Evaluation of the WHO Clinical Case Definition for AIDS in Uganda

Widy-Wirski, R

doi:10.1001/jama.1988.03410220070030

Cited by 54 publications

(13 citation statements)

References 3 publications

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“…A clinical diagnosis of AIDS is made if an individual presents with two major symptoms (extreme weight loss, chronic diarrhea, and prolonged fever) and one minor symptom (persistent cough, skin rash, herpes zoster, Candida, herpes simplex, and lymph node disease). Though this definition has its limitations (Colebunders et al, 1987; Gilks, 1991; Wabwire-Mangen et al, 1989; Widi-Wirski et al, 1988), it is still used where HIV testing is unavailable (as in this study).…”

Section: Methodsmentioning

confidence: 99%

Reliability and validity of two HIV/AIDS-specific quality of life instruments adapted for use in HIV-positive Zimbabweans

et al. 2009

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We sought to assess the reliability and construct validity of the HIV/AIDS-Targeted Quality of Life instrument (HAT-QoL) and the Medical Outcomes Study HIV Health Survey (MOS-HIV) adapted for use in Shona-speaking rural Zimbabwe. HAT-QoL and MOS-HIV were translated and culturally adapted into Shona, and administered to a convenience-sample of 400 patients with HIV-related opportunistic infections. HIV disease severity and bereavement history were assessed. Factor analysis of the HAT-QoL items produced seven factors that were nearly identical to the factor structure reported for an American sample that was the basis for the current HAT-QoL scales. Factor analysis of the MOS-HIV scales resulted in a single factor, not the expected two-factor structure (physical and mental). Convergent and discriminant validity assessments confirmed, in general, that similar Shona HAT-QoL and MOS-HIV dimensions were correlated and dissimilar ones not correlated. Construct validity assessments indicated that, on the whole, most Shona HAT-QoL and MOS-HIV dimensions were capturing anticipated subgroup differences. The exceptions were the Shona MOS-HIV dimensions of general health perceptions, cognitive function, and the quality of life (QoL) item. The reliability and validity of most Shona-adapted HAT-QoL and MOS-HIV dimensions suggest that both instruments are likely useful in measuring the QoL of rural, Shona-speaking populations in Zimbabwe, Mozambique, Zambia, and Botswana.

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Section: Methodsmentioning

confidence: 99%

Reliability and validity of two HIV/AIDS-specific quality of life instruments adapted for use in HIV-positive Zimbabweans

et al. 2009

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“…Centres for Disease Control criteria for definition of AIDS could not be applied due to the limited diagnostic resources available, and so the World Health Organisation (WHO) clinical case definition was used 16. Each subject provided a stool specimen on the study day and a history including gastrointestinal symptoms was taken.…”

Section: Methodsmentioning

confidence: 99%

HIV enteropathy: comparative morphometry of the jejunal mucosa of HIV infected patients resident in the United Kingdom and Uganda

Batman

Kapembwa

Miller

et al. 1998

Gut

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Aims-To compare jejunal mucosal morphometry in HIV infected patients resident in London and Uganda. Patients-Twenty HIV positive patients from London and 16 from Uganda were studied, and compared with HIV negative control subjects from both sites. Methods-Stools and biopsy specimens were examined for enteropathogens. Surface area to volume (S:V) ratio was estimated morphometrically, mean crypt length of jejunal biopsy specimens was measured, and HIV infected cells detected immunohistochemically were quantified. Results-Enteric pathogens were detected in none of the London patients, and in three Ugandan patients. S:V ratio was lower, and mean crypt length higher, in the specimens of London patients than in normal subjects, but there was no diVerence in S:V ratio or mean crypt length between Ugandan patients and controls. A negative correlation was present between S:V ratio and mean crypt length in all biopsy specimens analysed. HIV infected cells were detected only in lamina propria. Conclusion-Infection of cells in the lamina propria of the jejunum with HIV stimulates crypt cell proliferation, and a fall in villous surface area. The mucosal response to HIV is masked by other pathogens in the African environment. (Gut 1998;43:350-355)

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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: 57%

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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Evaluation of the WHO Clinical Case Definition for AIDS in Uganda

Cited by 54 publications

References 3 publications

Reliability and validity of two HIV/AIDS-specific quality of life instruments adapted for use in HIV-positive Zimbabweans

Reliability and validity of two HIV/AIDS-specific quality of life instruments adapted for use in HIV-positive Zimbabweans

HIV enteropathy: comparative morphometry of the jejunal mucosa of HIV infected patients resident in the United Kingdom and Uganda

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

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