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PubMed2003

Hidden health costs of pesticide use in Zimbabwe's smallholder cotton growers.

Balancing the numerous benefits that may accrue from pesticide use on cotton, farmers face health hazards. Pesticide-induced acute symptoms significantly increased the cost-of-illness in a survey of 280 smallholder cotton growers in two districts of Zimbabwe. Cotton growers lost a mean of 180 Zimbabwe dollars in Sanyati and 316 Zimbabwe dollars per year in Chipinge on pesticide-related direct and indirect acute health effects. These values are equivalent to 45% and 83% of annual household pesticide expenditures in the two districts. The time spent recuperating from illnesses attributed to pesticides averaged 2 days in Sanyati and 4 days in Chipinge during the 1998/1999 growing season. These pesticide health cost estimates represent lower bounds only; they omit chronic pesticide health effects as well as suffering and other non-monetary costs. Acute pesticide symptoms were determined in large part by pesticide use practices, notably the lack of protective clothing. Yet many smallholder farmers misunderstood pesticide health hazards, and so did little to protect themselves. Despite the use of simple color codes, 22% of smallholder cotton growers in Sanyati and 58% in Chipinge did not know how the four colored triangles communicated increasing degrees of pesticide toxicity. Better farmer education in exposure averting strategies is needed. Likewise, fuller accounting for hidden health costs in future would allow farmers to make more informed decisions about agricultural pest management.

Agricultural Workers' Diseases↗
PubMed2001

Consistency in condom use in the context of HIV/AIDS in Zimbabwe.

Against the backdrop of a high prevalence of the human immunodeficiency virus infection in Zimbabwe, this paper analyses data from the 1997 Zimbabwe Sexual Behaviour and Condom Use Survey to throw light on the degree to which sexually active adults consistently use condoms in high-risk sexual situations. The multivariate results indicate that at the time of the survey, consistent condom use in non-marital relationships is significantly higher for males than females, higher among those who had access to information about condoms from multiple sources than among those with limited access, and higher among those who have positive attitudes to condoms than among those with negative attitudes. Even though consistent condom use with non-marital partners is higher for those who know a source where condoms can be obtained, this effect is due to the fact that these respondents have more positive attitudes towards condoms. Likewise, the higher levels of consistent condom use exhibited by those who are aware of the efficacy of condoms are due to the fact that men have higher awareness of this, and men use condoms more consistently than women. In sum, the results suggest that the effects of the respondents' sex and their knowledge of the prophylactic importance of condoms and where condoms might be obtained are a function of other socioeconomic advantages they have. It is, therefore, concluded that programmes that use mass media information, education and communication campaigns to reduce shyness, embarrassment and stigma about condom use can help increase consistent use of condoms in non-marital relationships in Zimbabwe.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Measuring excess risk of child mortality: an exploration of DHS I for Burundi, Uganda and Zimbabwe.

This paper proposes a new method of measuring excess risk of child mortality in cross-sectional surveys, which is applied to DHS I data for Burundi, Uganda and Zimbabwe. The expected child mortality experience is estimated for each mother on the basis of child's age, mother's age at child's birth and her parity, and compared with her observed experience. Mothers who exceed their expected child mortality experience and also had more than one child die are considered to have excess child mortality. Zimbabwe had the greatest concentration of child deaths as measured by a simple ratio of mothers to deaths, but when observed experience was compared with expected it had less than half as many excess deaths as Uganda and Burundi. In all three countries mother's education had a strong negative association with the risk of excess child mortality, and in Zimbabwe and Burundi there were significant regional differences.

Adolescent↗
PubMed1995

Antigenic analysis of SAT 2 serotype foot-and-mouth disease virus isolates from Zimbabwe using monoclonal antibodies.

