Adult and Pediatric AIDS and AIDS-Related Syndromes in Rwanda

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Between December 1983 and December 1986 705 adult and pediatric cases of acquired immunodeficiency syndrome (AIDS) were officially reported to the Rwandan Ministry of Health and Social Affairs. 459 of these cases involved adults 129 (28%) of whom have already died. Rwandan adult AIDS cases have a male to female ratio of 1 to 7.1 supporting heterosexual transmission of infection especially through female prostitution. 70% of all reported AIDS cases are in the 20-39-year age group. Signs and symptoms in the 121 adult AIDS patients whose records were available for review included diarrhea (52%) weight loss (81%) and fever (74%). 10% presented with meningitis and 14% with Kaposis sarcoma. Minor signs included persistent cough generalized pruritus generalized lymphadenopathy zona oroesophageal candidiasis and disseminated tuberculosis. In terms of the socioeconomic status of these 121 cases 33 were jobless but living in the capital city 26 were prostitutes 20 were middle or upper-class government employees 8 were businessmen 6 were truck drivers and 4 were in the military. Each of the 121 AIDS patients whose case record was examined had a history of sexual promiscuity. Of the 246 Rwandan children under 15 years of age with AIDS 48 (19%) have died. 37% of the pediatric AIDS cases emerged in the 1st year of life; another 55% of cases developed between the 1st and 3rd birthdays. Maternal transmission is assumed responsible for the high number of AIDS cases in small children and infected children appear to have little chance of surviving beyond 3 years of age. Despite limited financial resources the Government of Rwanda has made substantial progress in preventing the Spread of AIDS through a public education campaign and blood screening. The principal preventive strategy is to persuade at-risk and diseased populations to modify the behaviors implicated in the transmission of AIDS.