UN Population Division, Department of Economic and Social Affairs,
with support from the UN Population Fund (UNFPA)
|
| UN Population Division, Department of Economic and Social Affairs, with support from the UN Population Fund (UNFPA) |
|
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SEA-AIDSFLASH
Number Four - 17 March 1996
The bi-weekly electronic news digest on HIV and AIDS
for the South East Asia Region
(Subscriber total today: 278)
______________________________________________________________________
CONTENTS
- World Tuberculosis Day - 24 March - the link between HIV and tuberculosis
- Facts about tuberculosis from the Global TB Programme of WHO
- The link between tuberculosis and HIV infection
- Stop TB at the source - message from the WHO Director-General
- New information and resources available in SEA-AIDSFiles
- New HIV/AIDS electronic mail resources and Internet services
- Forthcoming events, meetings and training in the SE Asia region
- How to retrieve materials from SEA-AIDSFiles
WORLD TUBERCULOSIS DAY 24 MARCH 1996
With World Tuberculosis Day this week, this is a good opportunity to
reiterate the close relationship between the disease and HIV infection in
the South East Asia Region. The increasing levels of HIV infection in the
region are expected to fuel a resurgence of tuberculosis in the Asia region
as a whole, where an estimated 1.4 million people harbour the tubercle
bacillus. It has been reported that up to half of the people with AIDS in
the South East Asia Region also have tuberculosis, compared with less than
10% in the U.S.A., for example.
To mark World Tuberculosis Day, and to encourage the exchange of relevant
information and experience through the SEA-AIDS services, this edition of
AIDSFlash will focus on tuberculosis and its relationship to HIV and AIDS.
Three short articles have been reproduced below in full, and numerous
extracts from tuberculosis materials have been added to AIDSFiles, including
relevant sections from the WHO 1995 Report on the Tuberculosis Epidemic. A
selection of short extracts will also be posted to sea-aids during the
coming week. Requests for hard copies of WHO materials cited can be sent to
SEAHAP by post, fax or e-mail (see below).
If your organization has any additional relevant materials, particularly
those pertinent to the SE Asia region, please let SEA-AIDS and other
subscribers know about them by posting a message to the group. If you would
like to send comments or thoughts to the group on this or any other
subjects, send them to:
sea-aids@lists.inet.co.th
FACTS ABOUT TUBERCULOSIS FROM THE GLOBAL TB PROGRAMME OF WHO
TB will kill 30 million people this decade
Tuberculosis is the leading infectious killer of adults.
TB causes 26 percent of avoidable adult deaths in the developing world.
TB is becoming the leading cause of death among HIV positive people.
Nearly 300,000 children will die of TB this year.
Someone is infected with TB every second!
One third of the world's population is already infected with the TB bacillus.
Left untreated, one person with active TB will infect 10 to 15 people in a
year's time.
Like the common cold - and unlike AIDS - TB is spread by relatively casual
contact.
Over 300 million additional people will become infected with TB in the next
decade.
TB drugs may become useless
There is no cure for some multidrug-resistant strains of TB.
Multidrug-resistant TB may be spreading rapidly in almost every part of the
world.
More than 50 million people may already be infected with drug-resistant
strains of TB.
Poorly-managed TB control programmes are the primary source of
multidrug-resistant TB.
THE LINK BETWEEN TUBERCULOSIS AND HIV INFECTION
Tuberculosis is a chronic, contagious disease that is caused by a bacterial
infection (Mycobacterium tuberculosis). It can be cured with the correct
treatment. It most often strikes young adults (15-35 years old), especially
those who are weak, poorly nourished, or who live with someone who has the
disease.
The relationship between tuberculosis and HIV can be summarized in the
following way:
If someone has HIV infection they are more likely to get tuberculosis.
The damage to the immune system caused by HIV means the immune defences are
weakened and that they can no longer keep the tuberculosis bacteria from
making a person ill. The tuberculosis bacteria, which may have remained
quiet in the body for years in some people, now cause the disease called
tuberculosis.
