Rapid emergence of AIDS in Abidjan, Ivory Coast.

Between July and November, 1988, 1501 consecutive adult medical admissions to the two largest hospitals in Abidjan, Ivory Coast, were studied. The overall prevalence of infection with human immunodeficiency virus (HIV) types 1 and 2 was 43% in hospital A and 28% in hospital B. AIDS accounted for 19% and 9%, respectively, of medical admissions to the two hospitals, and for 33% of medical deaths in hospital A. The risk of death was significantly higher in HIV-seropositive patients with acquired immunodeficiency syndrome (AIDS) (risk ratio 2.5, 95% confidence interval [CI] 2.0-3.2) and in HIV-positive patients who did not meet the AIDS case-definition (risk ratio 1.7, 95% CI 1.3-2.3) than HIV-negative patients. The male/female ratio of the 265 cases of AIDS identified was 4.8. 50% of patients with AIDS were seropositive for HIV-1 only, 4% for HIV-2 only, and 46% reacted serologically to both viruses. The minimum incidence of AIDS in adult male and female residents of Abidjan (per million per year) is estimated at 1447 and 340 cases, respectively. AIDS in this West African city has emerged as a major public health problem.