15 June 2008
opinion
Kampala — LAST Monday, for the first-time, the Government, public health and business leaders, heads of United Nations agencies and advocates met at the UN headquarters to acknowledge HIV/TB as an urgent priority.
The first HIV/TB Global Leaders' Forum was convened by Dr Jorge Sampaio, the UN Secretary General's special envoy to stop TB. The forum sought to galvanise leadership at all levels.
The 2008 Anti-Tuberculosis Drug Resistance in the World report and the 2008 Global Tuberculosis Epidemic Report of the World Health Organisation mandates much heightened urgency in responding to TB-HIV co-infection.
Many countries, including Uganda, are making impressive gains in treating people living with HIV, but this investment and progress is squandered by a preventable and curable tuberculosis.
HIV weakens the immune system and makes it more likely that latent TB infection progresses to active TB disease. People with HIV are up to 50 times more likely to develop TB disease.
Uganda has the 16th highest TB burden in the world. TB is the leading cause of death among people living with HIV. About a third of the 40 million people with HIV are also infected with TB.
In high TB and HIV burden settings, up to 80% of TB patients may be co-infected with HIV and half of AIDS-related deaths are caused by TB.
Without proper treatment for TB, about 90% of people living with HIV die within two to three months of becoming sick with TB, even if they are receiving anti-retroviral treatment.
Worldwide, about 250,000 people die from HIV/TB co-infection each year. However, adequate treatment of TB in people living with HIV has shown to prolong their life.
Transmission of TB
Studies suggest that transmission of TB, especially the drug-resistant strains, is more likely to take place where people with HIV congregate.
Healthcare settings, for example, anti-retroviral clinics, are one such place where improper infection control can put people with HIV at risk of contracting TB.
Preventing deaths from HIV/TB
Even where directly-observed treatment short-course programmes are available, current diagnostic tests fail to detect active TB in between 60% to 80% of people with HIV due to the predominantly smear-negative nature of TB in this group.
New strategies and tools are urgently needed to tackle the challenge of TB/HIV co-infection. WHO-recommended collaborative TB/HIV activities must be accelerated and research stepped up to deliver a new generation of effective anti-TB drugs and diagnostics to keep co-infected people alive.
In many countries insufficient laboratory capacity to test drug-resistance is an impediment in scaling up TB programmes. So, developing laboratories to provide rapid diagnosis of TB drug-resistance, particularly for people living with HIV, is of utmost importance to improve TB responses.
People living with HIV also need to be screened regularly for TB. Those who are sick with TB need effective treatment and those without TB disease should receive TB preventive therapy.
A six-month course of TB treatment costs $20 (about 32,000) and preventive drug therapy costs $2 (3,200).
There is need for closer coordination between national TB and HIV programmes and services.
But progress remains slow on detecting and treating TB among people cared for in HIV treatment settings. In 2006, only 1% of people living with HIV were screened for TB worldwide, according to WHO estimates.
The writer is the regional correspondent to HDN
Be the first to Write a Comment!
Copyright © 2008 New Vision. All rights reserved. Distributed by AllAfrica Global Media (allAfrica.com). To contact the copyright holder directly for corrections — or for permission to republish or make other authorized use of this material, click here.
AllAfrica aggregates and indexes content from over 125 African news organizations, plus more than 200 other sources, who are responsible for their own reporting and views. Articles and commentaries that identify allAfrica.com as the publisher are produced or commissioned by AllAfrica.
