title: Decline in national tuberculosis notifications with national scale-up of antiretroviral therapy in Malawi.
abstract: From 2000 to 2012, Malawi scaled up antiretroviral therapy (ART) from <3000 to 404 905 persons living with HIV/AIDS (human immunodeficiency virus/acquired immune-deficiency syndrome), representing an ART coverage of 40.6% among those living with HIV. During this time, annual tuberculosis (TB) notifications declined by 28%, from 28 234 to 20 463. Percentage declines in annual TB case notifications were as follows: new TB (26%), recurrent TB (40%), new smear-positive pulmonary TB (19%), new smear-negative pulmonary TB (42%), extra-pulmonary TB (19%), HIV-positive TB (30%) and HIV-negative TB (10%). The decline in TB notifications is associated with ART scale-up, supporting its value in controlling TB in high HIV prevalence areas in sub-Saharan Africa.
authors.affiliation: National Tuberculosis Control Programme, Community Health Science Unit, Lilongwe, Malawi.
authors.forename: H
authors.initials: H
authors.lastname: Kanyerere
authors.affiliation: Department of HIV and AIDS, Ministry of Health, Lilongwe, Malawi.
authors.forename: A
authors.initials: A
authors.lastname: Mganga
authors.affiliation: International Union against Tuberculosis and Lung Disease, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: A D
authors.initials: AD
authors.lastname: Harries
authors.affiliation: Medical Department, Operational Centre Brussels, Médecins Sans Frontières, MSF-Luxembourg, Luxembourg.
authors.forename: K
authors.initials: K
authors.lastname: Tayler-Smith
authors.affiliation: Department of HIV and AIDS, Ministry of Health, Lilongwe, Malawi ; International Training and Education Center for Health, Lilongwe, Malawi and University of Washington, Seattle, Washington, USA.
authors.forename: A
authors.initials: A
authors.lastname: Jahn
authors.affiliation: Department of HIV and AIDS, Ministry of Health, Lilongwe, Malawi.
authors.forename: F M
authors.initials: FM
authors.lastname: Chimbwandira
authors.affiliation: National Tuberculosis Control Programme, Community Health Science Unit, Lilongwe, Malawi.
authors.forename: J
authors.initials: J
authors.lastname: Mpunga
keywords: ART; HIV/AIDS; Malawi; TB; recurrent TB