HIV-1 seroprevalence in Zambian patients with acute diarrhea: a community-based study.
The seroprevalence of HIV-1 in sub-Saharan African patients with diarrhea in the community remains largely unknown. We present the findings of a 2-month study that we undertook to ascertain the seroprevalence of HIV-1 in Zambian patients presenting with acute diarrhea in a community-based health center. A total of 256 patients with diarrhea and 140 apparently healthy controls was seen. Of the patients with diarrhea, 161 were < 16 years old and 95 were adults. Most children with diarrhea were < 6 years old (147 of 161; 91%). Overall, 81 of 256 (32%) patients with diarrhea were HIV-1-seropositive. When results from children < 18 months old and possibly having maternal anti-HIV-1 antibodies were excluded, 64 of 172 (37%) patients with diarrhea were HIV-seropositive. Rates of HIV-1 seropositivity for patients with diarrhea were significantly higher than were rates for diarrhea-free controls (p < .001 for both the total population; odds ratio [OR], 95% confidence interval [CI], 1.42 < 2.48 < 4.35) and population > 18 months old (OR, 95% CI, 1.54 < 2.90 < 5.49). Among children between 18 months and 5 years old, 14 of 63 (22%) were HIV-1-seropositive compared with 8 of 62 (13%) without diarrhea (p > .05, not significant). Moreover, 49 of 95 (52%) adults with acute diarrhea were HIV-1-seropositive compared with 10 of 44 (23%) healthy adult controls (p < .003; OR, 95% CI, 1.51 < 3.62 < 8.87). No significant differences were found in HIV-1 seroprevalence rates between males and females in all age groups. These data show a close association between acute diarrhea and HIV seropositivity in Zambian adults in the community.
Department of Community Medicine, University Teaching Hospital, Lusaka, Zambia.
K S
KS
Baboo
N P
NP
Luo
J R
JR
Murphy
C
C
Cummings
C
C
Chintu
A
A
Ustianowski
H L
HL
DuPont
M
M
Kelinowski
J J
JJ
Mathewson
A
A
Zumla
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003151:Community Health Centers; D003967:Diarrhea / Q000150:complications*; D006679:HIV Seropositivity / Q000150:complications* / Q000453:epidemiology*; D015528:HIV Seroprevalence; D015497:HIV-1; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D015024:Zambia / Q000453:epidemiology