This assessment appears in the first issue for March 2006 of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
Tuberculosis is a contagious, potentially fatal infection primarily caused by the airborne bacterium Mycobacterium tuberculosis. Factors that contribute to the spread of TB, particularly in developing nations, include: overcrowding and unsanitary living conditions in urban areas, homeless shelters and prisons; the emergence of multi-drug resistant disease strains; and the spread of HIV and AIDS, which weaken the human immune system and make infection more likely.
Wing Wai Yew, M.B., of the Tuberculosis and Chest Unit at Grantham Hospital in Hong Kong, China, and a colleague examine the worldwide state of TB epidemiology, diagnosis and treatment as shown through research results published during 2005.
"In sub-Saharan Africa, tuberculosis remains the top cause of HIV-related mortality," said Dr. Yew. "The incidence of tuberculosis in adults receiving highly active anti-retroviral therapy is lower than in untreated HIV-infected adults, but still higher than among HIV-negative adults."
Another study cited by the authors highlights the importance of recent infection with M. tuberculosis in an area with high HIV prevalence, as shown by the situation in northern Malawi in Africa. "The proportion of (TB) strains found to be clustered [here] was among the highest in the world," noted the report.
In a study of South African gold miners, TB incidence doubled within the first year of HIV infection.