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H Francis

Publications and source records attributed to H Francis.

At least 73 records · Page 4Linked to original sources
PubMed1987

Evaluation of a clinical case-definition of acquired immunodeficiency syndrome in Africa.

A provisional clinical case-definition for acquired immunodeficiency syndrome (AIDS) developed by the World Health Organisation (WHO) for use in Africa was tested on 174 inpatients at Mama Yemo Hospital, Kinshasa, Zaire. In this hospital population with a 34% infection rate of human immunodeficiency virus (HIV), the clinical case-definition had a specificity of 90%, a sensitivity of 59%, and a predictive value of 74% for HIV seropositivity. These results support the use of the WHO clinical definition for AIDS in Africa. However, since HIV prevalence and disease expression vary, similar evaluations should be carried out in different regions.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Evaluation of a clinical case definition of AIDS in African children.

In July 1986, a provisional clinical case definition of AIDS in children, developed by the World Health Organization (WHO) for surveillance purposes in Africa, was tested on 159 patients hospitalized in the Department of Pediatrics at Mama Yemo Hospital, Kinshasa, Zaire. Twenty-one (13%) of these children were seropositive for HIV. In this population, the clinical case definition of pediatric AIDS was found to be fairly specific (87%) but lacked sensitivity (35%). The positive predictive value for HIV seropositivity was 25%. This study suggests that it is more difficult to define AIDS clinically in children than in adults and that the utility of the proposed WHO clinical case definition for pediatric AIDS for surveillance of children's AIDS in Africa is limited.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Generalized papular pruritic eruption in African patients with human immunodeficiency virus infection.

Of 284 patients hospitalized with HIV infection, 52 (18%) presented with a generalized pruritic papular eruption. No significant association between this eruption and other HIV manifestations or any opportunistic infection was found. Fifty-three of 61 (87%) consecutive African patients referred for a generalized papular pruritic eruption of unknown etiology of at least 1 month's duration were HIV seropositive, including 15 (65%) of 23 in good general condition. Thirty-seven (95%) of 38 patients with this eruption and severe weight loss (greater than 10% of normal body weight) were seropositive. The initial skin lesions were small, firm, intensely pruritic papules which released a small drop of clear fluid when scratched. Scratched papules became later hyperpigmented macules. Lesions were symmetrically distributed over the body and were most frequently found on the extensor surfaces of the arm, the dorsal surface of the hands, the inferior part of the legs, the ankles and the dorsum of the feet. Histologic examination showed a non-specific inflammatory reaction. Thirty-three (51%) patients reported that the skin eruption was their initial disease manifestation. In African patients, the presence of an unexplained generalized pruritic papular eruption is highly indicative of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Absence of association between Plasmodium falciparum malaria and human immunodeficiency virus infection in children in Kinshasa, Zaire.

The possible associations between Plasmodium falciparum malaria and HIV (human immunodeficiency virus) seropositivity were investigated in 1986 at the Mama Yemo Hospital in Kinshasa, Zaire. No significant difference was found in the HIV seropositivity rate of 164 children presenting with P. falciparum malaria (1.2%) and 169 healthy controls (0.6%). Secondly, no association was found between P. falciparum slide positivity (51.6%) and HIV seropositivity (3.8%) among 1046 children presenting to the hospital with medical complaints. Infants less than 6 months old had the lowest slide-positivity rate, but among infected children the younger ones more frequently had high parasitaemias. HIV seropositivity rates were highest for children less than 6 months old. In older children, seropositivity was strongly associated with a history of blood transfusion. Thus, in Kinshasa children, P. falciparum malaria is a major public health problem; perinatal transmission and blood transfusions constitute important mechanisms of HIV infection; and P. falciparum does not appear to act as an opportunistic agent in children infected with HIV.

Animals↗
PubMed1987

Benign joint hypermobility with neuropathy: documentation and mechanism of tarsal tunnel syndrome.

