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  • Title: Tuberculosis in the era of HIV: problems, challenges and hopes for Africa.
    Author: Mugerwa RD.
    Journal: Afr Health; 1998 Sep; 20(6):23-5. PubMed ID: 12321814.
    Abstract:
    After years of declining incidence, Mycobacterium tuberculosis has re-emerged as a major global pathogen. An estimated one-third of the world's population is infected with M. tuberculosis, 8 million new cases of active tuberculosis (TB) occur annually, and 2.6-2.9 million people die annually from TB-related causes. More than 95% of new TB cases and TB-related deaths occur among people living in developing countries, mainly in Asia and Africa. The number of reported TB cases in Africa increased markedly during the 1980s and 1990s, making sub-Saharan Africa the region with the highest incidence of TB. Worldwide, there were 9.4 million people co-infected with TB and HIV, of whom 6.6 million were in sub-Saharan Africa. An estimated 26% of TB cases in sub-Saharan Africa in 1995 were attributable to HIV infection. The observed increase in TB in sub-Saharan Africa may have resulted from several factors, including civil conflict leading to displacement, overcrowding, famine, and malnutrition. Together with economic decline, these factors have in many cases led to a breakdown in health infrastructure. Reduced case-finding and poor contact tracing are expected to lead to an increase in the number of chronic TB-excretors. The interaction between TB and HIV, clinical features, treatment, preventive therapy, and innovative approaches are discussed. TB and AIDS together threaten to reverse the social and economic gains achieved in Africa over the past 30 years, and to impede further development.
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