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ANNALS OF TROPICAL PAEDIATRICS. 1989 Mar; 9(1):1-5.A total of 177 children seen at 2 hospitals in Kampala are described who were strongly suspected of having acquired immunodeficiency syndrome (AIDS), either on clinical grounds or because they fulfilled WHO case- definition criteria for diagnosis of pediatric AIDS. Blood was taken from the 177 children and 154 of their mothers and tested for antibody to human immunodeficiency virus (HIV) by an enzyme-linked immunoassay (ELISA). Altogether, 119 (67%) children were seropositive, but only 85 (71%) fulfilled the WHO case-definition criteria, and they were significantly older than the 34 who did not fulfill the criteria. A further 58 children were seronegative but fulfilled the WHO criteria. Of the 119 seropositive children, only 3 had a history of previous blood transfusion, but 103 (98%) of 105 mothers were HIV seropositive: consequently, their children were considered to have been infected in utero or perinatally. 13 (26%) of 49 mothers of seronegative children were seropositive. 80% of HIV-infected children were under 2 years of age at diagnosis and 23% died within 3 months of diagnosis. None of the parents was known to be an intravenous drug user, a prostitute, or bisexual. The difficulty of accurate diagnosis of AIDS presents a major problem in Africa, as the WHO clinical case-definition criteria alone are clearly not adequate. (author's)
In: Diczfalusy, E., ed. Regulation of human fertility. (Proceedings of the WHO Symposium on Advances in Fertility Regulation, Moscow, USSR, November 16-19, 1976) Copenhagan, Denmark, Scriptor, 1977. p. 111-134A 6-month regimen for managing infertile men and/or women ideally forms 4 stages: 1) history and examination of the couple; 2) confirmation of ovulation, compatibility of sperm and mucus, and seminology; 3) tests for tubal patency; and 4) detailed endocrine tests for abnormalities found in Stages 1-3. Medical history should include emotional stress and work pressures, if any. Ovulation confirmation requires 2 tests combined from these 4: 1) basal body temperature; 2) endometrial biopsy; 3) blood progesterone levels; and 4) urinary pregnanediol. These procedures are outlined in detail, and figures chart body temperature variations and expected progesterone and pregnanediol levels. Assessment of cervical mucus and measurement of sperm penetration combine in vitro and in vivo tests. The Sims-Huhner test (postcoital test), though not standardized, is used to analyze sperm-mucus interaction by quantitative scoring of sperm count and motility. Other in vitro tests are the sperm-mucus match test and the fractional postcoital test (both described). Tubal patency is investigated by tubal insufflation with CO2, hysterosalpingography, endoscopy, and laparoscopy. Additional Stage 4 tests include vaginal cytology and assessment of estrogen and progesterone effects.