About 25% of TB Deaths Occur Among HIV-Positive People, WHO Global TB Control Report Says
March 25, 2009
About one-quarter of tuberculosis-related deaths involve an HIV-positive person, twice as high as previous estimates, according to the Global Tuberculosis Control Report 2009, which the World Health Organization released Tuesday to coincide with World TB Day, the Wall Street Journal reports.
There were about 1.3 million TB deaths among HIV-negative people and about 456,000 among HIV-positive people in 2007, the report said. TB was the No. 1 cause of death among people living with HIV/AIDS in 2007 (Washington Post, 3/25). Health officials noted that HIV-positive people are about 20 times more likely to develop TB than HIV-negative people in countries with high HIV prevalence and are between 26 and 37 times more likely to develop TB in countries with lower HIV prevalence (AP/Google.com, 3/24).
The report found a "sharp increase" in the number of HIV tests that are administered to people with TB, particularly in Africa. About 4% of TB patients in Africa were tested for HIV in 2004, compared with 37% in 2007. In several countries, more than 75% of TB patients received an HIV test, according to the report (WHO release, 3/24). Although efforts to address HIV/TB coinfection have improved, the report noted that such efforts are inadequate in many developing countries. De Cock noted that only one in seven HIV-positive people receive preventive treatment for TB. In addition, more than one-third of TB cases worldwide are undiagnosed, increasing the risk of transmission, the report said (AFP/Google.com, 3/24). The report recommended that HIV-positive people receive TB screenings and medications to reduce their risk of developing the disease.
The report also found an increase in drug-resistant strains of TB in recent years. According to the report, more than 500,000 people worldwide have been diagnosed with multi-drug resistant TB (Reuters, 3/24). Fewer than 1% of people with MDR-TB were receiving WHO-recommended treatment in 2007 (WHO release, 3/24). In addition, at least one case of extensively drug-resistant TB has been reported in 55 countries and territories worldwide, the report said. XDR-TB is resistant to two of the most potent first-line treatments and at least two of the classes of second-line drugs. Mario Raviglione, director of WHO's Stop TB Department, added that the actual prevalence of XDR-TB likely is higher because many developing countries do not conduct tests to determine the extent of drug-resistance in TB patients (Reuters, 3/24).
The report also documented concern over funding in the current economic downturn, noting that 94 countries that account for 93% of all TB cases worldwide have a funding shortfall of $1.5 billion to meet the targets in the Global Plan to Stop TB 2006-2015 (WHO release, 3/24). Michel Kazatchkine -- executive director of the Global Fund to Fight AIDS, TB and Malaria -- estimated that the shortfall will increase to at least $4 billion by 2010. "The [economic] crisis is severely affecting developing nations, but countries should realize health costs are an investment for development and not just a strain on budgets," Kazatchkine said (AP/Google.com, 3/24). United Nations Secretary-General Ban Ki-moon welcomed funding commitments made by governments, nongovernmental organizations, foundations, the private sector, academia and researchers to meet the United Nations Millennium Development Goals' target of reversing the spread of the disease by 2015. "In this time of economic crisis, we must protect investments in global health, particularly to protect the most vulnerable," Ban said (U.N. News Service, 3/24).
Health officials from the 27 countries that account for 85% of MDR-TB cases worldwide -- including Bangladesh, China, India, Russia and South Africa -- are expected to meet next week in Beijing to discuss efforts to address drug-resistant TB, AFP/Google.com reports (AFP/Google.com, 3/24).
This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily HIV/AIDS Report. Visit the Kaiser Family Foundation's website to find out more about their activities, publications and services.
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