サハラ以南のアフリカにおける結核とHIV感染
K M De Cock1, B Soro, I M Coulibaly
1Projet RETRO-CI, Abidjan, Ivory Coast.
JAMA
|September 23, 1992
まとめ
ヒト免疫不全ウイルス (HIV) は,サハラ以南のアフリカで結核に深刻な影響を及ぼし,死亡率を高めています. この無視された健康問題に取り組むには,診断とケアのための重要なリソースの割り当てが必要です.
科学分野:
- エピデミオロジー エピデミオロジー
- 感染症 感染症は感染症です.
- 公衆衛生は公衆衛生である.
背景:
- サハラ以南のアフリカは,ヒト免疫不全ウイルス (HIV) と結核 (TB) の二重負担に直面しています.
- HIVと結核の相互作用は,この地域ではユニークな臨床的,病理学的課題を提示しています.
- 公衆衛生への影響を理解することは,効果的な介入戦略を策定する上で極めて重要です.
研究 の 目的:
- サハラ以南のアフリカにおけるHIV関連結核の疫学,臨床,病理学的特徴をレビューする.
- この共流行病の公衆衛生上の影響を調査する.
- 地域におけるHIV-TBに関する現在の知識を統合する.
主な方法:
- 出版された医学文献 (英語,フランス語) と会議の議事録の体系的なレビュー.
- アフリカと世界のHIV感染と結核に最も関連する記事の選択.
- 定量的データ (例えば,HIVの血清流行率) と,選択された文献からの定性的な発見の直接報告.
主要な成果:
- サハラ以南のアフリカ全土で結核患者で報告された高いHIV感染率 (20-67%).
- 結核患者の増加は,いくつかのアフリカ諸国でのエイズの出現に伴い,同時に増加した.
- 結核は,アイボリー海岸のアビジャンのエイズ患者の中で最も頻繁な機会性感染症として特定され,HIV陽性者の死亡率は著しく高くなっています.
結論:
- HIV流行は,サハラ以南のアフリカにおける結核の流行病学を深刻に変えました.
- HIV関連結核は,かなりの資源投資を必要とする,見過ごされている世界的な健康問題です.
- 人的・物質的資源の強化は,この共流行病の管理に不可欠である.
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