Format

Send to

Choose Destination
See comment in PubMed Commons below
J Infect Dis. 2013 Dec 15;208(12):2075-84. doi: 10.1093/infdis/jit406. Epub 2013 Aug 2.

Potential impact of the US President's Emergency Plan for AIDS relief on the tuberculosis/HIV coepidemic in selected Sub-Saharan African countries.

Author information

1
British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital.

Abstract

BACKGROUND:

There are limited data measuring the impact of expanded human immunodeficiency virus (HIV) prevention activities on the tuberculosis epidemic at the country level. Here, we characterized the potential impact of the US President's Emergency Plan for AIDS Relief (PEPFAR) on the tuberculosis epidemic in sub-Saharan Africa.

METHODS:

We selected 12 focus countries (countries receiving the greatest US government investments) and 29 nonfocus countries (controls). We used tuberculosis incidence and mortality rates and relative risks to compare time periods before and after PEPFAR's inception, and a tuberculosis/HIV indicator to calculate the rate of change in tuberculosis incidence relative to the HIV prevalence.

RESULTS:

Comparing the periods before and after PEPFAR's implementation, both tuberculosis incidence and mortality rates have diminished significantly and to a higher degree in focus countries. The relative risk for developing tuberculosis, comparing those with and without HIV, was 22.5 for control and 20.0 for focus countries. In most focus countries, the tuberculosis epidemic is slowing down despite some regions still experiencing an increase in HIV prevalence.

CONCLUSIONS:

This ecological study showed that PEPFAR had a more consistent and substantial effect on HIV and tuberculosis in focus countries, highlighting the likely link between high levels of HIV investment and broader effects on related diseases such as tuberculosis.

KEYWORDS:

HIV; PEPFAR; coepidemic; incidence; mortality; sub-Saharan Africa; tuberculosis

PMID:
23911712
PMCID:
PMC3836466
DOI:
10.1093/infdis/jit406
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Silverchair Information Systems Icon for PubMed Central
    Loading ...
    Support Center