Contemporary treatment of tuberculosis in HIV prevalent countries in sub-Saharan Africa
Nuwaha, F.
East African Medical Journal 75(6): 358-363
1998
ISSN/ISBN: 0012-835X PMID: 9803621 Document Number: 489198
The HIV pandemic has been worst felt in sub-Saharan Africa. Tuberculosis is an opportunistic disease in the course of HIV infection and in the region, where the prevalence of both M. tuberculosis and HIV are very high, tuberculosis has become a major complication of HIV infection. The annual risk of tuberculosis infection remains high (1.5 to 2.5%) which is more than fifty times compared to the rates in Western Europe and the prevalence of HIV infection in tuberculosis patients ranges between 18 to 67%. More than 35% of the cases in most countries of sub-Saharan Africa are attributed to HIV. The tuberculosis treatment programmes in sub-Saharan Africa are overwhelmed with increasing number of clinical TB. This trend requires re-examination of the treatment strategy used in the region. There is need to replace streptomycin and thiacetazone in treatment regimens; provide effective short-course chemotherapy for all patients irrespective of their HIV status; use more of ambulatory treatment and expand the use of supervised intermittent therapy.