Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
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A move away from a narrow, top-down focus on acquired immunodeficiency syndrome (AIDS) is urged to maximize the impact of scarce medical services in developing countries. The current emphasis on researching and treating the opportunistic infections characteristic of full-blown AIDS has produced a mood of powerlessness and hopelessness in the medical community as well as the general population. In developing countries, however, early human immunodeficiency virus (HIV) disease is far more common than AIDS and more amenable to successful medical interventions. Non-AIDS patients tend to present with infections such as pulmonary or lymphatic tuberculosis or pneumococcal pneumonia that respond well to standard, inexpensive therapies. Tuberculosis, pneumonia, and salmonellosis are endemic in impoverished, overcrowded Third World communities so clinical initiatives targeted at their treatment would benefit both seropositive and seronegative residents. A strategy that emphasizes an improved clinical outcome for all who present with common treatable infections would further boost staff morale by overcoming the clinical hopelessness associated with efforts to save patients in the late stages of the disease process. Health ministries will have to commit extra staff and resources to meet the increased demand for short-course tuberculosis treatment, and it may be advisable to integrate tuberculosis and bacteriology laboratories. Patients with end-stage HIV disease can be provided with home-based symptom relief, nutritional supplementation, and psychological support.
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PMID:The clinical challenge of the HIV epidemic in the developing world. 790 16

International assistance for prevention of HIV infections has been requested jointly by the Southern African Frontline States and the Global Coalition for Africa. Sub-Saharan Africa has had more AIDS victims than anywhere else in the world. Over 8 million of the estimated 13 million HIV-positive adults worldwide are in sub-Saharan Africa, where transmission is primarily through heterosexual sex. The World Health Organization (WHO) estimates that 71% of cases worldwide are transmitted by heterosexual sex, 7% through injections or drug use, 5% by blood transfusion, and 15% through homosexual behavior. In Uganda, an estimated 1 out of every 6 adults is HIV-positive. The expectation by WHO is that 10-15 million children worldwide will lose both or at least one parent to AIDS by the year 2000. An extreme example was of a Ugandan grandmother who had lost 6 children to AIDS and cared for her 25 grandchildren. The consequences are far reaching. there is the cost of funerals, which many poor can not afford; there are orphans, lack of caretakers or overwhelmed caretakers, loss of productive workers, and drains on health services. There is contention about the extent of the AIDS incidence is Sub-Saharan Africa; some would argue that many deaths are due to endemic diseases. However, one consequence of the presence of the HIV virus is the damage to the immune system response to any disease. The actual cause of an AIDS death may be pneumonia, tuberculosis, or any other illness. The male high risk group is comprised of males aged 20030 years, away from home, a possible history of sexually transmitted disease, and contact with prostitutes. The female high risk group is comprised of single mothers aged 18025 years, with a history of sexually transmitted disease, and engaged in commercial sex. Lack of condom use is linked to alcohol consumption. An estimated 25% of patients attending sexually transmitted disease clinics in South Africa have HIV infections. In 1993, Tanzania had southern Africa's highest incidence of reported cases (37,719), followed by Zambia (29,734), Malawi (29,194), and Zimbabwe (25,332). AIDS has become so widespread that many feed a sense of hopelessness and engage in careless sexual behavior, seeking out teenage girls believed to be HIV-free. The high level of poverty in Africa makes AIDS difficult to combat.
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PMID:The scourge of HIV and AIDS in Africa. 1228 61