More needs to be done to tackle the “double cruelty” of HIV and TB in Africa, says governmentBMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d1937 (Published 25 March 2011) Cite this as: BMJ 2011;342:d1937
All rapid responses
We concur with the recommendation made by a special United Kingdom
parliamentary committee that the " double cruelty " of HIV and TB in
Africa must be tackled in order to lessen the morbidity and mortality
caused by this twin epidemic (1).
However, we believe that for the burden of HIV and TB to be tackled
effectively, urgent measures to target the control and spread of TB must
be made in those groups that are highly vulnerable to infection by the
bacilli. Here, prison communities readily come to mind.
In many countries of the world, more so in the least developed
countries most of whom are located in Sub Saharan Africa, a region
devastated by the AIDS pandemic, prisons are congested, have poor hygiene
and prisoners often live on meager and poor diets, conditions highly
conducive to the spread of TB and other infectious diseases (2). Indeed
in some countries TB infection rates in prisons maybe up to a hundred
times that found outside prison(3)
As many prisoners stay only a short time in prison, TB acquired
inside will no doubt be transmitted to the larger community outside. There
is therefore need to put the control of TB in prisons at the top of the
agenda. TB in prisons must be hit hard. Services to detect new cases,
strict treatment adherence and measures to improve the living conditions
in prisons will greatly contribute to tackling the double cruelty of HIV
and AIDS in Africa.
1) Moszynski, P. More needs to be done to tackle the double cruelty
of HIV and TB in Africa says Government. BMJ 2011;342:d1937
2) Human Rights Watch. Unjust and Unhealthy: HIV, TB and abuse in
Zambian prisons. Washington, USA, 2010.
3) World Health Organization. Literature Review on TB Control in
Prisons. WHO, Geneva, Switzerland, 2008.
Competing interests: No competing interests