Seasonality in tropical AIDS: a geographical analysis
Smallman-Raynor, M.R.; Cliff, A.D.
International Journal of Epidemiology 21(3): 547-556
1992
ISSN/ISBN: 0300-5771 PMID: 1634318 DOI: 10.1093/ije/21.3.547Document Number: 319734
Human geographers applied data of 12,444 cases of AIDS in Uganda diagnosed between January 1986-December 1989 to a statistical methodology used in geography to see if AIDS exhibits seasonal rhythms. The analysis revealed that seasonally recurring geographical patterns were the basis for the velocity of reported AIDS epidemics in different districts of Uganda (p.05). Epidemic acceleration was most evident in all regions of Uganda, except the Central region. The AIDS epidemic patterns paralleled the seasonal rhythms of agricultural production. In the Central region, crop production was perennial. Thus food was always available which may account for no apparent AIDS epidemic pattern in this region. On the other hand, pastoral activity and annual arable crop production predominated in the Eastern region where constant fluctuations in AIDS incidence occurred. In fact, people store foodstuffs and stocks wane towards the harvest in August, September, and October. The Western and Northern regions exhibit basically the same patterns. These observations suggested a correlation between nutritional deficiencies and progression of AIDS as often occurs with other infections under some tropical agricultural systems. This study appeared to be the 1st study to document statistical significance of a possible seasonally recurring component to the diagnosis of clinical AIDS in a tropical country. Additional research is needed to determine whether this seasonal pattern is due to insufficient data quality or an association with malnutrition does indeed exist.