This paper compares strains of foot-and-mouth disease (FMD) serotype SAT (South African Territories) 2 viruses isolated from Zimbabwe and other African countries using monoclonal antibodies (MAb). A sandwich-ELISA was used to examine the relative binding of anti-SAT 2 MAb to the various viruses. The MAb-binding profiles of viruses isolated from field samples were compared using hierarchical cluster analysis. Viruses were obtained from game animals, mainly African buffalo (Syncerus caffer) which is the natural host and reservoir for SAT serotypes in Africa, and from cattle showing clinical signs of FMD, as well as from animals suspected of carrying the virus subclinically. Some isolates have been adapted for use as vaccine strains. The results showed that most of the Zimbabwe isolates collected between 1989 and 1992 were an antigenically closely-related group. Although differences were observed between Zimbabwe isolates collected between 1989 and 1992 and those collected in 1987, there was no correlation with the different MAb binding patterns within the 1987 group and the epidemiological information received from the field. Similar profiles were observed for many SAT 2 viruses, including viruses isolated over a 50-year period and from geographically distant areas. This indicates an inherent stability in antigenic profiles of SAT 2 viruses. The MAb panel was capable of assessing antigenic variation, since very different profiles were obtained for some isolates. The work also allowed comparison and characterization of anti-type SAT 2 MAb from different laboratories. The findings are discussed with reference to selection of vaccine strains.

Animals↗
PubMed2004

Desire for a future pregnancy among women in Zimbabwe in relation to their self-perceived risk of HIV infection, child mortality, and spontaneous abortion.

In a background of very high prevalence of human immunodeficiency virus (HIV) infection among women of childbearing age and the increasing demand for treatment to prevent mother-to-child transmission, we investigated the desire for a future pregnancy among women in Zimbabwe in relation to (1) self-perceived risk of HIV infection, (2) child mortality, and (3) spontaneous abortion. A random cross-sectional sample of 2250 ever-married women aged 15-49 years was selected from 6,828 households in rural and urban Zimbabwe. The sample was representative of the geographic distribution of women. One eligible subject was selected per household for a structured interview on factors associated with the desire for future pregnancy. Overall, 54% of the participants desired to get pregnant in future; 55% perceived themselves at high risk for HIV infection; 6% reported the death of at least one child less than the age of 5 years in the last 5 years; and 12% reported at least one spontaneous abortion in the last 5 years. In multiple logistic regression analysis, reporting at least one child's death (OR = 1.77; 95% CI 1.13-2.78) and at least one spontaneous abortion in the last 5 years (OR = 1.81; 95% CI 1.08-3.04) were significantly associated with a higher desire to get pregnant; however, high self-perceived risk for HIV infection was not (OR = 0.85; 95% CI 0.67-1.09). High self-perceived risk for infection with HIV was not associated with a lower desire for a future pregnancy among women in Zimbabwe in a high-prevalence area. In fact, our data suggest an increased desire for future pregnancy to replace childhood deaths or spontaneous abortions that may result from HIV infection. Voluntary HIV testing services are challenged with balancing counseling messages on the strong desire for children, the risk of mother-to-child transmission, and poor fetal outcomes. Further research is needed to explore utilitarian-economic, social, and psychological values attributed to children by women and their partners. The involvement of men as partners in childbearing should be explored, as their desire for children may be the primary barrier to protective behavior change among women.

Abortion, Spontaneous↗
PubMed1999

Use of maternal care in a rural area of Zimbabwe: a population-based study.

