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Shifts in Focus Could Reduce Tuberculosis

Authors recommend screening for latent cases among foreign-born in United States, altering HIV/TB approach globally

TUESDAY, July 22 (HealthDay News) -- Focusing on some foreign-born individuals with latent tuberculosis infection may represent one of the more effective options for improving TB control in this group in the United States, and a framework of strategic activities in HIV care programs could address pressing global concerns related to TB, according to two studies in the July 23/30 issue of the Journal of the American Medical Association.

In the first study, Kevin P. Cain, M.D., of the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues assessed data from the U.S. National TB Surveillance System for cases reported between 2001 and 2006, during which time 46,970 TB cases were reported among foreign-born individuals. More than half of these cases were found in individuals born in sub-Saharan Africa and Southeast Asia. Testing and treatment of latent tuberculosis infection in individuals recently arrived from highest-risk countries -- typically from these world regions -- should be a pressing priority, the authors write.

In the other paper, Diane V. Havlir, M.D., of the University of California San Francisco, and colleagues discuss issues regarding the interaction of TB and HIV, particularly in resource-limited settings. These include elevated TB risk in those with HIV, the rise in drug-resistant TB, and difficulties with diagnosis and treatment. Activities in HIV programs that would better help address TB include better case finding; treating TB in HIV programs; prevention with isoniazid; and antiretroviral therapy to reduce the risk of TB.

"HIV care programs must take a bold approach to TB prevention, diagnosis, and treatment to successfully address the catastrophic and intersecting epidemics of HIV and TB," the authors write. "The possibility for progress has never been greater with the global commitment to health care infrastructure strengthening geared toward consolidating the momentum through disease-specific efforts such as those involving HIV and TB."

Abstract - Cain
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Abstract - Havlir
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