Trials of anti-tuberculosis treatment in areas of high human immunodeficiency virus prevalence in sub-Saharan Africa.
Sub-Saharan Africa is bearing the brunt of the human immunodeficiency virus (HIV) pandemic, and HIV-associated tuberculosis (TB) has become a major clinical and public health problem. There is evidence that HIV-infected patients not uncommonly develop disseminated TB, and that this diagnosis is often not made ante mortem because of limited diagnostic facilities and other factors. Where diagnostic facilities are limited, a trial of anti-tuberculosis treatment with drugs specific for Mycobacterium tuberculosis may be a useful way of diagnosing disseminated TB. The case for and against 'a trial of treatment' is presented, and a suggestion is made that 'a trial of treatment' can be incorporated into the case finding package of a National TB Control Programme.
Harries
A D
AD
National Tuberculosis Control Programme, Ministry of Health, Capital City, Lilongwe, Malawi. adharries@malawi.net
Hargreaves
N J
NJ
Kumwenda
J
J
Kwanjana
J H
JH
Salaniponi
F M
FM
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000517:prevention & control; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000465:Algorithms; D000995:Antitubercular Agents / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D015995:Prevalence; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control
D000995:Antitubercular Agents