PURPOSE: Our aim was to determine the coverage of antenatal and delivery care and the determinants of non-compliance in a rural area of Zimbabwe in order to improve the quality and efficiency of maternal health care services. METHODS: A community-based, cross-sectional study was carried out in the catchment area of Gutu Mission Hospital, in rural Zimbabwe, from January to June 1996. Two hundred and thirty-five women, aged 16 to 54 years, who had delivered a child in the past three years were interviewed on general characteristics (age, marital status, religion, education, work), obstetric history, use of family planning, pregnancy complications, number of antenatal visits, and use of maternity waiting shelters. Associations of these factors to non-use of antenatal care facilities and hospital delivery were studied. In the Gutu district, guidelines exist to identify women at high risk of complications during pregnancy and to indicate where women should give birth (hospital, rural clinic or at home). We evaluated which factors were important for non-compliance to these guidelines. The analyses were performed using a logistic regression model. RESULTS: Ninety-seven percent of the pregnant women attended the antenatal care facilities at least once. Seventy-three percent came at least five times or more. Belonging to certain religious groups proved to be the strongest explanatory factor for not attending antenatal care facilities. Use of maternity waiting shelters and complications during the pregnancy were important factors for hospital delivery, whereas unemployment and being without a husband were associated with deliveries outside the hospital. Identification as high risk of a complicated pregnancy by application of the existing guidelines was not associated with place of delivery. Delivery at a location that did not conform to the existing guidelines was associated with non-use of maternity waiting shelters, unemployment or being without a husband and use of traditional care. CONCLUSIONS: Our study showed a high attendance rate at antenatal care facilities in the Gutu District. By analyzing determinants of non-use of antenatal care facilities, of hospital delivery and of inappropriate location of delivery according to local guidelines, we identified certain risk factors which are suitable for modification and may help to improve antenatal and perinatal care in the Gutu District in Zimbabwe.

Adolescent↗
PubMed1997

An evaluation of dipstick-dot immunoassay in the detection of antibodies to HIV-1 and 2 in Zimbabwe.

There is a need, in many developing countries, for simple and inexpensive HIV serology tests for use at the district level of health care. The Programme for Appropriate Technology in Health has developed a simple dipstick ELISA to detect antibodies to HIV-1 and 2, at a cost considerably lower than current ELISAs, which requires no specialized washing or reading equipment. In order to evaluate this dipstick under local conditions we used a panel of 546 sera selected from frozen stocks maintained by the Zimbabwe AIDS Prevention Project in Harare, Zimbabwe. Prior to storage, the sera had been tested by Abbott recombinant peptide HIV-1 and 2 ELISA and Enzygnost synthetic peptide HIV-1 and 2 ELISA. The panel included sera that were positive by both (including symptomatics and asymptomatics), negative by both, and sera showing discrepant test results. The panel was not representative of a "normal' batch of sera in Zimbabwe, and in particular included an abnormally high number of sera showing discrepant results. Thawed sera were retested using the Abbott recombinant peptide HIV-1 and 2 ELISA and concurrently with the synthetic peptide ICL-Dipstick ELISA. Both the sensitivity and specificity of the ICL Dipstick exceeded 99% when using sera that were positive or negative in all 3 plate ELISAs as the gold standard. When using sera that gave discrepant results between the two pre-storage ELISAs, most results with the ICL Dipstick concurred with findings from other test systems, including Western blot and p24 antigen detection. Considering the accuracy, low cost and case of operation of the ICL Dipstick ELISA, this test can be recommended for use for the rapid detection of antibodies to HIV at district level in developing countries.

Enzyme-Linked Immunosorbent Assay↗
PubMed2003

The contribution of HIV to fertility decline in rural Zimbabwe, 1985-2000.

HIV-related sub-fertility has been reported for those populations in sub-Saharan Africa in which contraceptive use is low. We use data from a retrospective survey in rural Zimbabwe and multivariate logistic regression models to show that recent birth rates and current pregnancy rates are also lower among HIV-positive women than among HIV-negative women in those African populations where contraceptive use is high. The fertility reduction is smaller than where contraceptive use is low because age at first sexual intercourse is later and birth rates at older ages are already low. Nevertheless, total fertility is approximately 8.5 per cent lower and HIV-associated sub-fertility may account for as much as one-quarter of fertility decline in Zimbabwe since the late 1980s. Mechanisms for HIV-associated sub-fertility in rural Zimbabwe include more frequent widowhood and divorce, reduced coital frequency, increased amenorrhoea, and possibly, pelvic inflammatory disease. Miscarriage appears to be a less important factor than elsewhere possibly because syphilis is rare.

