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Tuberculosis Prevention and Care | (Last Updated: January 2005) |
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» TB/HIV Tools
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More than 25% of the 37.8 million people living with HIV/AIDS are estimated
to be co-infected with tuberculosis (TB). About 66% of those co-infected live in
sub- Saharan African and 20% live in South-East Asia.
Most people who breathe in
TB bacteria and become infected with TB have immune systems that are able to
fight the bacteria to stop them from growing. The bacteria become inactive, but
they remain in the body and can become active later. This is called latent TB
infection. Many people who have latent TB infection never develop active TB. But
in other people, especially people who have weak immune systems, the bacteria
become active and cause TB disease.
Among people with TB infection, HIV
infection is the most powerful known risk factor for the development of active
disease. TB is also one of the most common causes of illness and death in
HIV-infected individuals living in less-developed countries, causing an
estimated 11% of all adult AIDS deaths.
Screening for active TB should be
promoted at voluntary counseling and testing (VCT) sites, prenatal clinics,
prisons, HIV treatment programs, and other settings where HIV testing is
offered. HIV-infected persons who are found to have active TB should be referred
for TB treatment. HIV-infected persons who have latent TB infection should
receive preventive treatment.
Community and home-based care, including the use
of peer and community treatment supporters, has been shown to greatly enhance
direct observation of TB treatment and promote successful completion of
treatment regimens, which take months. Lessons learned from TB community and
home-based care also can help to develop models for delivery of HIV treatments.
HIV counseling and testing should be offered to all TB patients. Providing HIV
testing for people with active TB helps identify people who can benefit from
antiretroviral treatment (ART) and other needed HIV care and support. In high
HIV prevalence areas, the percentage of TB patients who test positive for HIV
may exceed 70%.
In Botswana, the U.S. Government (USG) through the Centers for
Disease Control and Prevention Global AIDS Program (GAP)... supports training;
clinical and operations research in TB to improve the diagnosis, treatment, and
clinical outcomes of TB patients; development of a national program for TB
screening among VCT center clients; provision of TB preventive therapy; and the
development of an electronic, patient- based TB surveillance system, which has
been adopted by other countries in the region.
In Uganda, the USG through GAP... supports a collaborative project of the Uganda Ministry of Health, the AIDS
Support Organization, Tororo and Busis District Health Departments, CDC, and the
Uganda Virus Research Institute Collaboration. The project seeks to develop a
resource-appropriate model for providing comprehensive HIV care and treatment
that TB treatment for a rural population in Uganda.
How does CDC promote TB prevention and care?
The Centers for
Disease Control and Prevention (CDC) is a partner in the Tuberculosis Coalition
for Technical Assistance (TBCTA), a USAID-funded coalition.
Using best practices
promoted by the World Health Organization and other international partners, CDC
works to control TB primarily by:
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promoting linkages between HIV and TB
prevention and treatment programs;
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encouraging community and home-based care
for people with HIV and active TB;
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helping countries develop the human and
fiscal resources needed to provide quality TB services.
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