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


METHODS
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.
Nelson
A M
AM
Projet SIDA, Kinshasa, Zaïre.
Perriëns
J H
JH
Kapita
B
B
Okonda
L
L
Lusamuno
N
N
Kalengayi
M R
MR
Angritt
P
P
Quinn
T C
TC
Mullick
F G
FG
D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D000293:Adolescent; D000328:Adult; D001344:Autopsy; D002487:Centers for Disease Control and Prevention, U.S.; D003644:Death Certificates; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D014481:United States; D014944:World Health Organization