Birth Rate↗
PubMed2005

Neurological complications of human immunodeficiency virus infection in Zimbabwe-2005.

Zimbabwe is a high prevalence area for HIV infection, and provides opportunities for studying complications of AIDS in both antiretroviral naive and treated groups of patients. Figures for HIV prevalence are among the highest in the world, but the number of people receiving treatment is very small. Economic and political factors contribute to this important health crisis. Opportunistic diseases as a whole and their relative frequencies of presentation in southern Africa are discussed, emphasizing the lead role of tuberculosis. The limited data that do exist regarding neurological complications in Zimbabwe are summarized, and combined with anecdotal experience from practicing clinicians. Opportunistic infections in the nervous system are very common, the most important being cryptococcal meningitis, causing half of all adult meningitis in the country. Tuberculous and bacterial meningitis have also become more common and carry a high mortality in HIV-infected people in Zimbabwe. Intracranial mass lesions, including tuberculoma, bacterial abscesses and toxoplasmosis encephalitis are less common and difficult to diagnose in the absence of stereotactic biopsy. Spinal tuberculosis and transverse myelitis are the most frequent causes of spinal cord opportunistic infections. Peripheral neuropathy is probably similar in presentation to that seen elsewhere, whereas dementia is less frequently recognized.

AIDS-Related Opportunistic Infections↗
PubMed2006

Toxicoepidemiology in Zimbabwe: pesticide poisoning admissions to major hospitals.

BACKGROUND: Acute pesticide poisoning (APP) is a well-recognized cause of morbidity and mortality but is not well described in developing countries. We describe the toxicoepidemiology of APP in Zimbabwe. METHODS: All cases of APP admitted to eight major referral hospitals in Zimbabwe from January 1998 to December 1999 (inclusive) were identified using ICD-9 codes and ward registers and relevant information recorded on a standard data collection sheet. RESULTS: There were a total of 914 single pesticide exposures. Almost half (49.1%) resulted from oral exposure to rodenticides, 42.2% from anticholinesterase-type pesticides (AChTP), mostly organophosphates (OP) that were responsible for over 90% of admissions from AChTP. Accidental and deliberate self-poisoning (27.1% and 58.6%, respectively) accounted for most cases with only eight homicides. The case fatality rate (CFR) in deaths/100 admissions was 6.8 [62 deaths; 95% Confidence Interval (CI) 5.2-8.6] and was significantly higher in males (9.4) than females (4.1) (CI for difference in proportions; 2.0-8.5). In addition, the CFR for deliberate self-poisoning (DSP), 6.5 deaths/100 admissions, was also significantly higher than that for accidental poisoning (0.8 deaths/100 admissions) (CI for difference in proportions 3.2-7.9). Organophosphates were implicated in 70.9% of all fatalities, with over 20% resulting from oral exposure to rat poison (RP). CONCLUSION: Organophosphates and rat poison (RP) are the leading causes of APP admissions to major referral hospitals in Zimbabwe, with most of the admissions being the result of deliberate self-poisoning. Greater control in the sale and use of these products could help prevent significant morbidity and mortality.

Accidents↗
PubMed2006

Toxicoepidemiology in Zimbabwe: admissions resulting from exposure to paraffin (kerosene).

