THE PREVALENCE AND ETIOLOGY OF PERSISTENT DIARRHEA IN ADULTS IN URBANZAMBIA

As the AIDS pandemic has spread, diarrhoea in adults has become a majo r burden on health care institutions in central Africa and on the fami lies of sufferers. In order to assess the magnitude of the problem, we carried out a survey of households in a high population density towns hip of Lusaka to determine the prevalence of persistent diarrhoea in a dults. We also carried out a study of the causes of persistent diarrho ea in patients attending the University Teaching Hospital, Lusaka. The community survey assessed 460 households, representing a sample of 14 40 adults. 94 adults were reported as having had diarrhoea in the 2 we eks prior to the survey, implying an attack rate of 1.74 per adult per year. Of these 94 cases, six had diarrhoea of between 2 and 4 weeks d uration, and ten had diarrhoea of over 4 weeks duration. In the hospit al study, 75 (97%) out of 77 patients with diarrhoea of over 1 months' duration were HN seropositive; potentially pathogenic parasites were found in 61/75 (81%) of seropositives. This information indicates that persistent diarrhoea in adults, mostly related to HIV infection, is l ikely to be an important and growing reservoir of enteric pathogens an d represents a significant burden on hospitals and relatives. This eme rging problem in sub-Saharan Africa may foreshadow developments in oth er continents.