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The looming epidemic of diabetes-associated tuberculosis: learning lessons from HIV-associated tuberculosis | Journal Article / Research | MSF Science Portal
Journal Article
|Research

The looming epidemic of diabetes-associated tuberculosis: learning lessons from HIV-associated tuberculosis

Harries AD, Lin YD, Satyanarayana S, Lonnroth K, Li L, Wilson N, Chauhan LS, Zachariah R, Baker MA, Jeon CY, Murray MB, Maher D, Bygbjerg IC, Enarson D, Billo NE, Kapur A
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Abstract
The prevalence of diabetes mellitus is increasing at a dramatic rate, and countries in Asia, particularly India and China, will bear the brunt of this epidemic. Persons with diabetes have a significantly increased risk of active tuberculosis (TB), which is two to three times higher than in persons without diabetes. In this article, we argue that the epidemiological interactions and the effects on clinical presentation and treatment resulting from the interaction between diabetes and TB are similar to those observed for human immunodeficiency virus (HIV) and TB. The lessons learned from approaches to reduce the dual burden of HIV and TB, and especially the modes of screening for the two diseases, can be adapted and applied to the screening, diagnosis, treatment and prevention of diabetes and TB. The new World Health Organization (WHO) and The Union Collaborative Framework for care and control of TB and diabetes has many similarities to the WHO Policy on Collaborative Activities to reduce the dual burden of TB and HIV, and aims to guide policy makers and implementers on how to move forward and combat this looming dual epidemic. The response to the growing HIV-associated TB epidemic in the 1980s and 1990s was slow and uncoordinated, despite clearly articulated warnings about the scale of the forthcoming problem. We must not make the same mistake with diabetes and TB. The Framework provides a template for action, and it is now up to donors, policy makers and implementers to apply the recommendations in the field and to 'learn by doing'.

Countries

China India

Subject Area

tuberculosisnon-communicable diseaseHIV/AIDS

Languages

English
DOI
10.5588/ijtld.11.0503
Published Date
06 Sep 2011
PubMed ID
21902876
Journal
International Journal of Tuberculosis and Lung Disease
Volume | Issue | Pages
Volume 15, Issue 11
Issue Date
2011-11-01
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