Eleven consecutive patients with tarsal tunnel syndrome were reviewed. All had pes planus, 8 had calcaneal valgus hindfoot, and generalized benign joint hypermobility syndrome was evident in 9. Detailed enquiry was necessary to identify apparently trivial precipitating events. In 6 patients there was superimposed secondary reflex sympathetic dystrophy which tended to obscure symptoms of the causative tarsal tunnel syndrome. Wider recognition of this cause-effect mechanism and early management with orthotic footwear and intrinsic foot muscle exercises may obviate the need for surgical intervention in many cases.

Exercise Therapy↗
PubMed1987

Persistent diarrhea, strongly associated with HIV infection in Kinshasa, Zaire.

Ninety-eight (40%) of 243 acquired immune deficiency syndrome inpatients at Mama Yemo Hospital, Kinshasa, Zaire, presented with a history of diarrhea for at least 1 month. To determine the predictive value of persistent diarrhea for human immune deficiency virus (HIV) infection, 128 consecutive patients presenting at Mama Yemo Hospital with persistent diarrhea were tested for the presence of HIV antibodies. One-hundred seven (84%) of the 128 patients with diarrhea lasting at least 1 month were found to be HIV seropositive. HIV seropositive patients with persistent diarrhea more often had a generalized papular pruritic eruption (p = 0.02), a genital herpes simplex infection (p = 0.05), a history of herpes zoster (p = 0.08), and infection with cryptosporidia (p = 0.006) than HIV seronegative patients with persistent diarrhea. Bacterial enteric pathogens were found in 5 (7%) of the 76 seropositive and in none of the 14 seronegative patients in whom stool cultures were performed. Presently persistent diarrhea in adults in central Africa is strongly associated with HIV infection, but the pathophysiological mechanisms causing this diarrhea remain unclear.

Acquired Immunodeficiency Syndrome↗
PubMed1986

HIV seroprevalence among hospital workers in Kinshasa, Zaire. Lack of association with occupational exposure.

A study of seroprevalence of the human immunodeficiency virus involving 2384 (96%) of Mama Yemo Hospital's (Kinshasa, Zaire) 2492 personnel found 152 (6.4%) to be seropositive. Prevalence was higher among women than among men (8.1% vs 5.2%); in women peak seroprevalence (13.9%) occurred in 20- to 29-year-olds. Workers most likely to be seropositive were those who were relatively young, those who were unmarried, those reporting a blood transfusion or hospitalization during the previous ten years, and those receiving medical injections during the previous three years. Medical, administrative, and manual workers had similar seroprevalence (6.5%, 6.4%, and 6.0%, respectively), and seropositivity was not associated with any measure of patient, blood, or needle contact. These findings are consistent with other hospital-based studies indicating low risks for occupational transmission of human immunodeficiency virus.

Adult↗
PubMed1986

Natural history of human immunodeficiency virus infection in Zaire.

The natural history of human immunodeficiency virus (HIV) infection in Zaïre was determined by identifying in October, 1984, 125 seropositive hospital personnel without signs or symptoms and 145 age and sex matched seronegative controls from the same population. Between July, 1985, and February, 1986, 67 seropositives, including 38 men and 29 women, and 113 seronegatives were interviewed and examined by an observer who did not know their serological status. The acquired immunodeficiency syndrome (AIDS) had developed in 1 seropositive and no seronegatives (rate difference, 1.3/100 person-years [py]; 95% confidence interval 0-3.3/100 py); AIDS-related complex or generalised lymphadenopathy had developed in 8 seropositives (12%) and 1 seronegative (1%) (rate ratio, 13.2; 95% confidence interval 1.3-134.6); and minimal lymphadenopathy had developed in 19 seropositives (28%) and 8 seronegatives (7%) (rate ratio, 3.9; 95% confidence interval 1.8-8.4). These data provide the first estimates for rates of progression to AIDS or AIDS-related conditions among healthy HIV seropositive heterosexual adults. Rates observed in this study are similar to those reported in US or European homosexual or bisexual men.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Risk factors for human immunodeficiency virus seropositivity among children 1-24 months old in Kinshasa, Zaire.

