Politics and science clash on African AIDS.

Abstract

Political sensitivity has hindered efforts to determine the prevalence of acquired immunodeficiency syndrome (AIDS) in Africa. Not a single case of AIDS has officially been reported from Central Africa presumably because government fear that adverse publicity about AIDS could discourage tourism and disrupt their economies. At a 1985 International Symposium of African AIDS held in Brussels several African researchers cancelled their presentations and rebutted claims that AIDS originated in Africa. Nonetheless there is evidence that new cases of AIDS are showing up at increasing rate in Africa especially in some urban areas of Central Africa. The disease seems to be spreading largely through heterosexual contact. 51% of serum samples collected from prostitutes in Kenya in 1984 compared to 7% in 1980 contained antibodies to the AIDS virus. In Rwanda 29 of 33 prostitues tested in 1984 had antibodies to the virus and 27 were showing symptoms of generalized lymphadenopathy. Another study in Rwanda indicated that 10.5% of a sample of 258 blood donations contained antibodies to AIDS. It has been estimated that 12% of European AIDS cases involve African patients from 21 different countries. Physicians have reported finding a new form of Kaposis sarcoma that tends to afflict younger people than the classic form of the disease and is more aggressive. It is likely that many cases of AIDS will to be diagnosed as other diseases because the spectrum of opportunistic infections is different in Africa from that in the US and Europe. For example Pneumocystis carinii pneumonia is infrequent in African AIDS patients while skin diseases cryptococcal meningitis and intestinal complications occur more frequently.