Important note: Information in this article was accurate in 1988. The state of the art may have changed since the publication date.
AIDS IN SUBSAHARAN AFRICA
AIDS, Acquired Immune Deficiency Syndrome, and other Manifestations of HIV Infection. Wormser GP et al, eds. Park Ridge, NJ, Noyes Publications, p. 108-27, 1987.. Unique Identifier : AIDSLINE ICDB/88646998 Biggar RJ; Agius G; International AIDS Epidemiology, NCI, Bethesda, MD
Abstract:
Acquired immunodeficiency syndrome (AIDS) is now widely recognized to be an important public health problem in many parts of central and eastern Africa. AIDS in sub-Saharan Africa is discussed, including initial recognition of the AIDS problem, serologic considerations, epidemiology of human immunodeficiency virus (HIV) and AIDS, and clinical features of AIDS in Africa. An AIDS definition is proposed for use in surveillance and clinical investigation of African patients (pts): For surveillance purposes, a case must have (1) absence of conditions that explain the pt's clinical or immunological status and (2) at least one of three clinical criteria (a syndrome of profound wt loss and either chronic diarrhea or fever; an opportunistic infection; confirmed human immunodeficiency virus (HIV)-induced immunosuppression and life-threatening illnesses). To be confirmed, a case must have (1) HIV antibodies and (2) immunodeficiency measured by T-subset analysis indicating a depletion of T-helper cells. It is important for clinicians dealing with African pts to recognize that not all illnesses in seropositive subjects are related to AIDS or immunosuppression. In some areas, a large number of seropositive subjects will be relatively recently infected and not (yet) immunosuppressed. The epidemic in Africa threatens to be a public health disaster affecting not only the personal well-being of individuals, but the development of the region. According to some authorities, there may be several million persons already infected with the virus. The authors feel that this number may overestimate the situation because HIV infection has been studied mainly in high-prevalence urban areas, whereas the bulk of the population lives in the rural areas which have a substantially lower HIV prevalence. The groups most at risk in Africa are those on whom these countries depend for the next generation of leaders, the urban educated elite. Loss of these persons just as they are at their peak productivity could have a devastating effect on development. In HIV infection, no cure is known, making prevention paramount and education to inform the general population of the routes of spread and measures to prevent exposure essential. Where HIV infection has not been introduced, or is rarely present, surveillance and education programs may be even more successful. Countries that currently have minimal problems with AIDS cannot afford complacency. (63 Refs)
Keywords: Acquired Immunodeficiency Syndrome/*MORTALITY/TRANSMISSION Adult Africa Child Cross-Sectional Studies Female Human Male Opportunistic Infections/MORTALITY Pregnancy Risk Factors MONOGRAPH REVIEW, TUTORIAL REVIEW
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Important note: Information in this article was accurate in 1988. The state of the art may have changed since the publication date.
