AIDS in a Zambian district
Van der Hoek, W.
Nederlands Tijdschrift Voor Geneeskunde 136(49): 2432-2435
1992
ISSN/ISBN: 0028-2162 PMID: 1470244 Document Number: 326286
In 1990, among pregnant women .1% tested positive for HIV antibodies in Amsterdam compared to 24.5% in Lusaka, Zambia. During 1990 and 1991 data were collected from 231 patients fulfilling the WHO clinical criteria for the diagnosis of AIDS in 3 hospitals of Sesheke, a rural Zambian district. 46.3% of the group was male and 53.7% was female, and the mean age of women was significantly lower than that of men (25.2 vs. 31.1 years, p 0.001). A total of 185 patients could be tested for HIV-1 antibodies using ELISA-Welcozyme and HIVCECK-Du Pont. There were 141 (81.6%) positive results, 19 (10.3%) negative results, and in 15 (8.1%) cases the outcome was not clear. Seroprevalence figures for HIV-1 in the same period were 16% for blood donors and 41% for patients attending the clinic for sexually transmitted diseases. Most patients with AIDS in Sesheke district present with a wasting syndrome, and in these cases, tuberculosis (TB), whose incidence has increased dramatically, has to be excluded. Loss of more than 10% of body weight was the most common symptom followed by chronic cough lasting for more than 1 month, fever persisting for more than 1 month, and chronic diarrhea lasting for more than 1 more. Chronic coughing was more frequent among adults than among children (P 0.001). Weight loss, chronic diarrhea, persistent coughing, generalized lymphadenopathy, generalized dermatitis, and oropharyngeal candidiasis occurred among both adults and children equally often. Only 4 patients (18%) and extrapulmonary TB in 10 patients (4%). In the district there was no registration system for the dead and the follow-up of AIDS patients were not organized well, but as of January 1, 1992, from hospital records it was established that 74 patients out of the 231 studied were decreased. The outlook for the population in Sesheke and Zambia is dim in light of the current high seroprevalence rate.