Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
HIV-1 INFECTION AND AIDS IN AFRICA
The Epidemiology of AIDS: Expression, Occurrence, and Control of Human Immunodeficiency Virus Type 1 Infection. Kaslow RA and Francis DP, eds. New York, Oxford University Press, p. 194-220, 1989.. Unique Identifier : AIDSLINE ICDB/90668118 Quinn TK; Mann J; Johns Hopkins Hosp., 600 North Wolfe St., Blalock 1111,; Baltimore, MD 21205
Abstract:
As of February 1988, 39 African countries had reported over 10,000 cases of AIDS, but these figures underestimate the true number of AIDS cases because of problems associated with obtaining an accurate diagnosis. Seroprevalence rates in some areas range from 5-15% among pregnant women and blood donors and up to 20-80% among prostitutes and people attending sexually transmitted disease clinics. HIV-1 infection and AIDS in Africa are reviewed, including history; methodologic issues; AIDS surveillance; seroprevalence studies; modes of transmission (sexual, parenteral [blood transfusions and injections and scarifications], perinatal transmission, and transmission through other routes); clinical features; natural history of HIV-1 infection; other HIV infection in West Africa; and prevention and control of HIV-1 in Africa. Perhaps most impressive of the clinical presentations of HIV-1 infection in Africa is the appearance of enteropathic AIDS, frequently referred to as 'slim disease.' In most clinical studies in central Africa, profound weight loss and unexplained diarrhea occur in 99% and 80% of cases, respectively. Seroprevalence studies demonstrated HIV-1 antibody in all the patients who present with clinical diarrhea and a wt loss of 10 kg or more. A major problem in the differential diagnosis of AIDS has been tuberculosis, which has many of the signs and symptoms commonly seen in HIV-1 infection and is frequently associated with HIV-1. Immunologic studies have demonstrated a significant elevation of activated (HLA-DR+ and CD3+) lymphocytes and immune complexes in both African heterosexual and US homosexual populations relative to the US heterosexual population. The AIDS problem in Africa already is severe. In areas where more than 10% of the population appear to be infected, the toll of disease and death in the next decade or so will be enormous if the infection manifests a natural history similar to that seen in the US. The impact of maternally acquired infection on child mortality rates may be profound. AIDS threatens the economic and social development and even the political stability of Africa, because it affects primarily people between 20 and 40 yr of age, the age group that contributes most to national development. The most pressing research need in Africa is for development of effective control measures. (128 Refs)
Keywords: Acquired Immunodeficiency Syndrome/*EPIDEMIOLOGY/TRANSMISSION Adolescence Adult Africa/EPIDEMIOLOGY Child Child, Preschool Comparative Study *Cross-Cultural Comparison Cross-Sectional Studies Female Human HIV Infections/*EPIDEMIOLOGY/TRANSMISSION HIV Seroprevalence HIV-1/*PATHOGENICITY Incidence Infant Infant, Newborn Longitudinal Studies Male Middle Age Population Surveillance Pregnancy Prostitution Risk Factors MONOGRAPH REVIEW, TUTORIAL REVIEW 901230
M90C3729
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Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
