HIV infection through normal heterosexual contact in Uganda

One hundred and fourteen household contacts of 23 patients with AIDS or suspected AIDS were examined for evidence of infection with HIV. In total 12 contacts had antibodies to the virus by a competitive enzyme-linked immunosorbent assay (ELISA), confirmed by Western blot. Ten of these seropositive contacts were the sexual partners of the index cases. Overall 71% of sexual partners (10:14) were seropositive. By contrast only 2:100 of the non-sexual contacts had evidence of infection. These were the daughter of an index case and her 2-year-old son who were seropositive but had their own independent risk factors. The data presented here support the hypothesis that a major route of transmission of HIV in an African population is through heterosexual contact and furthermore suggest that transmission by other means such as intimate non-sexual contact, insect vectors, or the use of non-sterile needles is much less important.

Slim disease: a new disease in Uganda and its association with HTLV-III infection

A new disease has recently been recognised in rural Uganda. Because the major symptoms are weight loss and diarrhoea, it is known locally as slim disease. It is strongly associated with HTLV-III infection (63 out of 71 patients) and affects females nearly as frequently as males. The clinical features are similar to those of enteropathic acquired immunodeficiency syndrome as seen in neighbouring Zaire. However, the syndrome is rarely associated with Kaposi's sarcoma (KS), although KS is endemic in this area of Uganda. Slim disease occurs predominantly in the heterosexually promiscuous population and there is no clear evidence to implicate other possible means of transmission, such as by insect vectors or re-used injection needles. The site and timing of the first reported cases suggest that the disease arose in Tanzania.