The growing burden of tuberculosis: global trends and interactions with the HIV epidemic.
Elizabeth L. Corbett,Catherine J. Watt,Neff Walker,Dermot Maher,Brian G. Williams,Mario C. Raviglione,Christopher Dye +6 more
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TLDR
The prevention of HIV and TB, the extension of WHO DOTS programs, and a focused effort to control HIV-related TB in areas of high HIV prevalence are matters of great urgency.Abstract:
BACKGROUND: The increasing global burden of tuberculosis (TB) is linked to human immunodeficiency virus (HIV) infection. METHODS: We reviewed data from notifications of TB cases, cohort treatment outcomes, surveys of Mycobacterium tuberculosis infection, and HIV prevalence in patients with TB and other subgroups. Information was collated from published literature and databases held by the World Health Organization (WHO), the Joint United Nations Programme on HIV/Acquired Immunodeficiency Syndrome (UNAIDS), the US Census Bureau, and the US Centers for Disease Control and Prevention. RESULTS: There were an estimated 8.3 million (5th-95th centiles, 7.3-9.2 million) new TB cases in 2000 (137/100,000 population; range, 121/100,000-151/100,000). Tuberculosis incidence rates were highest in the WHO African Region (290/100,000 per year; range, 265/100,000-331/100,000), as was the annual rate of increase in the number of cases (6%). Nine percent (7%-12%) of all new TB cases in adults (aged 15-49 years) were attributable to HIV infection, but the proportion was much greater in the WHO African Region (31%) and some industrialized countries, notably the United States (26%). There were an estimated 1.8 million (5th-95th centiles, 1.6-2.2 million) deaths from TB, of which 12% (226 000) were attributable to HIV. Tuberculosis was the cause of 11% of all adult AIDS deaths. The prevalence of M tuberculosis-HIV coinfection in adults was 0.36% (11 million people). Coinfection prevalence rates equaled or exceeded 5% in 8 African countries. In South Africa alone there were 2 million coinfected adults. CONCLUSIONS: The HIV pandemic presents a massive challenge to global TB control. The prevention of HIV and TB, the extension of WHO DOTS programs, and a focused effort to control HIV-related TB in areas of high HIV prevalence are matters of great urgency.read more
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References
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Journal ArticleDOI
Global Burden of Tuberculosis: Estimated Incidence, Prevalence, and Mortality by Country
TL;DR: The global burden of tuberculosis remains enormous, mainly because of poor control in Southeast Asia, sub-Saharan Africa, and eastern Europe, and because of high rates of M tuberculosis and HIV coinfection in some African countries.
Journal ArticleDOI
A Prospective Study of the Risk of Tuberculosis among Intravenous Drug Users with Human Immunodeficiency Virus Infection
Peter A. Selwyn,Diana Hartel,Victor A. Lewis,Ellie E. Schoenbaum,Sten H. Vermund,Robert S. Klein,Angela T. Walker,Gerald Friedland +7 more
TL;DR: The data suggest that in HIV-infected persons tuberculosis most often results from the reactivation of latent tuberculous infection; these results lend support to recommendations for the aggressive use of chemoprophylaxis against tuberculosis in patients with HIV infection and a positive PPD test.
Journal ArticleDOI
An Outbreak of Tuberculosis With Accelerated Progression Among Persons Infected With the Human Immunodeficiency Virus. An Analysis Using Restriction-Fragment-Length Polymorphisms
Charles L. Daley,Peter M. Small,Gisela F. Schecter,Gary K. Schoolnik,Ruth Mcadam,William R. Jacobs,Philip C. Hopewell +6 more
TL;DR: There should be heightened surveillance for tuberculosis in facilities where HIV-infected persons live, and investigation of contacts must be undertaken promptly and be focused more broadly than is usual.
Journal ArticleDOI
Treatment of 171 Patients with Pulmonary Tuberculosis Resistant to Isoniazid and Rifampin
TL;DR: For patients with pulmonary tuberculosis that is resistant to rifampin and isoniazid, even the best available treatment is often unsuccessful, and only about half of such patients eventually have negative sputum cultures despite carefully selected regimens administered for extended periods.
Journal ArticleDOI
Global trends in resistance to antituberculosis drugs. World Health Organization-International Union against Tuberculosis and Lung Disease Working Group on Anti-Tuberculosis Drug Resistance Surveillance.
Marcos A. Espinal,Adalbert Laszlo,Lone Simonsen,Fadila Boulahbal,S. J. Kim,Ana Reniero,Sven Hoffner,Hans L. Rieder,Nancy J. Binkin,Christopher Dye,Rosamund Williams,Mario C. Raviglione +11 more
TL;DR: The survey conducted by the World Health Organization and the International Union against Tuberculosis and Lung Disease to assess trends in resistance to antituberculosis drugs in countries on six continents found that for patients with newly diagnosed tuberculosis, the frequency of resistance to at least one antituber tuberculosis drug ranged from 1.7 percent in Uruguay to 36.9 percent in Estonia.
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