Tuberculosis control and the AIDS epidemic in developing countries

Article Abstract:

The epidemic proportion of acquired immunodeficiency syndrome (AIDS) in developing countries is having an impact on the control of tuberculosis in those countries. Although tuberculous infection and tuberculosis are already common in some populations in such countries, the introduction and spread of AIDS compounds the problem because the rate of tuberculosis can increase markedly; moreover, human immunodeficiency virus (HIV) infection may be increasingly common in patients with tuberculosis. For example, the percentage of in- and outpatients with tuberculosis who had HIV in their blood (were seropositive) was 59 percent in Zambia, 58 percent in Uganda, 34 percent in Zimbabwe, and 16 percent in Nairobi. Of children with pulmonary tuberculosis in Zambia, 24 percent were found to be HIV-seropositive. In Florida, 75 to 91 percent of migrant workers had positive skin tests for tuberculosis; the prevalence of HIV seropositivity among Haitians with tuberculosis exceeded 45 percent. There are additional problems: in developing areas, tuberculosis control programs are stretched because of scarce resources, and drug-based tuberculosis prevention programs have a low priority in developing countries, yet this may be the most cost-effective way to approach the dual problem. There is an urgent need for studies to determine the most cost-effective way to control tuberculosis in the face of an already high or increasing rate of HIV infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Developing countries, Tuberculosis, HIV seropositivity, HIV positive, editorial

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Nodular cutaneous microsporidiosis in a patient with AIDS and successful treatment with long-term oral clindamycin therapy

Article Abstract:

AIDS patients may be susceptible to microsporidial infection of the skin. Microsporidia are protozoa more often seen in veterinary medicine. A 36-year-old women with late-stage AIDS developed recurrent painful, nodular skin lesions and infection of the underlying bone. Short courses of drug therapy did not permanently resolve the infection. Electron microscopy of a biopsy specimen revealed microspores. High-dose oral clindamycin therapy successfully eradicated the infection, and one year of continuous treatment prevented recurrence.

Care and treatment, Causes of, Protozoan diseases, Skin lesions, Clindamycin, Microsporidia, Microsporida

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