title: The prevalence and aetiology of persistent diarrhoea in adults in urban Zambia.
abstract: As the AIDS pandemic has spread, diarrhoea in adults has become a major burden on health care institutions in central Africa and on the families of sufferers. In order to assess the magnitude of the problem, we carried out a survey of households in a high population density township of Lusaka to determine the prevalence of persistent diarrhoea in adults. We also carried out a study of the causes of persistent diarrhoea in patients attending the University Teaching Hospital, Lusaka. The community survey assessed 460 households, representing a sample of 1440 adults. 94 adults were reported as having had diarrhoea in the 2 weeks prior to the survey, implying an attack rate of 1.74 per adult per year. Of these 94 cases, six had diarrhoea of between 2 and 4 weeks duration, and ten had diarrhoea of over 4 weeks duration. In the hospital study, 75 (97%) out of 77 patients with diarrhoea of over 1 months' duration were HIV seropositive; potentially pathogenic parasites were found in 61/75 (81%) of seropositives. This information indicates that persistent diarrhoea in adults, mostly related to HIV infection, is likely to be an important and growing reservoir of enteric pathogens and represents a significant burden on hospitals and relatives. This emerging problem in sub-Saharan Africa may foreshadow developments in other continents.
authors.affiliation: University of Zambia School of Medicine, University Teaching Hospital, Lusaka, Zambia.
authors.forename: P
authors.initials: P
authors.lastname: Kelly
authors.forename: K S
authors.initials: KS
authors.lastname: Baboo
authors.forename: M
authors.initials: M
authors.lastname: Wolff
authors.forename: B
authors.initials: B
authors.lastname: Ngwenya
authors.forename: N
authors.initials: N
authors.lastname: Luo
authors.forename: M J
authors.initials: MJ
authors.lastname: Farthing
mesh_terms: D000328:Adult; D003967:Diarrhea / Q000453:epidemiology* / Q000209:etiology; D015658:HIV Infections / Q000150:complications; D006801:Humans; D015995:Prevalence; D015024:Zambia / Q000453:epidemiology