A person infected with both tuberculosis and HIV is up to thirty times more
likely to become sick with TB than a person infected with only tuberculosis.
If someone has HIV infection the symptoms of tuberculosis can be unusual.
In 1994, 5.6 million people were co-infected by both TB and HIV. By the end
of the century, tuberculosis is likely to be the leading cause of death
among HIV-positive people. If TB cases were properly handled, it is possible
that one half of the future health care costs for AIDS patients could be
avoided.
The situation is especially critical in Asia, home to two-thirds of all
TB-infected people. Now, HIV infection is spreading more rapidly in Asia
than in any other part of the world. Preliminary studies show that TB is
already the leading infectious complication in between 50 to 70 percent of
AIDS patients in Asia.
[Extracted from: The WHO Report on The Tuberculosis Epidemic 1995
(WHO/TB/95.183), and The WHO AIDS Home Care Handbook (WHO/GPA/IDS/HCS/93.2)]
STOP TB AT THE SOURCE
The most effective way to fight tuberculosis is to stop it at the source.
The source of the epidemic's uncontrolled spread is sick and infectious TB
patients who are not cured. Once people are cured of TB, they can no longer
infect others.
WHO's strategy for curing TB patients is to use directly-observed treatment,
short-course (DOTS). DOTS is a system where health workers watch as each
patient takes the correct medication. By using DOTS one can almost be
certain that TB patients will be cured.
Successful programmes in Tanzania, New York City and China have demonstrated
that it is possible to reverse the TB epidemic by using WHO's TB control
strategy. Each of these programmes administers directly-observed treatment,
short-course, to their infect ious patients.
Yet surprisingly few countries are implementing WHO's proven and
cost-effective TB control strategy. Some countries have developed a false
sense of security about TB, having succeeded in controlling the epidemic
within their own borders. Since infectious diseases do not respect national
boundries, these countries need to also address the worsening global TB
epidemic as a means of protecting their own citizens.
Many developing countries have become fatalistic in fighting TB, believing
there is little they can do to control the disease. These countries must
begin investing in the cost-effective TB control strategies which are now
available.
The 1995 WHO Tuberculosis Report was written to persuade both rich and poor
nations that it is in their own best interests to cure infectious TB cases
throughout the world.
DOTS is the most affordable way to save the lives of the 20 million people
who are currently sick with TB. It is also the best way to prevent further
TB infections, thereby providing countries and economies with substantial
savings in future medical costs.
More urgently, DOTS is our only available hope for preventing a plague of
incurable drug-resistant TB from worsening to terrifying and unimaginable
proportions. While there is still time, world leaders must come together to
fight the TB epidemic and to stop it at the source.
Hiroshi Nakajima
Director-General, World Health Organization, March 1995.
NEW INFORMATION AND RESOURCES AVAILABLE IN SEA-AIDSFILES
The following information/materials have recently been added to the
SEA-AIDSFiles archives (see
below for retrieval instructions):
Growing Crisis in Paying for Care (by John S. James; from AIDS TREATMENT
NEWS Issue #241).
This article examines the increasing number of questions concerning how [in
the U.S.] the rapidly emerging new standards of care for people with AIDS --
including antiretroviral combinations and viral load tests will be paid for?
(12.3kB; imeco3.txt)
Update on progress following the 1994 Paris AIDS Summit. Taken from the
February issue of Update on progress following the 1994 Paris AIDS Summit.
ICASO Update. (7.6kB; plpub7.txt)
Abstract and Introduction from: Risk Factors for HIV-1 Seroconversion Among
Young Men in Northern Thailand (JAMA.1996;275:122-127) David D. Celentano et
al (6.8kB; stsex6.txt)
Tuberculosis: General Information Taken from the Internet page of the U.S.