INTRODUCTION: Paraffin (kerosene) ingestion is the most common form of childhood poisoning in most developing countries. Despite this, there is a paucity of toxicoepidemiological data which could potentially be used in measures to reduce preventable exposures. This article reports on the patterns of hospital admissions resulting from paraffin exposure in Zimbabwe. METHODS: All cases of paraffin ingestion admitted to eight major referral hospitals in Zimbabwe from January 1998 to December 1999 (inclusive), were identified using ICD-9 codes and ward registers and relevant information recorded on a standard data collection sheet. RESULTS: There were a total of 327 admissions due to oral exposure to paraffin. This represented 11.8% of all the poisoning admissions to the eight study hospitals. Most exposures (300; 91.7%) occurred accidentally, with only 6.7% resulting from deliberate ingestion of the chemical. The median age on admission was 2 years (interquartile range [IQR] 1-2 yrs) with over 85% of cases in the 0-5 year age range and less than 10% above the age of 12 years. The median age on admission was much higher for deliberate self poisoning (23 yrs; IQR 19-26 yrs) compared to that for accidental poisoning (1.5 yrs; IQR 1-2 yrs). Accidental poisoning from paraffin occurred throughout the year. Over three-quarters of patients received an antibiotic either alone, or in combination with another antibiotic or drug. Paracetamol (24.3%) was the next most commonly encountered treatment. The case fatality rate (CFR) was therefore 0.3 deaths per 100 admissions (95% Confidence Interval 0.0-1.7). CONCLUSION: Paraffin ingestion remains an important cause of poisoning morbidity in Zimbabwe throughout the year, particularly in children. Clinical management appears adequate with a low mortality, although there may be overuse of prophylactic antibiotics. Further study specific to this area is warranted to prevent unnecessary antibiotic use and wastage of resources.

Accidents↗
PubMed2005

Patterns of movement and risk of HIV infection in rural Zimbabwe.

BACKGROUND: High rates of population movement may have helped spread human immunodeficiency virus (HIV) in southern Africa, including Zimbabwe, but whether mobility continues to influence the epidemic is unclear. METHODS: The relationship between movement, risk behaviors, and prevalence of HIV was assessed from a general population survey of >9800 adults in 12 rural communities in Manicaland province in eastern Zimbabwe. RESULTS: HIV prevalence varied with socioeconomic development. In community centers, prevalence among women was 49.9% (95% confidence interval [CI], 46.1%-53.6%), compared with 24.7% (95% CI, 22.6%-26.7%) in the least-developed subsistence-farming areas. Mobility was not associated with risk of HIV infection, except for those who migrated between rural locations. Among migrant agricultural workers, prevalence was 38.8% (95% CI, 33.1%-44.6%) for women and 26.4% (95% CI, 23.8%-28.9%) for men, compared with 29.7% (95% CI, 28.3%-31.1%) and 20.9% (95% CI, 19.3%-22.4%) for other sexually active women and men, respectively. Risk was increased if an individual traveled to Harare in the last month, without their spouse, but this risk was not transferred to the partner. CONCLUSION: Rural-urban migration does not appear to be responsible for maintaining the high HIV prevalence in rural Zimbabwe, but rates of HIV infection may be affected by rural-rural migration.

Adolescent↗
PubMed2003

Indoor air pollution from biomass combustion and acute respiratory illness in preschool age children in Zimbabwe.

BACKGROUND: Reliance on biomass for cooking and heating exposes many women and young children in developing countries to high levels of air pollution indoors. This study investigated the association between household use of biomass fuels for cooking and acute respiratory infections (ARI) in preschool age children (<5 years) in Zimbabwe. METHODS: Analysis is based on 3559 children age 0-59 months included in the 1999 Zimbabwe Demographic and Health Survey (ZDHS). Children who suffered from cough accompanied by short, rapid breathing during the 2 weeks preceding the survey were defined as having suffered from ARI. Logistic regression was used to estimate the odds of suffering from ARI among children from households using biomass fuels (wood, dung, or straw) relative to children from households using cleaner fuels (liquid petroleum gas [LPG]/natural gas, or electricity), after controlling for potentially confounding factors. RESULTS: About two-thirds (66%) of children lived in households using biomass fuels and 16% suffered from ARI during the 2 weeks preceding the survey interview. After adjusting for child's age, sex, birth order, nutritional status, mother's age at childbirth, education, religion, household living standard, and region of residence, children in households using wood, dung, or straw for cooking were more than twice as likely to have suffered from ARI as children from households using LPG/natural gas or electricity (OR = 2.20; 95% CI: 1.16, 4.19). CONCLUSIONS: Household use of high pollution biomass fuels is associated with ARI in children in Zimbabwe. The relationship needs to be further investigated using more direct measures of smoke exposure and clinical measures of ARI.

