World Health Organization clinical case definition for AIDS in Africa: an analysis of evaluations.

In 1985 at a World Health Organization (WHO) workshop on AIDS in Bangui, Central African Republic, a clinical case definition of Acquired Immune Deficiency Syndrome (AIDS) was developed for developing countries, such as sub-Saharan Africa, where sophisticated diagnostic equipment is not widely available. A particular cachectic syndrome, the "slim disease", which is highly suggestive of AIDS in Africa, constitutes the substratum for the clinical definition for AIDS. The WHO/Bangui definition in adults has a sensitivity of 60%, a specificity of 90%, and a high predictive value especially in endemic areas. The WHO/Bangui clinical case definition for paediatric AIDS is less easy to use in practice. Its low sensitivity (about 35%) is in relation to its incapacity to diagnose many of the frequently observed secondary infection for paediatric AIDS according to the CDC criteria. The WHO/Bangui clinical definition for AIDS seems to be convenient for epidemiological surveillance of the HIV epidemic in Africa. Nevertheless, the low sensitivity and the low specificity result in the failure to detect some cases of full blown AIDS.