Clinical and Social Determinants of Diarrhoeal Disease in a Rural HIV/AIDS Clinic, South Africa: A Case-Control Study

Summary:
Diarrheal diseases are a common cause of morbidity and are associated with mortality in HIV-infected populations. Little is known about the contribution of clinical and socio-environmental factors to the risk of diarrhea in these populations in rural sub-Saharan Africa. The authors conducted a case-control study of people attending a rural HIV clinic with an episode of diarrhea in Bushbuckridge, South Africa. In multivariate analysis, diarrhea remained associated with female gender, limited access to water and pre-ART status. Further intervention research is urgently needed, combining community- and clinic-based approaches, to improve access to water, sanitation and ART for rural areas with high HIV prevalence, along with structural interventions to address gender inequities.