Acute Disease↗
PubMed2002

Measuring the quality of supervisor-provider interactions in health care facilities in Zimbabwe.

OBJECTIVE: Measuring performance is the first step on the road to improving it. This report presents the results of an exploratory study sponsored by the Quality Assurance (QA) Project to describe and quantify the quality of supervisor-provider interactions in health care facilities in Zimbabwe in 1999. Supervisors were district and municipal nursing officers who are responsible for guiding, assisting, and motivating health providers at government and missionary health facilities. DESIGN: The study's design was qualitative. It involved the triangulation of data from various sources: structured observations of supervisors, audiotaping of supervisor-provider interactions, recording of all supervisory activities, and interviews with supervisors and supervisees. A team composed of current and past supervisors, along with researchers, determined the supervisory practices that would be measured. STUDY PARTICIPANTS: Sixteen district-level government, municipality, and Zimbabwe National Family Planning Council supervisors from four provinces participated in the study. RESULTS: The study found that supervisors devoted <5% of their time to patient care issues. The supervisors' main strengths were in giving feedback on technical standards, discussing and analyzing data, and developing a rapport with the providers. They were most deficient in making suggestions, seeking client input, problem solving with the providers, and building on previous (and future) supervisory visits. None of the supervisors observed achieved the threshold set in advance by the team for exemplary performance. CONCLUSION: The study concludes with recommendations to the Ministry of Health and Child Welfare on how the quality of supervision in Zimbabwe could be improved.

Adult↗
PubMed1997

Recent upturn in mortality in rural Zimbabwe: evidence for an early demographic impact of HIV-1 infection?

OBJECTIVES: To describe recent mortality trends in rural Zimbabwe and to assess the impact of HIV-1 infection. METHOD: Comparative, cross-sectional, retrospective, demographic survey with 1-year follow-up. Parallel HIV-1 surveillance. Comparison of results with 1992 national census and vital registration data and results from mathematical model-based population projections. SETTING AND PARTICIPANTS: Residents of 929 (745 revisited in 1995) households in two rural areas of Manicaland Province, Zimbabwe, with contrasting HIV-1 prevalence: Honde and Rusitu valleys. Subjects gave information on parental survival for 2320 resident children. Female residents aged 13-49 years (n = 1237) provided information on birth histories and child survival. Consenting women attending local antenatal clinics (n = 487) provided blood samples for HIV-1 screening and demographic information. MAIN OUTCOME MEASURES: HIV-1 prevalence in pregnant women; per capita death registration rates; incidence of parental death for children aged under 8 years; infant mortality and age-specific death probabilities. RESULTS: HIV-1 prevalence was high in each study area. Death registration and age-specific mortality have begun to rise. The largest increases were seen in the area of higher HIV-1 prevalence (Honde) and among younger adults, particularly men. Incidence of parental death was observed to be rising. Increases in registered deaths were concentrated among HIV-1-associated causes. CONCLUSIONS: The observed increases in mortality by age, sex and cause of death were consistent with those expected early in a severe HIV-1 epidemic, on the basis of mathematical model projections and observations elsewhere in Africa. Further rises in mortality, particularly among women and young children, and consequent increases in orphanhood, are to be expected in rural areas of Zimbabwe.

Adolescent↗
PubMed1999

Aids and cancer in Africa: the evolving epidemic in Zimbabwe.

