The tuberculosis challenge in a rural South African HIV programme
| Autor: | Cooke Graham S, Lessells Richard J, Mutevedzi Portia C, Houlihan Catherine F, Tanser Frank C, Newell Marie-Louise |
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| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: | |
| Zdroj: | BMC Infectious Diseases, Vol 10, Iss 1, p 23 (2010) |
| Druh dokumentu: | article |
| ISSN: | 1471-2334 12903590 |
| DOI: | 10.1186/1471-2334-10-23 |
| Popis: | Abstract Background South Africa remains the country with the greatest burden of HIV-infected individuals and the second highest estimated TB incidence per capita worldwide. Within South Africa, KwaZulu-Natal has one of the highest rates of TB incidence and an emerging epidemic of drug-resistant tuberculosis. Methods Review of records of consecutive HIV-infected people initiated onto ART between 1st January 2005 and 31st March 2006. Patients were screened for TB at initiation and incident episodes recorded. CD4 counts, viral loads and follow-up status were recorded; data was censored on 5th August 2008. Geographic cluster analysis was performed using spatial scanning. Results 801 patients were initiated. TB prevalence was 25.3%, associated with lower CD4 (AHR 2.61 p = 0.01 for CD4 25 copies/ml (OR 1.75 p = 0.11). A low-risk cluster for incident TB was identified for patients living near the local hospital in the geospatial analysis. Conclusion There is a large burden of TB in this population. Rate of incident TB stabilises at a rate higher than that of the overall population. These data highlight the need for greater research on strategies for active case finding in rural settings and the need to focus on strengthening primary health care. |
| Databáze: | Directory of Open Access Journals |
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