TB in HIV Patients: Strengthening Control Measures
It is clear that there are several factors e.g. the increasing disparities in wealth, health inequality leading to poor access to health services, free movement of individuals across the globe thus spreading infectious diseases and lack of commitment of some governments of the world poorest countries towards provision of adequate health care services to the populace, that led to the upsurge in number of Tuberculosis (TB) cases seen in recent times across the globe and more to the sub-Saharan Africa. this rise is not unrelated to the rise of the prevalence HIV (Human Immunodeficiency Virus). It is very clear that airborne route is the most common route of transmission for greater majority of TB cases seen. This is worsened by continual interaction of patients wit overt TB and those with HIV infection in the community, clinics or hospitals. Although most of those immune-competent individuals exposed to the TB pathogen (M. Tuberculosis) do not become infected, the disease seen in HIV immune-compromised patients occurs either as a new infection, re-infection or reactivation as a result of poor cellular immunity. Several studies have shown that despite increase funding towards fighting the infectious diseases across the globe, the population especially on the sub-Saharan continent are now more susceptible to tuberculosis. This is partly as a result of increase prevalence of HIV on the Africam continent leading to lack of cellular immunity on this patients. It is also important to note that there is loss of priority by policy makers in some of these countries diverting resources meant for effective TB control to other health programmes, which they consider more important especially in the short term. This review, discusses the importance of streghthening different TB control measures both in the community and hos[pital environment to be able to reduce the increases in cases of TB seen in HIV patients and further prevent the emergence of drug resistant TB.
Keywords: Human immunodeficiency virus, tuberculosis, multidrug resistance TB, surveillance, outbreak