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A trend analysis and sub-regional distribution in number of people living with HIV and dying with TB in Africa, 1991 to 2006
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Uthman, Olalekan A., Yahaya, Ismail, Ashfaq, Khalid and Uthman, Mubashir B. (2009) A trend analysis and sub-regional distribution in number of people living with HIV and dying with TB in Africa, 1991 to 2006. International Journal of Health Geographics, 8 . 65. doi:10.1186/1476-072X-8-65 ISSN 1476-072X.
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Official URL: http://doi.org/10.1186/1476-072X-8-65
Abstract
Background:
The tuberculosis (TB) bacillus and the Human Immunodeficiency Virus (HIV) have formed a powerful alliance and are together responsible for more than five million deaths per year. TB is leading to increased mortality rates among people living with HIV/acquired immunodeficiency syndrome (AIDS). The aim of this study was to investigate the geographical and temporal distribution of TB-HIV deaths in Africa in order to identify possible high-risk areas.
Methods:
Time trends in the 16-year study period from 1990 to 2005 were analyzed by multilevel Poisson growth curve models. Moran global and local indicators of spatial associations were used to test for evidence of global and local spatial clustering respectively.
Results:
Eastern, Southern, Western, and Middle Africa experienced an upward trend in the number of reported TB-HIV deaths. The spatial distribution of TB cases was non-random and clustered, with a Moran's I = 0.454 (p = .001). Spatial clustering suggested that 13 countries were at increased risk of TB-HIV deaths, and six countries could be grouped as "hot spots".
Conclusion:
Evidence shows that there is no decline in growth in the number of deaths due to TB among HIV positive in most Africa countries. There is presence of 'hot-spots' and very large differences persist between sub-regions. Only by tackling TB and HIV together will progress be made in reversing the burden of both diseases. There is a great need for scale-up of preventive interventions such as the World Health Organization '3I's strategy' (intensified case finding, isoniazid preventive therapy and infection control).
Item Type: | Journal Article | ||||||||
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Subjects: | R Medicine > RC Internal medicine | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | HIV-positive persons -- Africa, Tuberculosis -- Africa | ||||||||
Journal or Publication Title: | International Journal of Health Geographics | ||||||||
Publisher: | BioMed Central Ltd. | ||||||||
ISSN: | 1476-072X | ||||||||
Official Date: | 24 July 2009 | ||||||||
Dates: |
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Volume: | 8 | ||||||||
Article Number: | 65 | ||||||||
DOI: | 10.1186/1476-072X-8-65 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||
Date of first compliant deposit: | 5 August 2016 | ||||||||
Date of first compliant Open Access: | 5 August 2016 |
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