Centers for Disease
Control, Atlanta. (5.8kB; plpub6.txt)
Several sections have been extracted from the WHO Report on the Tuberculosis
Epidemic, 1995, including:
WHO's Recommended Strategy (6.8kB;plun12.txt)
Tanzania's Success Story (5.1kB;plun13.txt)
New York City's Success Story(5.3kB;plun14.txt)
China's Success Story (5.5kB;plun15.txt)
The TB Epidemic Is Getting Worse (6.6kB;plun16.txt)
WHO's TB Control Initiative (4.7kB;plun17.txt)
Leading the Fight Against TB (5.8kB;plun18.txt)
Managing Tuberculosis at District Level: A Training Course
A description of a modular course offered by the WHO Global Programme on
Tuberculosis. (3.5kB;plun19.txt)
Abstract from: The Emerging Genetic Diversity of HIV: The Importance of
Global Surveillance for Diagnostics, Research and Prevention
(1996;275:210-216) Dale J. Hu et al (1.8kB;pvres2.txt)
Abstract from: Detection of Virus in Vertically Exposed
HIV-Antibody-Negative Children. Lancet (1/27/96) (2.1Kb;pvver1.txt)
On 8 March 1996, World Women's Day, a meeting was held in Bangkok to
consider the Role of Women in the Eighth National Economic and Social
Development Plan of Thailand. Files containing the following opening
addresses to this seminar are available:
Opening Address of Lorraine Corner, Chair, Gender, Women and Development
Working Group of the United Nations System in Thailand (6.8Kb;stdis8.txt)
Opening Address of Michael Heyn, Resident Coordinator of the United Nations
System in Thailand (5.8Kb;stdis9.txt)
Welcome address by Mr. Adrianus Mooy, Executive Secretary,
ESCAP(3.1Kb;stdis10.txt)
Extracted from the 1996 UNICEF book 'State of the World's Children':
Foreword by Boutros Boutros-Ghali United Nations Secretary-General
Preface by Carol Bellamy UNICEF Executive Director
Regional spotlights on East Asia and the Pacific & South Asia (6.1kB;plun20.txt)
Format and Guidelines for the Preparation of National Drug Control Master
Plans. Published by the United Nations International Drug Control
Programme, Vienna (61kB;plun21.txt)
NEW HIV/AIDS ELECTRONIC MAIL RESOURCES AND INTERNET SERVICES
News services for Cambodia now avaialable through electronic mail. To join
CIC's news and announcements mailing list send and e-mail to:
camnews-request@cambodia.org
including the following in the subject line of the message: subscribe
FORTHCOMING EVENTS, MEETINGS AND TRAINING IN THE SE ASIA REGION
DON'T FORGET to send sea-aids details of forthcoming events and activities
in the region. This might include meetings, seminars, forthcoming study
tours, training opportunities or electronic events. Details should be sent
to: tfran@mozart.inet.co.th
INSTRUCTIONS FOR RETRIEVING FILES
The materials mentioned above are stored in a computer. The computer is
like an electronic filing cabinet - it has drawers and files. You have to
tell it which drawer to open and which file to select. Following each of
the document descriptions above there is a number and a file name given in
brackets e.g., (8.8Kb; news4.txt). The number shows the size of the file
(8.8 kilobytes in this case), and the filename first shows the name of the
drawer (in this instance 'news') and then gives the file number (for this
file it is 4). To obtain a copy of this document you send an e-mail to:
ftpmail@inet.co.th with the following in the text of the message:
open
get /pub/sea-aids/news/news4.txt
close
Other files can be retrieved using the same general format for your message.
For example:
open
get /pub/sea-aids/drawername/filename
close
Because these requests are answered automatically by computer, you must be
very careful to copy the format of the message carefully (including spaces
and slashes). If you would like further instructions for retrieving files
in this way, send an e-mail to:
majordomo@lists.inet.co.th
with the following in the text of the message:
get sea-aids retrev.idx
FEEDBACK PLEASE!
Do not hesitate to tell us what you want from sea-aids, or to get in touch
if you need any help using these services.
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AIDSFlash is produced as part of the sea-aids information support services by:
South East Asia HIV/AIDS Project/UNAIDS, UNESCAP Building (B359)
Rajadamnoen Nok Avenue, Bangkok 10200
Tel: (66 2) 288 2498 Fax: (66 2) 288 1092
Direct E-mail: tfran@mozart.inet.co.th
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