Addressing comorbidities and risk factors for tuberculosis (TB) is a crucial component of the World Health Organization (WHO)’s End TB Strategy. This WHO operational handbook on tuberculosis. Module 6: tuberculosis and comorbidities aims to support countries in scaling up people-centred care, base...d on the latest WHO recommendations on TB and key comorbidities, and drawing upon additional evidence, best practices and inputs from various experts and stakeholders obtained during WHO processes. It is intended for use by people working in ministries of health, particularly TB programmes and the relevant departments or programmes responsible for comorbidities and health-related risk factors for TB such as HIV, diabetes, undernutrition, substance use, and tobacco use, as well as programmes addressing mental health and lung health. This operational handbook is a living document and will include a separate section for each of the key TB comorbidities or health-related risk factors. The third edition includes guidance for HIV-associated TB, mental health conditions and diabetes, which are three conditions strongly associated with TB and which result in higher mortality, poorer TB treatment outcomes and negatively impact health-related quality of life. The operational handbook aims to facilitate early detection, proper assessment and adequate management of people affected by TB and comorbidities. Full implementation of this guidance is expected to have a significant impact on TB treatment outcomes and health-related quality of life for people affected by TB.
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In the Indian state of Bihar, visceral leishmaniasis (VL) is a major public health issue that has been aggravated by the rising incidence of new Human immunodeficiency virus (HIV) infections. In endemic areas, the risk of VL infections in patients living with HIV (PLHIV) is higher. It is important t...o investigate the disease-related knowledge, attitude, and practices (KAP) of PLHIV in Bihar in order to monitor HIV/VL co-infection. Adequate knowledge, a positive attitude, and good practices for VL control are essential to stamp out the disease. This study investigated the KAP towards VL in HIV patients attending antiretroviral therapy (ART) clinic at ICMR-RMRIMS, Patna.
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Journal of Tuberculosis Research, 2017, 5, 189-200
Background: In Benin, little is known about the influence of both gender and
HIV-status on diagnostic patterns and treatment outcomes of Tuberculosis
(TB) patients. Objective: To assess whether differences in gender and HIV
status affect diagn...ostic patterns and treatment outcomes of TB patients. Methods:
Retrospective cohort study of patients registered in 2013 and 2014 in
the three largest TB Basic Management Units in south Benin. Results: Of 2694
registered TB patients, 1700 (63.1%) were male. Case notification rates were
higher in males compared with females (96 vs 53/100,000 inhabitants). The
male to female ratio was 1:1 in HIV positive patients, but was 2:1 among HIV
negative cases. In HIV-positive patients, there were no differences in TB types
between men and women. In HIV-negative patients, there were significantly
higher proportions of females with clinically diagnosed pulmonary TB (p =
0.04) and extrapulmonary TB (p < 0.001). Retreatment TB was 4.65 times
higher amongst males compared with females. For New bacteriologically confirmed
pulmonary TB, no differences were observed in treatment outcomes
between genders in the HIV positive group; but significantly more unfavorable
outcomes were reported among HIV negative males, with higher rates of
failure (p < 0.001) and loss-to-follow up (p = 0.02). Conclusion: The study
has shown that overall TB notification rates were higher in males than in females
in south Benin, with more females co-infected with HIV. Unfavorable outcomes were more common in HIV-negative males.
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From policy to practice: how the TB-HIV response is working
“The HIV community must place much more focus on TB co-infection than
it has done to date. TB takes the lives of over 1000 people living with HIV
every day, a number which is absolutely unacceptable. This report highlights that
TB d...oesn’t have to be a death sentence for people living with HIV, but we need
more action. By joining forces, the HIV and TB community can finally give this
deadly issue the attention it deserves.”
– Mike Podmore, Director STOPAIDS
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This online learning course is for primary care of children witt TB. It covers clinical presentation, diagnosis, management and prevention of tb in children and HIV/TB co-infection
The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the... 3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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This Tuberculosis guide has been developed jointly by Médecins Sans Frontières and Partners In Health. It aims at providing useful information to the clinicians and health staff for the comprehensive management of tuberculosis. Forms of susceptible and resistant tuberculosis, tuberculosis in child...ren, and HIV co-infection are all fully addressed.
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Urogenital schistosomiasis is a common neglected tropical disease in many rural communities in African countries, with patches of infection in the Eastern Mediterranean Region. Globally, an estimated 239 million people are currently infected, with burden estimated at more than 3.5 million disability...-adjusted life years (DALYs). In many endemic areas, severely infected individuals may suffer fibrosis of the bladder, kidney damage, bladder cancer, and death if untreated. This, however, depends on several factors such as host-parasite genetics, degree and length of exposure, intensity of infection, host immune response to the parasites, and coinfections with other tropical diseases such as malaria and HIV-1.
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The update of the ESTC was conducted as a joint endeavour with ERS, consulting experts from international societies and organisations, national TB programmes, civil society and affected communities. The second edition of the ESTC includes 21 standards in the areas of diagnosis, treatment, HIV and co...-morbidities and public health and prevention. The ESTC is a user-friendly guide for clinicians and public health workers to help them achieve optimal diagnosis, treatment and prevention of TB
Available in 25 languages: https://ecdc.europa.eu/en/all-topics-ztuberculosisprevention-and-control/european-union-standards-tuberculosis-care
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This Tuberculosis guide has been developed jointly by Médecins Sans Frontières and Partners In Health. It aims at providing useful information to the clinicians and health staff for the comprehensive management of tuberculosis. Forms of susceptible and resistant tuberculosis, tuberculosis in child...ren, and HIV co-infection are all fully addressed.
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Série de bulletins techniques
Tuberculose et co-infection par le VIH | 1 - 3
Accessed November 2017
PLOS ONE | https://doi.org/10.1371/journal.pone.0210937
February 5, 2019
ECDC MISSION REPORT 19–21 September 2016 ; 14–15 November 2016
Clinical Guidance across the continuum of care
Chapter 8_ARV Guidelines
Research Article
Karo et al. BMC Infectious Diseases 2014, 14:148 http://www.biomedcentral.com/1471-2334/14/148