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Epidemiol Infect. 1991 August; 107(1): 69–80.
PMCID: PMC2272046

Civil war and the spread of AIDS in Central Africa.


Using ordinary least squares regression techniques this paper demonstrates, for the first time, that the classic association of war and disease substantially accounts for the presently observed geographical distribution of reported clinical AIDS cases in Uganda. Both the spread of HIV 1 infection in the 1980s, and the subsequent development of AIDS to its 1990 spatial pattern, are shown to be significantly and positively correlated with ethnic patterns of recruitment into the Ugandan National Liberation Army (UNLA) after the overthrow of Idi Amin some 10 years earlier in 1979. This correlation reflects the estimated mean incubation period of 8-10 years for HIV 1 and underlines the need for cognizance of historical factors which may have influenced current patterns of AIDS seen in Central Africa. The findings may have important implications for AIDS forecasting and control in African countries which have recently experienced war. The results are compared with parallel analyses of other HIV hypotheses advanced to account for the reported geographical distribution of AIDS in Uganda.

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Selected References

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  • Piot P, Quinn TC, Taelman H, Feinsod FM, Minlangu KB, Wobin O, Mbendi N, Mazebo P, Ndangi K, Stevens W, et al. Acquired immunodeficiency syndrome in a heterosexual population in Zaire. Lancet. 1984 Jul 14;2(8394):65–69. [PubMed]
  • Van de Perre P, Rouvroy D, Lepage P, Bogaerts J, Kestelyn P, Kayihigi J, Hekker AC, Butzler JP, Clumeck N. Acquired immunodeficiency syndrome in Rwanda. Lancet. 1984 Jul 14;2(8394):62–65. [PubMed]
  • Quinn TC, Mann JM, Curran JW, Piot P. AIDS in Africa: an epidemiologic paradigm. Science. 1986 Nov 21;234(4779):955–963. [PubMed]
  • Fleming AF. AIDS in Africa--an update. AIDS Forsch. 1988 Mar;3(3):116–138. [PubMed]
  • N'Galy B, Ryder RW. Epidemiology of HIV infection in Africa. J Acquir Immune Defic Syndr. 1988;1(6):551–558. [PubMed]
  • Berkley S, Okware S, Naamara W. Surveillance for AIDS in Uganda. AIDS. 1989 Feb;3(2):79–85. [PubMed]
  • Carswell JW, Sewankambo N, Lloyd G, Downing RG. How long has the AIDS virus been in Uganda? Lancet. 1986 May 24;1(8491):1217–1217. [PubMed]
  • Carswell JW. HIV infection in healthy persons in Uganda. AIDS. 1987 Dec;1(4):223–227. [PubMed]
  • de Lalla F, Rizzardini G, Rinaldi E, Santoro D, Zeli PL, Verga G. HIV, HBV, delta-agent and Treponema pallidum infections in two rural African areas. Trans R Soc Trop Med Hyg. 1990 Jan-Feb;84(1):144–147. [PubMed]
  • Konde-Lule JK, Berkley SF, Downing R. Knowledge, attitudes and practices concerning AIDS in Ugandans. AIDS. 1989 Aug;3(8):513–518. [PubMed]
  • Hunt CW. Migrant labor and sexually transmitted disease: AIDS in Africa. J Health Soc Behav. 1989 Dec;30(4):353–373. [PubMed]
  • McCarthy MC, Hyams KC, el-Tigani el-Hag A, el-Dabi MA, el-Sadig el-Tayeb M, Khalid IO, George JF, Constantine NT, Woody JN. HIV-1 and hepatitis B transmission in Sudan. AIDS. 1989 Nov;3(11):725–729. [PubMed]
  • Santos-Ferreira MO, Cohen T, Lourenço MH, Almeida MJ, Chamaret S, Montagnier L. A study of seroprevalence of HIV-1 and HIV-2 in six provinces of People's Republic of Angola: clues to the spread of HIV infection. J Acquir Immune Defic Syndr. 1990;3(8):780–786. [PubMed]
  • Chelala CA. Central America: the cost of war. Lancet. 1990 Jan 20;335(8682):153–154. [PubMed]
  • Low N, Smith GD, Gorter A, Arauz R. AIDS and migrant populations in Nicaragua. Lancet. 1990 Dec 22;336(8730):1593–1594. [PubMed]
  • Saimot AG, Coulaud JP, Mechali D, Matheron S, Dazza MC, Rey MA, Brun-Vezinet F, Leibowitch J. HIV-2/LAV-2 in Portuguese man with AIDS (Paris, 1978) who had served in Angola in 1968-74. Lancet. 1987 Mar 21;1(8534):688–688. [PubMed]
  • de Lalla F, Rizzardini G, Santoro D, Galli M. Rapid spread of HIV infection in a rural district in central Africa. AIDS. 1988 Aug;2(4):317–317. [PubMed]
  • Serwadda D, Mugerwa RD, Sewankambo NK, Lwegaba A, Carswell JW, Kirya GB, Bayley AC, Downing RG, Tedder RS, Clayden SA, et al. Slim disease: a new disease in Uganda and its association with HTLV-III infection. Lancet. 1985 Oct 19;2(8460):849–852. [PubMed]

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