Tuberculosis and HIV: a global menace exacerbated via sex trafficking.
OBJECTIVE
Global tuberculosis (TB) elimination requires recognition and management of TB/HIV co-infected individuals, including those in marginalized and/or understudied populations. We sought to examine the prevalence of TB among repatriated sex trafficked Nepalese girls and women in whom a high HIV prevalence was previously reported.


METHODS
We reviewed case records for cases of TB among 287 sex trafficked girls and women repatriated to a single, rehabilitation non-governmental organization in Kathmandu, Nepal between 1997 and 2005. TB case detection was based on sputum smear results for acid-fast bacilli, radiographs, or histories, as reported in medical tests and/or case records.


RESULTS
There were 17 cases of TB that developed after rescue within the sample of girls and women who were aged 7-32 years when they were trafficked. The majority of cases (70%) were likely pulmonary TB. Nearly 9 in 10 individuals who developed TB were HIV co-infected.


CONCLUSIONS
Although preliminary in nature, our findings highlight the need for more comprehensive exploration of TB prevalence within sex trafficked populations, particularly in light of the large numbers of individuals who are sex trafficked in South Asia, the high prevalence of HIV documented in this group, and the risk of transmission of TB from and to others.
Dharmadhikari
Ashwin S
AS
Brigham & Women's Hospital, FXB Building, 7th Floor, 651 Huntington Avenue, and Harvard School of Public Health, Boston, MA 02115, USA. adharmadhikari@partners.org
Gupta
Jhumka
J
Decker
Michele R
MR
Raj
Anita
A
Silverman
Jay G
JG
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission; D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission; D015497:HIV-1; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D009390:Nepal / Q000453:epidemiology; D015995:Prevalence; D012742:Sex Offenses; D013183:Sputum / Q000382:microbiology; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D016387:Women's Health; D055815:Young Adult