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  • Title: [AIDS: the view from Africa].
    Author: Pereira MH.
    Journal: Acta Med Port; 1995 Nov; 8(11):655-9. PubMed ID: 8713513.
    Abstract:
    Epidemiological data on AIDS in several zones in Africa is presented. The clinical and diagnostic aspects of HIV infection in Africa, based on the definition of Bangui's AIDS (1986), are analysed and the criteria is presented. The treatment and follow-up of a patient with infusion by HIV in the African context is discussed. Reference is then made to some data on the status of AIDS in Angola. From the end of the 1970s up to June 1994, a total of 985,119 cases of AIDS had been reported to the World Health Organization (WHO), of which figure 331,376 were from Africa (33.5%). WHO has also calculated that the real figure was around 4 million cases since the beginning of the epidemic, of which 67% had occurred in Africa. In addition there were an estimated 16 million cases of HIV infection including 1 million children in the whole world. Again, sub-Saharan Africa was the most affected and the transmission was predominantly heterosexual. In Africa the majority of individuals with HIV infection have chronic persistent lymphadenopathy. There are different classifications of AIDS based on clinical criteria: the Bangui Definition of 1986 used at locations without laboratories, the Centers for Disease Control and Prevention/WHO Definition of 1987, the Water Reed Institute Classification, the WHO Classification of 1970 of HIV-1 and HIV-2. Among opportunistic infections tuberculosis and Kaposi's sarcoma are the most frequent. Particular clinical aspects for children include malnutrition, fever, and diarrhea. Sickle cell anemia and blood transfusion patients are at increased risk of getting infected. Tests for the detection of antibodies against HIV include the enzyme-linked immunosorbent assay (ELISA) and the passive hemagglutination test. For confirmation of the positive results the Western Blot, indirect immunofluorescence, and radioimmunoprecipitation tests are used. The treatment of HIV-infected patients in Africa consists of the treatment of the HIV infection, that of opportunistic infections and tumors, and primary and secondary prophylaxis of opportunistic infections. Counseling and psychosocial support even utilizes traditional healers and the large African family. Prevention and control of AIDS must combat polygamy, the oppression of women, wars, natural catastrophes, and the shortage of physicians. In Angola 26% of AIDS cases could not be traced, the future depopulation of the country threatens, there is a growing trend of AIDS, and a significant underreporting of cases.
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