA att kategorisera sina bedömningar och intryck.

By knowing the incidence of an infectious disease, we can ascertain the high risk factors of the disease as well as the e ectiveness of awareness programmes and treatment strategies. Since the work of Hugo Muench in 1934, many methods of estimating the force of infection have been developed, each with their own advantages and disadvantages. The objective of this thesis is to explore the di erent compartmental models of infectious diseases and establish and interpret the parameters associated with them. Seven models formulated to estimate the force of infection were discussed and applied to data obtained from CAPRISA. The data was agespeci c HIV prevalence data based on antenatal clinic attendees from the Vulindlela district in KwaZulu-Natal. The link between the survivor function, the prevalence and the force of infection was demonstrated and generalized linear model methodology was used i to estimate the force of infection. Parametric and nonparametric force of infection models were used to t the models to data from 2009 to 2010. The best tting model was determined and thereafter applied to data from 2002 to 2010. The occurring trends of HIV incidence and prevalence were then evaluated. It should be noted that the sample size for the year 2002 was considerably smaller than that of the following years. This resulted in slightly inaccurate estimates for the year 2002. Despite the general increase in HIV prevalence (from 54.07% in 2003 to 61.33% in 2010), the rate of new HIV infections was found to be decreasing. The results also showed that the age at which the force of infection peaked for each year increased from 16.5 years in 2003 to 18 years in 2010. Farrington's two parameter model for estimating the force of HIV infection was shown to be the most useful. The results obtained emphasised the importance of HIV awareness campaigns being targeted at the 15 to 19 year old age group. The results also suggest that using only prevalence as a measure of disease can be misleading and should rather be used in conjunction with incidence estimates to determine the success of intervention and control strategies. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2013.