ArticleBulletin of the World Health Organization2019
Tuberculosis decline in populations affected by HIV: a retrospective study of 12 countries in the WHO African Region.
Article in Bulletin of the World Health Organization, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 37 citations in OpenAlex.
- Computer-aided X-ray screening for tuberculosis and HIV testing among adults with cough in Malawi (the PROSPECT study): A randomised trial and cost-effectiveness analysis.PLoS medicine · 2021Trial
- Antiretroviral Treatment-Induced Decrease in Immune Activation Contributes to Reduced Susceptibility to Tuberculosis in HIV-1/Mtb Co-infected Persons.Frontiers in immunology · 2021Trial
- Trial
- Towards ending tuberculosis in South Africa: an uncertainty analysis of the programmes and factors most critical to future declines.Global health action · 2026Article
- Within-household transmission risk of pulmonary tuberculosis in the era of universal antiretroviral therapy.medRxiv : the preprint server for health sciences · 2026Article
- Genomic epidemiology ofMicrobial genomics · 2026Article
- Temporal trends in tuberculosis and time from enrolment in care to antiretroviral therapy initiation: A multicountry cohort study from Latin America.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2025Article
- The potential impact, cost and cost-effectiveness of tuberculosis interventions - a modelling exercise.medRxiv : the preprint server for health sciences · 2025Article
- Impact of Community-Wide Tuberculosis Active Case Finding and Human Immunodeficiency Virus Testing on Tuberculosis Trends in Malawi.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Transmission modeling to infer tuberculosis incidence prevalence and mortality in settings with generalized HIV epidemics.Nature communications · 2023Article
- The impact of HIV and tuberculosis interventions on South African adult tuberculosis trends, 1990-2019: a mathematical modeling analysis.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2022Article
- Gaps related to screening and diagnosis of tuberculosis in care cascade in selected health facilities in East Africa countries: A retrospective study.Journal of clinical tuberculosis and other mycobacterial diseases · 2021Article
- Assessment of the tuberculosis case-finding and prevention cascade among people living with HIV in Zambia - 2018: a cross-sectional cluster survey.BMC public health · 2021Article
- Activation-Induced Marker Expression IdentifiesImmunoHorizons · 2020Article
- Immune Phenotype and Functionality ofPathogens (Basel, Switzerland) · 2020Article
- TheFuture virology · 2020Review
- Adolescent tuberculosis.The Lancet. Child & adolescent health · 2020Review
- Tuberculosis Antigen-Specific T-Cell Responses During the First 6 Months of Antiretroviral Treatment.The Journal of infectious diseases · 2020Article
- Successful expansion of community-based drug-resistant TB care in rural Eswatini - a retrospective cohort study.Tropical medicine & international health : TM & IH · 2019Article
- Decreased risk of HIV-associated TB during antiretroviral therapy expansion in rural Eswatini from 2009 to 2016: a cohort and population-based analysis.Tropical medicine & international health : TM & IH · 2019Article
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate which of the World Health Organization recommended methods for tuberculosis control have had the greatest effect on case incidence in 12 countries in the World Health Organization (WHO) African Region that carry high burdens of tuberculosis linked to human immunodeficiency virus (HIV) infection.
methodsWe obtained epidemiological surveillance, survey and treatment data on HIV and tuberculosis for the years 2003 to 2016. We used statistical models to examine the effects of antiretroviral therapy (ART) and isoniazid preventive therapy in reducing the incidence of tuberculosis among people living with HIV. We also investigated the role of tuberculosis case detection and treatment in preventing
findingsBetween 2003 and 2016, ART provision was associated with the decline of tuberculosis in each country, and with differences in tuberculosis decline between countries. Inferring that ART was a cause of tuberculosis decline, ART prevented 1.88 million (95% confidence interval, CI: 1.65 to 2.11) tuberculosis cases in people living with HIV, or 15.7% (95% CI: 13.8 to 17.6) of the 11.96 million HIV-positive tuberculosis cases expected. Population coverage of isoniazid preventive therapy was too low (average 1.0% of persons eligible) to have a major effect on tuberculosis decline, and improvements in tuberculosis detection and treatment were either weakly associated or not significantly associated with tuberculosis decline.
conclusionART provision is associated with tuberculosis decline in these 12 countries. ART should remain central to tuberculosis control where rates of tuberculosis-HIV coinfection are high, but renewed efforts to treat tuberculosis are needed.
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