CDC HIV/Hepatitis/STD/TB Prevention News Update Monday, November 07, 2011

[Sailas Nyareza]

CDC HIV/Hepatitis/STD/TB Prevention News Update Monday, November 07, 2011

 

INTERNATIONAL NEWS

 

 

GLOBAL:

“WHO Framework Targets Tuberculosis-Diabetes Link”

The Lancet Vol. 378; P. 1209-1210 (10.01.11)::John Maurice

 

     A 2010 World Health Organization study of TB risk factors, based on 22 high-burden countries, found that diabetes contributes to an estimated 8 percent of new active TB cases. A new WHO collaborative framework aims to address the diabetes-TB nexus, which results in more than 700,000 cases annually worldwide.

     “On an individual level, we hope it will increase the number of people receiving timely, accurate diagnosis and proper treatment for the two diseases,” said Dr. Mario Raviglione, head of WHO’s Stop TB department. “On a public health level, we hope it will help to reduce the incidence of the two diseases.”

     Diabetes increases the risk of delayed response to TB treatment, death during treatment, and TB relapse after treatment is completed, said Knut Lonnröth, WHO TB risk expert and the framework’s author. “The net effect is that the diabetes epidemic is hampering efforts to control tuberculosis,” he said. “We now know that diabetes increases by three-fold the risk of a person developing [TB].”

     “We can’t screen the whole world population to detect and  treat tuberculosis patients before they infect the community,” Raviglione said. “So we’re focusing on the vulnerable groups with risk factors.”

     “Doctors and other health care providers will have to crank up their level of suspicion when seeing a patient with either diabetes or TB,” said Raviglione. “That shouldn’t be a problem. Initial screening for tuberculosis in a diabetes patient will take just a few basic questions: ‘Have you been coughing for more than two or three weeks? Have you had a fever? Do you sweat at night?’ And a rapid blood-sugar test would be enough to suggest whether or not a tuberculosis patient has diabetes.”

     Initial screening is the least costly, most manageable way to identify the diseases, Lonnröth said.

     Health ministers will be the first recipients of the framework, but the objective is to solidify the TB-diabetes linkage “right down to the primary health care centers,” Raviglione said.

 

 

SOUTH AFRICA:

“The Business of Fighting AIDS: For Anglo's Brian Brink, Combating AIDS Is a Financial as Well as Moral Imperative”

The Guardian (London)  (11.04.11)::Richard Wachman

     HIV/AIDS affects some 16 percent of mining group Anglo-American’s overall permanent workforce of 70,000. In hard-hit South Africa, where Anglo is the largest private-sector employer, addressing how the disease impacts employees is critical.

     “There was a time when investors were getting on the phone and asking whether the disease was going to bring down the organization,” said Anglo’s Brian Brink. “We were training two people for the same role in case one died on the job. It was that bad.”

     In 2002, the mining firm began offering free HIV testing to all employees and providing free treatment for them and their dependants. Currently, approximately 94 percent of employees undergo voluntary testing.

     “We have gone some way to remove the stigma surrounding HIV within the workforce,” said Brink. “We want to take the ‘exceptionalism’ out of AIDS, because treatment allows people with HIV to lead a near-normal life, and they can continue to work.”

     Brink said providing free HIV/AIDS treatment has boosted employee morale and improved relations with unions. “We have done the health economics and shown that for every dollar we invest in our AIDS initiatives, we get a financial return that is way in excess of that initial investment,” he said.

     But rising health care costs remain a concern, and Brink said the solution is reducing new infections through prevention and education. “Until we stop new infections, we aren’t going to win,” he added. “But I am optimistic. One of the most encouraging pieces of research this year found the risk of transmitting the virus to an uninfected partner was reduced by 96 percent if the carrier adhered to an effective antiretroviral therapy regime.”