Abstract:
Surveillance of the AIDS pandemic in Africa has always posed
formidable problems for epidemiologists. Diagnostic
accuracy-according to the case definitions for AIDS used in
industrialised countries-is impossible to achieve in all but a
few places with the right diagnostic facilities. Responding to
the urgent need for surveillance, the World Health Organisation
drew up a clinical case definition (the WHO/Bangui
definition), which depended on clinical criteria without the
need for serological verification.'2
Judged by its use, the WHO/Bangui definition has been
successful-52 African countries have reported cases ofAIDS
using mainly this definition.3 Some countries have modified it
to fit local circumstances, removing a defining symptom here,
adding the need for an extra sign there, and many now accept
or encourage a positive result of an HIV test as supportive
evidence. (At least one, COte d'Ivoire, requires such a result.2)
