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Divining without SeedsThe Case for Strengthening Laboratory Medicine in Africa$
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Iruka N. Okeke

Print publication date: 2011

Print ISBN-13: 9780801449413

Published to Cornell Scholarship Online: August 2016

DOI: 10.7591/cornell/9780801449413.001.0001

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Detecting Covert Infection ahead of the Final Diagnosis

Detecting Covert Infection ahead of the Final Diagnosis

(p.91) 6 Detecting Covert Infection ahead of the Final Diagnosis
Divining without Seeds

Iruka N. Okeke

Cornell University Press

This discusses how slow and inadequate diagnoses amplify epidemics of sexually transmitted diseases and incurable infections caused by viruses, including HIV. Across Africa, hepatitis B is among the most important causes of death in middle age. This disease is controllable and treatable. But since decades can pass between the time of infection and the point of diagnosis and death from liver cancer, prevention and early diagnosis are key. The diagnostic dilemma posed by hepatitis B is also seen in many sexually transmitted diseases, for which symptoms in at least some infected people are few or none but long-term infection can be devastating or irreversible. With regards to HIV, a recent study showed that universal testing and access to antiretrovirals would lower transmission rates. Moreover, exaggerations of the state of the HIV epidemic in both directions—underestimates and overestimates—have been extreme, and they remain dangerous because they undermine intervention programs, which today are largely focused on changing behaviors. Inadequate surveillance data are fostered by continuing diagnostic insufficiency and adversely affect prevention and treatment of the disease, irrespective of how widespread it is at different localities.

Keywords:   infectious disease, Africa, epidemics, viruses, HIV, AIDS, hepatitis B, diagnosis, sexually transmitted disease

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