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AIDS Epidemic Sweeps Through Uganda : Experts Say 10% of the Sexually Active Populace May Be Infected

May 24, 1986|CHARLES T. POWERS | Times Staff Writer

KAMPALA, Uganda — A major epidemic of AIDS is sweeping through the most populous regions of southern Uganda, and researchers here say they believe that 10% of the sexually active population in the area--women as well as men--may be infected with the deadly virus.

Physicians studying the disease at Kampala's Mulago Hospital describe the situation as "a disaster" and compare it to a nuclear accident.

"It is as if an entire segment of the population here had been irradiated," Dr. J. Wilson Carswell, one of the researchers, said recently. "What we've got here is a sort of Chernobyl."

When Carswell, a Scottish physician at Mulago who has been in the country for 18 years, was asked if Uganda was experiencing an AIDS epidemic, he replied: "It was an epidemic last year. It is now a disaster. It is going to wipe out many, many people here."

Uganda, an East African nation with a population of 14 million, has just ended a five-year civil war which some observers believe may have taken as many as 200,000 lives. The country is still scarred by the bloody rule of dictator Idi Amin, under whose reign another quarter of a million Ugandans may have been killed. Now, on top of those tragedies, doctors here say they fear the new disease, which destroys a vital part of the body's immune system, could kill several hundred thousand Ugandans over the next 10 years.

In a report recently submitted to the Ugandan Ministry of Health, the Mulago researchers say they believe the number of AIDS patients admitted to hospitals will continue to rise.

"There is no evidence from Uganda or elsewhere that the disease is likely to decline in the near future," their report concluded. "On the contrary, all the facts suggest that the number of affected patients will continue to increase, and the epidemic to spread at the present rate."

Heterosexual Sex

One reason that the doctors fear that the disease is spreading rapidly is that AIDS in Uganda, as in other areas of Africa, appears to be transmitted mostly by heterosexual sex. In the United States and Europe, homosexuals and intravenous drug users are those most at risk--a much smaller portion of the population.

The researchers say that AIDS-acquired immune deficiency syndrome--has now become the leading cause of death in Mulago Hospital, the country's largest medical facility, and that AIDS admissions have risen steadily over the last months and now stand at three a day.

By the end of 1985, they say, 170 AIDS cases had been documented in Uganda. In the first four months of this year, 285 more cases have been documented at Mulago alone.

The physicians say that their research indicates that the rate of infection among young adults in the populous southern regions of Uganda may stand at 10% or higher.

Several Thousand Infected

"We may be getting on toward several hundred thousand infected," said Carswell. "The indications are that 10% of the healthy young adults may be infected with the AIDS virus, and if that isn't a disaster, I don't know what is. It's like these people are carrying a time bomb inside their bodies--it just has a long fuse."

The doctors reach their estimate of 10% by extrapolating from a variety of studies and such factors as hospital admissions and death rates. They cite, for instance:

--AIDS cases now account for more than 10% of the admissions to the hospital's medical wards.

--A study of 900 women at a prenatal clinic in Kampala found that 14% of those tested had HTLV-III antibodies. HTLV-III is the virus responsible for AIDS.

--A study of 300 blood donors which discovered that 11% had the AIDS antibodies.

--A study done in late 1985 that found HTLV-III antibodies present in 10.7% of a sample of 103 pregnant women in the Kampala area.

--Another sample, in which the virus was found in seven out of 70 2-year-old children suffering from measles.

--Yet another study of 270 healthy adults, conducted in the vicinity of the hospital late in 1985, which turned up 11.8% positive. By comparison, tests on blood donors in the United States find the AIDS antibodies in 0.1% to 0.25%.

More Research Needed

The doctors in Uganda concede that their test samples are still small and that more research is urgently needed. But they say they believe that the results gathered so far, despite their narrow base, are a matter of grave concern.

"What our numbers suggest," said Dr. Rick Goodgame, an American missionary physician on the staff at Mulago, "is that we have more people with the virus in Uganda than in the whole of the United States. Numbers like this have not been seen anywhere in the Western world."

They have, however, been mentioned in a number of Western medical journals in articles about the incidence of AIDS in African countries. The 10% figure has been cited for blood studies done in Rwanda, Zambia and Uganda.

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