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Zaire Incidence of Disease
Infectious and parasitic diseases are a major health
threat,
accounting for at least 50 percent of all deaths in Zaire.
(The
United States rate, by comparison, is 1.5 percent.)
Malaria,
trypanosomiasis (sleeping sickness), onchocerciasis (river
blindness), and schistosomiasis are all endemic. Malaria,
long a
significant cause of illness and death, is increasingly
menacing
because of its growing resistance to antimalarial drugs.
Cases of
trypanosomiasis are increasing, primarily because of a
reduction in
the number of mobile teams engaged in controlling the
spread of the
vector, the tsetse fly. Diseases such as measles,
diarrheal
diseases, tetanus, diphtheria, pertussis, poliomyelitis,
tuberculosis, and leprosy are preventable or curable given
available technology; unfortunately, only 30 to 40 percent
of the
population has access to such technology and services. The
UN has
estimated the immunization rate in the early 1990s to be
only 38
percent for measles and 35 percent for diphtheria,
pertussis, and
tetanus. In addition, a majority of the population is
infected with
intestinal worms, including ascaris, hookworms, and
ankylostomes;
the effect of these parasites is to further weaken a
population
already suffering from widespread malnutrition.
The disease burden has fallen particularly heavily on
children
under the age of five. They constitute roughly 20 percent
of the
population and account for 80 percent of all deaths.
Malaria is the
primary killer among infants, while measles, malaria, and
diarrheal
diseases are responsible for the bulk of deaths of
children under
five.
Acquired immune deficiency syndrome (AIDS) and other
sexually
transmitted diseases have been spreading rapidly. As of
1990, the
number of reported cases in Zaire totaled 11,732, a 60
percent
increase over 1989. In urban areas, the AIDS epidemic is
the most
threatening public-health problem facing the nation.
Seropositivity
statistics (the proportion of a population whose blood
serum tests
positive for the AIDS virus) in Kinshasa for the general
population
in 1987 were 6 to 8 percent; among prostitutes the figure
was as
high as 30 percent. The scanty data from rural areas show
a lower
incidence, but the samples are too small to be
statistically
significant.
AIDS is regarded as a potentially even greater
public-health
hazard in the face of the virtual collapse of the
state-run health
care system. By most accounts, in 1993 the majority of
blood banks
had been closed, and blood screenings were rare.
AIDS transmission in Zaire occurs primarily through
sexual,
mostly heterosexual, intercourse (80 percent); infected
blood
transfusions and contaminated skin-piercing instruments
account for
15 percent of cases, and transmission from infected
mothers to
their offspring for 5 percent. The significance of
heterosexual
intercourse in the spread of the disease is documented in
the ratio
of afflicted men to afflicted women; in Zaire it is 1:1.4,
while in
the United States it is 13:1.
Initial public reaction to the early warnings sounded
by the
medical authorities tended to be skeptical. In a play on
the French
acronym for AIDS, SIDA (syndrome immunité déficient
acquis),
Kinshasa street slang labeled the new disease the
"syndrome
inventé pour décourager les amoureux," or, crudely
translated,
"syndrome invented to discourage lovers." But as
increasing numbers
of well-known musicians and other public figures have
contracted
the disease and died, public attitudes have grown more
sober.
Public health authorities have attempted to promote
safe-sex
education in their health education programs. In addition,
the
United States Agency for International Development (AID)
funded
AIDS research programs and health education programs
through
Project SIDA, and the government used a US$500,000 grant
from the
World Health Organization, together with money from other
international agencies, to establish a national AIDS
control
program. Thus far, however, success in slowing the spread
of the
epidemic remains elusive, and rates of prophylactic use
remain low.
Data as of December 1993
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