Background: The majority of HIV infected adults live in Africa, and 30% of adults residing in Kigali, the capital of Rwanda, are HIV positive(+). Between April and August 1994, a genocide took place in Rwanda; of 7.5 million Rwandan civilians, over 1 million died. Methods: Four hundred one women HIV(+) since 1986 were recruited from pediatric and prenatal clinics in Kigali, Rwanda, and were seen every 6 months prior to war and every 3 months post-war. Causes of death are drawn from medical charts and interviews with family and caretakers. The Kigali staging system is used to describe the stage of HIV disease. Results: By March 1994, 125 women had died, 105 due to AIDS related illness. From April-August 1994, 75 women died or disappeared during the war. Between September 1994-2000, 75 women died, 65 due to AIDS related illness. As of September 2000, 85 remain alive, 63 in HIV stages 1-2 and 22 in stages 3-4. Forty-one women have been lost to follow up. AIDS related deaths due to nonspecific illness such as diarrhea, wasting, enteritis increased from 31% before the war to 41% after the war (p=.036). Deaths due to tuberculosis increased from 13%- 26% (p=.034). Deaths due to Kaposi’s sarcoma, cryptococcal meningitis, esophageal candida decreased from 17%-5% (p=.02). Conclusion: The overall destruction of infrastructure caused by civil strife meant a lack of available treatment and decline in sanitation, leaving HIV-infected people more susceptible to gastroenteritis and TB.
Learning Objectives: N/A
Keywords: HIV/AIDS, Third World
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.