Evaluation of the World Health Organization Clinical Case Definition of AIDS among Tuberculosis Patients in Kinshasa, Zaire

Colebunders, R; Mm, Braun; Nzila, N; Dikilu, Kalunga; K, Muepu; Ryder, Robert W.

doi:10.1093/infdis/160.5.902

Cited by 17 publications

(1 citation statement)

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“…The sensitivity, specificity and predictive value of the WHO CCD were lower as compared to the results in the developing countries of Africa [14][15][16]. There was no significant age difference between the patients with AIDS and without AIDS.…”

Section: Discussionmentioning

confidence: 58%

Evaluation of the WHO Clinical Case Definition of AIDS in the Indian Context: Suggesting a Prediction Rule

Kaushik¹,

Pandey

Pande³

2000

Med Princ Pract

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Objective: To test the statistical significance of the existing World Health Organization (WHO) clinical case definition for the diagnosis of acquired immunodeficiency syndrome (AIDS) in areas where diagnostic resources are limited in India, and frame a prediction rule that is sensitive and specific for the clinical diagnosis of AIDS. Methodology and Results: In a case-load study, we evaluated the WHO clinical case definition of AIDS in 162 patients, the training set (58 seropositives) at the All India Institute of Medical Sciences, New Delhi. This definition had a sensitivity of about 29%, specificity of about 29%, positive predictive value of about 19% and negative predictive value of about 42%. We analyzed the clinical data of these 162 patients using stepwise logistic regression analysis. Generalized lymphadenopathy, oropharyngeal candidiasis, presumptive esophageal candidiasis, herpes zoster in the last 5 years and a total lymphocyte count of less than 1,000 × 10⁹/l emerged as important predictors. A prediction rule for the diagnosis of AIDS in the Indian context was then developed empirically using the coefficients of these predictors. We further tested the rule prospectively in 50 patients, the test set (11 seropositives) and found it to have a sensitivity of 81.8%, specificity of 97.4%, positive predictive value of 90%, and a negative predictive value of 95%. Conclusion: The WHO definition was not significant statistically for clinical use in India. The new prediction rule may help in AIDS surveillance in India.

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Section: Discussionmentioning

confidence: 58%

Evaluation of the WHO Clinical Case Definition of AIDS in the Indian Context: Suggesting a Prediction Rule

Kaushik¹,

Pandey

Pande³

2000

Med Princ Pract

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Intestinal parasites in Zambian patients with AIDS

Huntér

Bagshawe

Baboo

et al. 1992

Transactions of the Royal Society of Tropical Medicine and Hygi

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Previous studies have found a high prevalence of Isospora belli and Cryptosporidium parvum infections in African acquired immune deficiency syndrome (AIDS) patients with chronic diarrhoea. We aimed to determine the prevalence of gastrointestinal parasite in AIDS patients in hospital, not only those with diarrhoea, and to compare them with the general community. Clinically diagnosed AIDS patients in a Zambian teaching hospital were interviewed and examined, and stool specimens were studied for parasite infection. A control group was recruited from adults in a township near Lusaka. Of 90 AIDS patients (58% male), 50 (56%) had chronic diarrhoea and 9 (10%) had diarrhoea of shorter duration. In the control group (105 adults; 85% female), only one complained of diarrhoea. A variety of intestinal protozoa and helminths was found in 57% of AIDS patients and 88% of the community members. Isosporiasis was detected in 7, and cryptosporidiosis in 2, AIDS patients, all with diarrhoea, but not in any control. Strongyloides was found in 2 AIDS patients with diarrhoea and one community resident. Hospital patients with AIDS had fewer Entamoeba coli and E. histolytica infections, probably because of previous chemotherapy. We conclude that AIDS predisposes to isosporiasis and cryptosporidiosis, but not to infection with extracellular intestinal parasites, such as Entamoeba species, Blastocystis, Chilomastix, Endolimax, Ascaris and Necator.

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