The forgotten killer, a need for shorter, better treatment, a measure of failures to diagnose children, and the impacts of inequity . . . We’re reading about tuberculosis

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NewWWREnergizing the fight against HIV/AIDS in South Africa – A  history of inequality, a government’s long refusal to acknowledge the virus, a donor relationship in perpetual transition . . . these are among the challenges to controlling HIV in this epicenter of the pandemic. But, this report notes, one of the biggest challenges to success against the impacts of HIV in South Africa is a failure to match resources to need for tuberculosis prevention, diagnosis and treatment. In 2014, as HIV incidence dropped, and antiretroviral  treatment access there continued to grow, tuberculosis took the lives of 89,000 people, including 64,000 with HIV, and remains the leading infectious disease killer there. Yet, this report from a team from the Center for Strategic and International Studies that visited earlier this year notes, the disease remains “an afterthought” in discourse about HIV.

Frequently asked questions about WHO shorter MDR-TB treatment regimen – Every year an estimated 500,000 people are found to be sick with tuberculosis that will not respond to the most commonly used drugs. This means that instead of six months of grueling and often incapacitating treatment, they face close to two years or more of even harsher treatment, with less chance of success. As a trial to test a shorter, less toxic regimen continues, the World Health Organization has recommended a 9-month to to one-year regimen that showed effectiveness in more than 85 percent of the patients among whom it was used. The answers here show why that is but one necessary step forward, and gives an idea of how complicated treating and stopping the spread of multidrug-resistant tuberculosis remains.

Mumbai: 6-month-old contracts MDR-TB after mother dies of same disease – This description of a new life, begun in tragedy and continuing in agony tells why the status quo — of the impact of drug-resistant tuberculosis on one struggling family, of tuberculosis treatment that can’t be completed during pregnancy, of resources inadequate to need where tuberculosis flourishes — is untenable. Born to a mother sick with multidrug-resistant tuberculosis, the boy whose story is told here began to show signs of illness at two months, and spent the next four months of his young life undergoing harrowing procedures to diagnose and treat his disease while his sister relapsed as well. From the mother who worried about the effects of the medicines she needed to save her own life on the child she was carrying, to the surviving relatives who are pooling their resources to supply adequate medicine and nutrition for the children, the story shows one family’s determination to defeat tuberculosis.

Smear positivity in pediatric and adult tuberculosis: systematic review and meta-analysis – This analysis underscores the inadequacy of the most commonly used tuberculosis diagnostic tool, particularly in discovering the disease in children. It highlights, the authors note, the need for new tools and methods, if people with tuberculosis are to be correctly counted and treated.

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