People with HIV account for over 60% of TB cases in Southern Africa
Slightly more than 60% of tuberculosis disease cases in southern Africa occur in people with HIV infection, according to a regional analysis of TB numbers. Across the world, people with HIV account for 21% of all TB deaths.
Informed tuberculosis planning depends on the best possible
estimates of TB incidence (the new-diagnosis rate) and
prevalence. TB estimates appear yearly in the World Health
Organization (WHO) Global Tuberculosis Reports (linked below).
Researchers from the Futures Institute, WHO, and other
institutions developed new methods to determine whether
overall results were similar to prior WHO estimates and to
make country-by-country estimates of TB in people with HIV.
The investigators devised a regression model to relate
CD4-count changes to risk of TB disease. Into this model they
incorporated all available country-level data on TB incidence
in people with HIV. For countries with no TB-HIV incidence
data, they applied global regression parameters determined by
averaging results over countries that did have HIV-TB
incidence data.
These methods yielded estimates reasonably close to those of
existing estimates of global TB-HIV burden. The model figured
the people with HIV and TB account for 12.6% of worldwide TB
incidence, 21.3% of all TB deaths, and 20% of all HIV
deaths.
Regional estimates indicated the highest absolute TB incidence
in East and Southeast Asia but the highest per capita
incidence in sub-Saharan Africa. In Central sub-Saharan
Africa, an estimated 12.5% of all TB disease cases occur in
people with HIV. In Southern sub-Saharan Africa, an estimated
60.6% of all TB disease cases occur in people with HIV.
Regional analysis also showed that a disproportionate
percentage of global TB deaths (12.1%) relative to global TB
incidence (8.7%) occur in Southern sub-Saharan Africa.
This analysis yielded TB-HIV incidence and mortality results
published in WHO’s Global Tuberculosis Report 2013 and
Global Tuberculosis Report 2014 (linked below). The authors
note that the simple method they developed generates
“internally consistent estimates for tuberculosis/HIV
incidence and mortality, which have had immediate tuberculosis
programme planning uses.”
Source:
Carel Pretorius, Philippe Glaziou, Peter J. Dodd, Richard
White, Rein Houben. Using the TIME model in Spectrum to
estimate tuberculosis-HIV incidence and mortality.
AIDS. 2014; 28 (Suppl 4): S477-S487.
For the Global Tuberculosis Report 2013
For the Global Tuberculosis Report 2014
Source:
IAS
