BMJ 1994;309:1230-1231 (5 November)

Letters

Tuberculosis and slim disease in Africa

EDITOR, - S B Lucas and colleagues found that tuberculosis was associated with the wasting that is characteristic of so many deaths related to HIV infection in Africa.1 They conclude that the aim should be prophylaxis or earlier diagnosis and treatment.

Preventive treatment for tuberculosis in Africa continues to excite controversy. The International Union against Tuberculosis and Lung Diseases and the World Health Organisation issued a joint statement in October 1993 which recommended "isoniazid preventive therapy for individuals with both tuberculosis and HIV infections."2 Meanwhile, in December 1993, one of the final recommendations of the African regional meeting of the international union was that "Preventive chemotherapy of HIV seropositive individuals infected by the tuberculosis bacillus is not a cost-effective measure in programmes in Africa, and is not possible in countries with a high prevalence of tuberculosis."3

These positions are not contradictory: rather, they emphasise the different priorities for individual people . . . [Full text of this article]


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Relevant Article

Contribution of tuberculosis to slim disease in Africa
S B Lucas, K M De Cock, A Hounnou, C Peacock, M Diomande, M Honde, A Beaumel, L Kestens, and A Kadio
BMJ 1994 308: 1531-1533. [Abstract] [Full Text]

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