Healthlink Worldwide

Treating TB and HIV

Tuberculosis (TB) is an infection caused by the bacillus Mycobacterium tuberculosis. The usual form is pulmonary TB, which affects the lungs, but TB germs can spread to other organs in the body too (extra-pulmonary TB).

When a person is exposed to TB germs and becomes infected, they have TB infection. Sometimes this infection develops into active TB, but not everyone infected with TB germs develops active TB.

According to World Health Organization (WHO) estimates, each year around eight million people develop TB, but treatment currently reaches only about a quarter of these people. Approximately 1.8 million people die each year from TB, according to the WHO.

TB can have a negative effect on people’s lives as well as their health. Poor people become poorer as they fall sick and are unable to earn money or to take care of family commitments. Some families take children out of school so that they can care for sick relatives, look after younger siblings or go out to work. Others sell land or animals or take out loans and go into debt to pay for treatment.

People may not seek treatment for a number of reasons. For example:

• It may be difficult for them to take time off work or away from family commitments.
• They may be too weak to visit a health centre, especially if they have HIV or are elderly.
• They may not be able to pay for the cost of transport to the health centre, or diagnosis, or drugs.
• They may not view health services as ‘user-friendly’ and may choose instead to visit a private or traditional health practitioner.
• Women especially may be concerned about the stigma and discrimination surrounding TB and HIV and AIDS.

Many people do seek treatment but are not initially diagnosed as having TB, and may be given non-TB treatment many times before TB is recognised. Other people are diagnosed correctly but are given inadequate or incorrect treatment, often without follow-up or supervision of treatment. This means that people often stop taking their treatment as soon as they feel better, although they may still have TB. They may return to a health facility when they fall sick again (often now with drug-resistant TB) and be afraid to tell the health worker that they previously had TB and did not complete their treatment. So again they will be treated as if they are a new case.

TB and HIV
Approximately one third of the world’s population is infected with Mycobacterium tuberculosis and 36 million people are infected with HIV. There are about 12 million people in the world infected with both HIV and TB. Of those people, approximately 70 per cent live in sub-Saharan Africa. TB is the most common opportunistic infection and the most frequent cause of death in people living with HIV in Africa.

People infected with HIV are more likely to develop active TB after they have been exposed to TB germs because they have weakened immune systems, so the TB germs multiply quickly. People who are infected with both TB and HIV are 25-30 times more likely to develop active TB than people only infected with TB. TB deaths are expected to double to four million people a year by 2010 as HIV makes increasing numbers of people more vulnerable to active TB. WHO estimates say that one third of TB deaths are in people with HIV.

The emergence of high numbers of people with TB and HIV co-infection and an increasing number of people with multi-drug resistant TB presents new challenges to those treating TB.

This article is the introduction to the Healthlink Worldwide publication Treating TB and HIV.

Download the full article (PDF 8 pages 131 KB)

 

This article was written by Healthlink Worldwide in response to requests from our partner organisations. Other individuals and organisations are welcome to adapt or reproduce the article for non-profit uses, provided that Healthlink Worldwide and the individual author(s) are clearly credited.