ABSTRACT
OBJECTIVES: To compare the specificity of the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) case definitions for AIDS in autopsy cases from Zaïre. SETTING: Mama Yemo Hospital and University Hospital morgues in Kinshasa, and Karawa Hospital in Equateur Region, Zaïre. METHODS: Autopsy cases with a clinical diagnosis of AIDS on the death certificate or chart were studied. Evaluation included post-mortem HIV-1 serology, chart review for specific AIDS-related symptoms and signs, and application of WHO and CDC case criteria to the clinical and autopsy diagnoses. RESULTS: Of the 68 diagnosed AIDS cases, 98% fulfilled WHO criteria for AIDS and 93% fulfilled both WHO and CDC criteria. All cases fulfilling both criteria were HIV-1-seropositive. Opportunistic infections accounted for 84% of CDC AIDS-defining conditions. Disseminated tuberculosis was the most frequent (41%) specific diagnosis; Pneumocystis carinii pneumonia was rare (< 2%). CONCLUSIONS: There was good concordance between WHO and CDC case definitions. A diagnosis of AIDS on the chart or death certificate is adequate for surveillance purposes in this population.
Subject(s)
Acquired Immunodeficiency Syndrome/diagnosis , Acquired Immunodeficiency Syndrome/epidemiology , Acquired Immunodeficiency Syndrome/pathology , Adolescent , Adult , Autopsy , Centers for Disease Control and Prevention, U.S. , Death Certificates , Democratic Republic of the Congo/epidemiology , Female , Humans , Male , Medical Records , Middle Aged , United States , World Health OrganizationABSTRACT
This study examines the impact of HIV-1 infection and AIDS on 500 of 563 consecutive deaths at University Hospital, Kinshasa, Zaire, in late 1987. HIV-1 seroprevalence was 31% for the entire population and 43% for the 247 adults. Forty-two (38%) of the 110 HIV-1-seropositive adult deaths occurred in those between the ages of 25 and 34 years. The mean age of death for seropositives was 36 years, 7.5 years less than seronegative deaths. AIDS and AIDS-associated diagnoses such as cryptococcal meningitis, chronic diarrhea and pneumonia accounted for 42% of all adult deaths and 74% of all HIV-1-seropositive adult deaths. Seventeen per cent of 50 sera initially negative by enzyme-linked immunosorbent assay (ELISA) were ultimately found to be HIV-1-seropositive by Western blot or p24 antigen testing. The data indicate that HIV-1 infection and AIDS contribute significantly to adult mortality in Kinshasa population and that sensitivity of ELISA tests decreases in terminal HIV-1 infection.
Subject(s)
Acquired Immunodeficiency Syndrome/mortality , HIV Infections/mortality , HIV Seroprevalence , Acquired Immunodeficiency Syndrome/epidemiology , Adolescent , Adult , Blotting, Western , Child , Child, Preschool , Democratic Republic of the Congo/epidemiology , Enzyme-Linked Immunosorbent Assay , Female , Gene Products, gag/analysis , HIV Core Protein p24 , HIV Infections/epidemiology , HIV-1/analysis , Humans , Infant , Infant, Newborn , Male , Middle Aged , Viral Core Proteins/analysisABSTRACT
A Burkitt's type of lymphocytic lymphoma associated with Schistosoma mansoni intestinal schistosomiasis was diagnosed in a 14 year old Zairian girl. The literature concerning this association is reviewed and discussed and various pathogenic hypotheses are proposed.