A prevalence study of antibody to human immunodeficiency virus (HIV) was conducted in Kinshasa, Zaïre, among 258 children 2-24 months old who were in hospital, 191 children 1-20 months old who were attending a well-child clinic, and their mothers. 8% of the mothers of both groups of children were seropositive. Among children under 9 months old, 12 of 102 (12%) hospital inpatients and 11 of 136 (8%) clinic attenders were seropositive, while in the 9-24-month age group 20 of 156 (13%) hospital children and only 1 of 55 (2%) clinic children were seropositive (Fisher's exact test, p = 0.01). 61% of the seropositive children had seropositive mothers, indicating a high rate of vertical transmission. Factors associated with seropositivity among hospital children with seronegative mothers included male sex, increased lifetime number of medical injections, and previous blood transfusion or hospital admission. Among children who had not previously been transfused or admitted to hospital the seropositives had received more medical injections than the seronegatives (median 34.5 versus 14.5; Wilcoxon rank sum test, p = 0.006). HIV infection accounted for or complicated a substantial proportion of hospital paediatric admissions. Public health measures are urgently required to prevent parenteral and vertical transmission of HIV to infants and young children in Kinshasa.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Prevalence of HTLV-III/LAV in household contacts of patients with confirmed AIDS and controls in Kinshasa, Zaire.

Household members of 46 patients with confirmed acquired immunodeficiency syndrome (AIDS) and 43 human T-cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV)-seronegative controls from Kinshasa, Zaire, were identified and sought for serologic testing for evidence of HTLV-III/LAV infection. Twenty (9.8%) of 204 case-household members and three (1.9%) of 155 control-household members were HTLV-III/LAV seropositive (relative risk = 5.1; 95% confidence interval, 1.7 to 15.2). Eleven (61.1%) of 18 spouses of patients with AIDS were HTLV-III/LAV seropositive, compared with one (3.7%) of 27 control spouses (relative risk = 16.5; 95% confidence interval, 3.7 to 75.0). Except for spouses, the rate of HTLV-III/LAV seropositivity did not differ significantly between case and control households. Furthermore, for adults in case households who were not spouses, the number seropositive for HTLV-III/LAV was identical to that predicted from sex- and age-specific HTLV-III/LAV seroprevalence rates. These data from Zaire confirm the results of US and European studies of household contacts of infected hemophiliacs and pediatric patients with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Surveillance for AIDS in a central African city. Kinshasa, Zaire.

Surveillance for acquired immunodeficiency syndrome (AIDS) in Kinshasa, Zaire, was initiated in July 1984, using a modified version of the case definition developed by the Centers for Disease Control. During the first eight months, 332 patients met all clinical and laboratory criteria; surveillance information was available for 295 (89%) of these patients. Of the sera tested from these patients, 99% had antibodies to human T-cell lymphotropic virus type III/lymphadenopathy-associated virus by both enzyme-linked immunosorbent assay and Western blot procedures. The male-female case ratio was 1:1.1; the mean age of patients was 33.6 years (median, 32 years; range, 1.5 to 64 years); and men were significantly older than women (mean, 37.4 vs 30.0 years). The estimated incidence rate for adults in Kinshasa is 380 cases per 1 million people per year. Peak age-specific incidence rates for men and women occurred among the 30- to 39-year age group, although the rate for men in this age group was 24% higher than the rate for women (786 vs 601 per 1 million). A reasonable estimate of the current annual incidence of AIDS is 550 to 1,000 cases per 1 million people. Surveillance of AIDS in Zaire provides important information on transmission patterns and rates in Africa.

Acquired Immunodeficiency Syndrome↗