Tuberculosis in Africa--any news?

The tuberculosis situation in Africa in the AIDS era has become bleak. The tuberculosis incidence has increased in most sub-Saharan African countries, diagnosis has become more difficult, response to treatment, though initially good, is eventually less effective, and patient compliance, which has been a major problem in tuberculosis control before the HIV epidemic, has now become even more difficult. BCG vaccination, already ineffective before the AIDS era in preventing tuberculosis transmission, is now even less an appropriate tool in tuberculosis control. During a four year stay in Agogo Hospital, Ashanti, Ghana, the author has conducted some studies on tuberculosis and Buruli ulcer, which were combined in an academic thesis, and which are briefly summarized in this review. Immunotherapy using a heat-killed strain of Mycobacterium vaccae may bring about a change in future management of tuberculosis and other mycobacterial infections, but further studies are warranted to confirm a promising impression.