Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
THE AFRICAN AIDS EXPERIENCE IN CONTRAST WITH THE REST OF THE WORLD
Infect Dis Ther; 3:43-56 1989. Unique Identifier : AIDSLINE ICDB/90665437 Clumneck N; Carael M; Van de Perre P; Dept. of Internal Medicine, Free Univ. of Brussels, Brussels,; Belgium
Abstract:
HIV infection is now endemic in most sub-Saharan African countries. It is thought that 50,000-100,000 people have suffered or died from AIDS in Africa so far. Seroprevalence rates of 1-20% are found in the general population; and 27-88% of certain groups, such as female prostitutes and their clients, may be infected. Several million infected individuals may exist in Africa. Viruses involved in African AIDS, risk factors and cofactors in heterosexual transmission of AIDS, and clinical aspects of HIV infection in Africa are reviewed. HIV in Africa is characterized by heterosexual transmission of the virus in the general population, especially in urban areas. As a consequence of high seroprevalence rates among young women in their childbearing years, HIV infection is affecting children also, and major demographic consequences can be expected in the coming decades. Two forms of Kaposi's sarcoma (KS) exist in Africa. In equatorial Africa, KS is extremely common and accounts for 12.8% of malignant tumors in Zaire, 4.5% in Tanzania, 4.2% in Uganda, and 2.9% in Kenya. A changing pattern of KS was first noted in 1983 in Lusaka, Zambia. The 'new' pattern of KS among African patients (pts) consists of generalized lymphadenopathy and oral, gastrointestinal, or bronchial lesions together with cutaneous infiltrative plaques on the trunk, genital organs, face, and more rarely, limbs. When associated with opportunistic infection, the disease is rapidly fatal. Pts respond about as well to immunotherapy or chemotherapy as American or European homosexual pts. In Africa, as in Western countries, measures aimed at avoiding any further spread of the epidemic among heterosexuals should focus on prevention, detection, and treatment of sexually transmitted infections in general. A community-based approach to control of sexually transmitted infection, focused on prostitutes and other women with multiple sexual partners, pts with sexually transmitted infections, and adolescents, should be implemented together with control of blood donation. Health education programs should be instituted to inform the population about the risk of HIV transmission through contaminated needles, skin-piercing instruments, and sexual contact. Major impediments to such programs in Africa are cost, logistic problems, and misinformation. (60 Refs)
Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS/*EPIDEMIOLOGY/ TRANSMISSION Africa/EPIDEMIOLOGY Comparative Study *Cross-Cultural Comparison *Disease Outbreaks Human HIV Infections/COMPLICATIONS/*EPIDEMIOLOGY/TRANSMISSION HIV-1/*ISOLATION & PURIF HIV-2/*ISOLATION & PURIF Opportunistic Infections/COMPLICATIONS/EPIDEMIOLOGY Risk Factors Sarcoma, Kaposi's/EPIDEMIOLOGY Skin Neoplasms/EPIDEMIOLOGY JOURNAL ARTICLE 901030
M90A0697
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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.
