Association of TB, HIV Linked to Increase in TB Cases in Zimbabwe

Panganai Dhliwayo, the World Health Organization medical officer in Harare, said Monday the increase in the number of people with TB in Zimbabwe is the result of the association between TB and HIV infection.

"The number of new TB cases has risen since 1990, and the overwhelming reason for this is the onset of the HIV/AIDS pandemic," Dhliwayo said. "The decline in the economy had added to the increase, as TB had always been a disease of poverty," he said. New TB cases had declined steadily beginning in the early 1960s, and by the early 1980s had fallen to less than 50 new cases per 100,000 people. However, "The rate increased from about 68 cases per 100,000 people in 1987 to more than 350 cases per 100,000 in 2001," Dhliwayo said. Now there are 485 new cases per 100,000 people, he said.

Rural to urban migration, Dhliwayo said, had resulted in a high incidence of TB, thanks to overcrowding and the emergence of backyard shacks. He said the greatest challenge now is combating the TB/HIV epidemic in a synchronized manner that addresses both infections: Tackling one but not the other would not be effective.

The effort entails the countrywide diagnostic services for direct sputum microscopy and community involvement in direct observation of treatment. There is a great need to remove the stigma surrounding the infections if efforts to control them in Zimbabwe are to be successful. In countries like Uganda, where there has been more openness about HIV, stigma is less common, Dhliwayo said.

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