A clinical and pathological comparison of the WHO and CDC case definitions for AIDS in Kinshasa, Zaïre: is passive surveillance valid?

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.

Prevalence of enteric viruses among hospital patients with AIDS in Kinshasa, Zaire.

Diarrhoea is the most common manifestation of acquired immunodeficiency syndrome (AIDS) in Africa. Numerous parasitic or bacterial agents have been implicated, but a pathogen-specific aetiology has not been found. Enteric viruses (i.

CD34+ bone marrow cells are infected with HIV in a subset of seropositive individuals.

Individuals infected with HIV frequently develop cytopenias and suppressed hematopoiesis. The role of direct HIV infection of hematopoietic progenitor cells in this process has not been defined. In this study, purified CD34+ bone marrow progenitor cells from 74 Zairian and American patients were studied by both coculture viral isolation and polymerase chain reaction for evidence of HIV infection.

[Etiologic aspects of low back pain in rheumatic patients in Kinshasa (Zaire). Apropos of 169 cases].

A study over a period of 27 consecutive months showed that among patients seen in a Kinshasa hospital outpatient clinic for rheumatologic diseases, 46.5% sought medical advice for lower back pain. Lumbar arthrosis (74.

Neurological complications of HIV-1-seropositive internal medicine inpatients in Kinshasa, Zaire.

Because little was known about the prevalence of neurological complications of human immunodeficiency virus type 1 (HIV-1) infection in Africa, we conducted a cross-sectional study among consecutive admissions to the internal medicine wards of Mama Yemo Hospital in Kinshasa, Zaire. Of the 196 patients studied, 104 (53%) were HIV-1 seropositive, of whom 50 (48%) had stage 3 and 49 (47%) had stage 4 HIV-1 infection according to the provisional WHO staging criteria for HIV infection. Neuropsychiatric abnormalities were present in 43 (41%) of 104 HIV-1-seropositive patients.

[Osteoarthrosis, gout and arthritis rheumatoid in internal medicine in Kinshasa].

Rheumatic disorders are relatively rare among internal medicine out-patients in Kinshasa. Diseases encountered most often are osteoarthrosis, gout and rheumatoid arthritis. The authors report the relative incidence of these diseases and note that sites of osteoarthrosis are predominantly axial, that the clinical pattern of rheumatoid arthritis is less severe with the absence of abarticular manifestations and that gout, in contrast, does not differ from the classical features described in the literature.

Isolation of mycobacteria from stools and intestinal biopsies from HIV seropositive and HIV seronegative patients with and without diarrhea in Kinshasa, Zaïre. Preliminary results.

To determine the role of mycobacteria as etiologic agent in HIV related enteritis in Africa, the following study was performed in 1986, in the department of Internal Medicine in Mama Yemo Hospital in Kinshasa, Zaire. Stool and intestinal biopsies were obtained from HIV seropositive and HIV seronegative patients with and without diarrhea. Patients with known Mycobacterium tuberculosis infection were not enrolled.

An analysis of the economic impact of HIV infection among patients at Mama Yemo Hospital, Kinshasa, Zaire.

In a prospective study of adult admissions to the Department of Internal Medicine at Mama Yemo Hospital, Kinshasa, Zaire in late 1988, 129 women and 122 men were screened for HIV infection. Fifty per cent were found to be seropositive, with half of the seropositives meeting the World Health Organization (WHO) clinical AIDS definition. The HIV seropositives had a mortality rate of 50%, which was significantly higher (P = 0.

HIV-1 infection in HIV-1 enzyme-linked immunoassay seronegative patients in Kinshasa, Zaire.

Serum samples of 62 African patients who had clinical manifestations of HIV-1 infection but were seronegative for HIV-1 by ELISA (Organon) were subsequently further tested by another HIV-1 ELISA test (Wellcozyme), HIV-1 IgG Western blot, HIV-1 antigen detection and HIV-2 ELISA. Patients' lymphocytes were cultured for HIV-1 and 2. Because of limited quantities of serum available all tests were not performed on all samples.

[Opportunistic parasitic diseases in Africa. Clinical aspects and diagnosis].

Opportunistic parasitic infections are diagnosed more and more often in African patients with AIDS. Cryptosporidiosis is the most frequent with a prevalence between 7 and 31%. The prevalence of Isospora belli is between 5 and 19% and that of strongyloidiasis between 2 and 5%, depending on the authors.

Persistent diarrhoea in Zairian AIDS patients: an endoscopic and histological study.

To determine the aetiology of persistent diarrhoea in African patients with acquired immunodeficiency syndrome (AIDS), 42 patients with human immunodeficiency virus (HIV) and persistent diarrhoea were enrolled in a microbiological, endoscopic, and histological study. Cryptosporidium was the intestinal parasite most often identified (30%); Isospora belli was found in 12% of the patients. Histological examination of the duodenal mucosa showed a non-specific inflammatory reaction in a significantly higher number of HIV-seropositive patients (82%) than HIV-seronegative controls without diarrhoea (52%) (p = 0.

Serologic and immunologic studies in patients with AIDS in North America and Africa. The potential role of infectious agents as cofactors in human immunodeficiency virus infection.

Serologic and immunologic studies were performed in 38 African and 60 US patients with acquired immunodeficiency syndrome (AIDS), 100 African and 100 US heterosexual men and women, and 100 US homosexual men to examine the potential role of infectious agents in human immunodeficiency virus (HIV) infection. There were no significant differences in the prevalence of antibodies to cytomegalovirus, Epstein-Barr virus, hepatitis A and B viruses, herpes simplex virus, syphilis, and toxoplasmosis among the African and US patients with AIDS, African heterosexual controls, and US homosexual men. However, these four groups all demonstrated a significantly greater prevalence of antibodies to each of these infectious agents compared with US heterosexual men.

Isolation of human immune deficiency virus from African AIDS patients and from persons without AIDS or IgG antibody to human immune deficiency virus.

We previously reported a high incidence of acquired immune deficiency syndrome (AIDS) in Kinshasa, Zaire, as well as a high frequency of antibody to human immunodeficiency virus (HIV), which includes HTLV-III and LAV viruses, in persons without AIDS. In this report we assessed the frequency of HIV virus infection in persons with and without clinical AIDS and the association of virus isolation to presence of antibody. We isolated HIV from 27 (77%) of 35 patients with AIDS, and 5 of 9 patients with AIDS-related complex (ARC).

Parasitological observations of chronic diarrhoea in suspected AIDS adult patients in Kinshasa (Zaire).

The parasitological profile of chronic diarrhoea in 46 Zairian adults suspected of Aids demonstrated that the frequency of protozoa was five times higher than that of helminths; 86% of the protozoa were sporozoa: Isospora belli was the most frequent (19%), followed by Cryptosporidium isolated for the first time in Zaire (8%) and Blastocystis hominis (2%). 37 of the 46 patients were immunodeficient.

[Rupture of the mitral chordae tendinae].

Twenty-seven cases of ruptured chordae tendineae have been discovered during surgery for mitral regurgitation (9,3 %) : the highest incidence of ruptured chordae tendineae has been found among pure mitral insufficiency (36 %). In thirteen cases, the rupture was isolated, without any other valvular lesion. The syndrome described as characteristic of rupture was present in one third of our patients : isolated cases do not differ clinically from the others but for a more frequent acute evolution.