Friday, March 25, 2011

Stemming the HIV Tide

With an estimated 2% of the adult population living with HIV, at the moment Angola has one of the lower HIV prevalence rates in sub-Saharan Africa as deemed by UN health agencies.  During the 1975–2002 Angolan civil war, cross-country travel was nearly impossible, impeding the spread of HIV/AIDS. Since the war, however, movement has become less restricted, and the likelihood of HIV reaching once-isolated communities has increased dramatically. In 2009, UNAIDS estimated that 200,000 people in Angola were HIV positive.

With a relatively young population, coupled with widespread high-risk sexual behaviors and an ambivalence toward safe health practices, puts Angola in danger of a more severe HIV/AIDS epidemic.

This trend was experienced first-hand by Dr. Nicholas Comninellis, visiting doctor to CEML Hospital.  He writes:

"I first worked in Angola during its civil war and encountered all the injuries and disease of poverty one can possible imagine: gun shots, land mines, measles, malaria, typhoid fever.  What i did not see was HIV disease.  While the rest of Africa was being ravaged by HIV, Angola was spared - largely because no one from neighboring nations had any reason or courage to travel to Angola.  But now peace has come, so has commerce and tourism, and HIV.  For several days I've been caring for Paula, a young woman with TB infection in her lungs. Her vomiting has been constant, and malnutrition worsening day by day.  Her arms and legs are literally skin and bones.  I'm treating her with TB medications and IV fluids, but she's just not getting better.  This morning I tested Paula for HIV, and her positive result helps explain why Paula continues to decline.  Some in the US are lured into thinking that we're overcoming this disease - but its true of wealthier nations. Here the epidemic continues to be explosive.  Indeed, life in Angola is far better than during the war, but HIV reminds me that both peace has its costs, and peace also allows us to effectively mobilize again this and the other heartbreaking diseases of poverty!" 

In Angola, tuberculosis (TB) co-infection with HIV is a major concern. TB is the leading cause of death among people who are HIV positive. After decades of civil war, the country’s health infrastructure is not adequate to address the TB epidemic. In 2008, TB incidence was 290 cases per 100,000 population, according to the World Health Organization (WHO). Nineteen percent of newly diagnosed TB patients are also HIV positive. (USAID Angola Report 2011)

Check out Dr. Cominellis' blog and website for more information on international medicine INMED

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