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Epidemiology of Drug-Susceptible, Drug-Resistant Tuberculosis and HIV in Africa

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HIV and Tuberculosis

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Abstract

In Africa, TB-HIV co-infection rates are estimated to be 72%. Within sub-Saharan Africa, 34 countries recently reported patients with newly diagnosed MDR-TB, representing 14% of all emerging multi-drug resistant reports worldwide. In addition, eight African countries reported patients harboring extensively drug-resistant TB. More importantly, sub-Saharan Africa bears unacceptably high TB incidence rates coupled with the highest HIV prevalence rates globally. Occurrence of TB related death and new TB infections persist, with men disproportionately affected. A gradual reduction in TB incidence rates from 1.4% per annum between 2000 to 2017 to 1.9% per annum between 2015 and 2016 has been observed. Of note, eight out of the sixteen high burden African countries showed a sharp decline in TB incidence rates, surpassing the “End TB Strategy” goal of a 4% per annum decline. Additionally, substantial decreases in TB mortality in HIV infected patients in nine of sixteen high TB burden African countries were also observed. Programmatic uptake and scale up of TB screening, introduction of new TB diagnostic tests, TB preventive therapy and ART have collectively contributed to this success. Regardless of these improvements, TB remains Africa’s foremost cause of ill-health and death, with greater efforts required in curbing drug resistant TB incidence, poor drug resistant TB treatment outcomes, and in finding and treating missing TB patients.

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Abbreviations

AIDS:

Acquired immunodeficiency syndrome

ART:

Antiretroviral therapy

DOTS:

Directly observed treatment short course

DR-TB:

Drug resistant tuberculosis

HCWs:

Healthcare workers

HIV:

Human immunodeficiency virus

HTS:

HIV testing service

IPT:

Isoniazid preventative therapy

MDR-TB:

Multi drug resistant tuberculosis

Mtb:

Mycobacterium tuberculosis

NSP:

National strategic plan

PLHIV:

People living with HIV

SA:

South Africa

SSA:

sub-Saharan Africa

TB:

Tuberculosis

TB-IC:

Tuberculosis infection control

UN:

United Nations

WHO:

World Health Organization

XDR-TB:

Extensively drug resistant tuberculosis

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Authors and Affiliations

  1. Centre for the AIDS Programme of Research in South Africa (CAPRISA), 2nd Floor K-RITH Tower Building, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa

    Kogieleum Naidoo & Nikita Naicker

  2. South African Medical Research Council (SAMRC)-CAPRISA HIV-TB Pathogenesis and Treatment Research Unit, Durban, South Africa

    Kogieleum Naidoo

Authors
  1. Kogieleum Naidoo
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  2. Nikita Naicker
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Correspondence to Kogieleum Naidoo .

Editor information

Editors and Affiliations

  1. National Institute of Health, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA

    Irini Sereti

  2. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Gregory P. Bisson

  3. Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, Department of Medicine, University of Cape Town, Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa

    Graeme Meintjes

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Naidoo, K., Naicker, N. (2019). Epidemiology of Drug-Susceptible, Drug-Resistant Tuberculosis and HIV in Africa. In: Sereti, I., Bisson, G.P., Meintjes, G. (eds) HIV and Tuberculosis. Springer, Cham. https://doi.org/10.1007/978-3-030-29108-2_2

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