BACKGROUND: Zimbabwe is severely affected by the AIDS epidemic, and many cancers in African populations are related to infectious agents. OBJECTIVE: To study the current pattern, and short-term changes in incidence, of cancers related to infectious agents (and especially to HIV), with respect to the evolving epidemic of AIDS. METHODS: Analysis of data on the African population of Harare, Zimbabwe, from the Zimbabwe Cancer Registry, for the period 1990-1995. Comparison with data on prevalence of HIV seropositivity, and notifications of AIDS. RESULTS: Comparing results from 1993-1995 with those for 1990-1992 shows a continuing increase in the incidence of Kaposi's sarcoma with a doubling of the rates in both men and women. A dramatic increase in the incidence of squamous cell tumours of the conjunctiva was also observed, as well as a significant increase in the incidence of non-Hodgkin's lymphoma in women. There was no apparent increase in risk for Hodgkin's disease, myeloma, liver cancer, or cancer of the cervix. CONCLUSIONS: The AIDS epidemic has had a dramatic effect on the profile of cancer. The changes in incidence involve several cancers previously linked to AIDS in North America and Europe.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Coping with epilepsy in Zimbabwe and the Midwest, USA.

In this article, the experiences of persons with epilepsy were explored in terms of coping with providing a basis of discussion and training to support groups, particularly in Zimbabwe. Coping mechanisms lay stress upon the individual's control in mastering the disease. It was assumed that a systematic research effort of intra-cultural and cross-cultural sharing of experiences could enhance discussion and training in the support groups. Coping with epilepsy was explored with 37 adults (27 from Zimbabwe and 10 from the Midwest, USA) using open-ended questions in a written questionnaire. Questions aimed to elicit general feelings, experiences and strategies and skills in coping with epilepsy. The questionnaire covered such semantic domains as childhood, education, employment, friendships, relations within the family, and handling of seizures in public places. Coping mechanisms were categorized into two modes, one, adjustment to the disability (palliative), the other adjustment to the environment (problem-solving). In comparing the information between the two groups, some trends can be distinguished which need a larger scale validation. First, palliative skills during childhood in the Zimbabwean group is indicative for early development of personality characteristics and socialization as a result of the illness experiences. A great variety in palliative mechanisms in handling seizures indicates better familiarity with seizures in the Midwestern group. Similarities between the two groups are found in the friendship domain, where palliative coping skills seem to be of no importance, as well as in the domain of intimate relations, where a trend in adherence to medication is observed in both groups. Second, many problem-solving skills are developed in both groups but vary in context. In view of public education and training activities and the enhancement of problem-solving skills, the domain of education for the Zimbabwean group and the domains of friendship with the Midwestern group and the family perhaps deserve more attention. Third, coping skills in the Zimbabwean group tend to be related to the experience of 'being different', while in the Midwestern group 'not being able to doing things' is a major experience. Fourth, in linking coping mechanisms to the cultural environment, two major cultural influences in Zimbabwe stand out as being different from the Midwest, the first being the belief in external control and cause of mental and physical health, and the second, cultural conflict.

Adaptation, Psychological↗
PubMed1999

Primary subtype C HIV-1 infection in Harare, Zimbabwe.

Heterosexual transmission of HIV-1 is widespread in Southern Africa. Heteroduplex mobility assays (HMA) and phylogenetic analyses of V3-V5 envelope (env) gene sequences demonstrate that subtype C predominates in Zimbabwe. To elucidate factors contributing to the epidemic in Zimbabwe, clinical and virologic characteristics of recently acquired subtype C HIV-1 infection among 21 men and 1 woman were determined. In 12 of 19 men providing clinical histories, a sexually transmitted infection preceded serologic evidence of HIV-1, and 14 of 19 men complained of rash or fever before seroconversion. Quantitative p24 antigen levels, reverse transcriptase activity, and HIV RNA levels of 22 viral isolates correlated with in vitro infectivity in peripheral blood mononuclear cells (p < .05). Biologic phenotype assessed in MT-2 cells demonstrated that 3 of 22 isolates (14%) were syncytia inducing (SI) and the remaining 19 nonsyncytium inducing (NSI). Early growth of virus in culture was associated with increased plasma HIV RNA levels, decreased CD4 cell levels, and SI virus. Recent subtype C HIV-1 infection through heterosexual transmission in Zimbabwe demonstrated clinical and virologic features consistent with reports of seroconversion to subtype B viruses.

Adult↗