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Final Issue: Volume 16 Number 51
Published on: 21 December 2006
Final Issue in PDF
Last updated: Volume 15, No.12 (PDF file, 779 KB)
World TB Day is an initiative of the Stop TB Partnership hosted by the World Health Organization (WHO) to mark the occasion when Robert Koch first announced his discovery of the mycobacterium bacillus in Berlin 1882. The aim of World TB Day is to bring to the attention of the world the global burden of tuberculosios (TB) and invigorate efforts in TB control. Each year, the Stop TB Partnership focuses on a different theme and this year it is the central role of front line TB care providers in the fight against TB. Globally, the partnership wishes to:
WHO has published its 2005 global TB control report (1), which contains information on case reports in 2003. For five of the six WHO regions, the news is positive and TB incidence rates are falling. The WHO region where this is not the case is Africa where incidence has tripled since 1990 fuelled by the HIV epidemic. This is one of the major challenges in the global fight against TB and the United Kingdom‘s International Development Secretary has called for the international community to tackle both diseases together. Other key figures from the WHO report include:
The WHO press release for World TB Day is available at: <http://www.who.int/mediacentre/news/releases/2005/pr14/en/index.html>.
The Stop TB World TB Day website is available at <http://www.stoptb.org/WTBD2005/)>.
The HPA TB website is available at <http://www.hpa.org.uk/infections/topics_az/tb/menu.htm>.
To coincide with World TB Day the Health Protection Agency has published a newsletter, Tuberculosis Update 2005, on the its website (2) which gives a update on the global and national situation and on the Agency’s activities in contributing to the control of tuberculosis in the UK. The final 2002 enhanced tuberculosis surveillance report for England, Wales, and Northern Ireland is now available (3).
Tuberculosis treatment outcome monitoring: preliminary results for cases reported in 2002
Monitoring the completion of treatment in all tuberculosis cases is a key tool in assessing the effectiveness of the national tuberculosis control effort and enables identification of areas or groups in which problems with effective treatment delivery may be occurring. Preliminary results are now available on treatment outcome monitoring of cases that were reported by enhanced tuberculosis surveillance in 2002 in England, Wales, and Northern Ireland. This is the second year of treatment results (4).
A full analysis and complete report will be published later in 2005.
1.World Health Organisation .Global tuberculosis control: surveillance, planning, financing. WHO report 2005 (WHO/HTM/TB2005.349). Geneva: World Health Organisation, 24 March 2005. Available at <http://www.who.int/tb/publications/global_report/en/>.
2.Health Protection Agency. Tuberculosis (TB) Update 2005. London: Health Protection Agency, March 2005. Available at : <http://www.hpa.org.uk/infections/topics_az/tb/pdf/newsletter_2005.pdf>.
3.Health Protection Agency. Annual report on tuberculosis cases reported in 2002 in England, Wale,s and Northern Ireland. London: Health Protection Agency, March 2005. Available at: <http://www.hpa.org.uk/infections/topics_az/tb/pdf/2002_Annual_Report.pdf>.
4.Health Protection Agency. First Annual Report on Tuberculosis Treatment Outcome Surveillance in England, Wales, and Northern Ireland. London: Health Protection Agency, July 2005. Available at: <http://www.hpa.org.uk/infections/topics_az/tb/pdf/firstTOMTB2001.pdf>.
In March 2005, a paper on the national trends of the estimated number and proportion of late HIV diagnoses and short-term mortality following diagnoses among men who have sex with men (MSM) was published in AIDS (1).
Case reports for more than 14,000 newly diagnosed HIV-infected MSM in England and Wales (aged over 15 years) covering Jan 1993 to Dec 2002 were analysed. It was estimated that almost one-third were diagnosed late (defined as those with CD4 cell counts below 200 cells/mm3) over the period. The proportion of men diagnosed late fell gradually between 1993 and 2001 (figure 1).
Figure 1 HIV trends in new diagnoses, late diagnoses, and short-term mortality of MSM: 1993 to 2001
MSM diagnosed late were about ten times more likely to die within one year of their HIV diagnosis than those who were not diagnosed late. In 2001, one in four HIV-infected MSM in England and Wales were diagnosed late and 10% died within a year compared to only 0.5% of those not diagnosed late. Short-term mortality fell markedly among both the late diagnosed and others as HAART became available in 1996 (figure 1). Late diagnosis and short-term mortality disproportionately affected MSM who were older, and MSM who were diagnosed outside London – late diagnosis was also more common among non-white individuals, but short-term mortality was not associated with ethnicity.
In his annual report for 2003 (2), the Chief Medical Officer (CMO) for England highlights the problems associated with the late diagnosis of HIV-infected individuals. Early HIV diagnosis is vital in getting highly active antiretroviral therapy (HAART) started, which is important for survival and is likely to limit the spread of infection. Although treatment raises CD4 cell counts and quickly reduces the risk of progression, early diagnosis and prompt treatment would minimise the period of high risk of death. In 2001, early diagnosis could have reduced the number of infected men dying within one year of diagnosis by 84%, and all HIV-related mortality by 22%. These results support Department of Health recommendations for increased testing for all MSM, together with MSM- targeted awareness-raising promotions (3).
For further information on the results of this paper, contact Tim Chadborn at the Health Protection Agency, Centre for Infections,
tel: 020 8327 7559; email: <firstname.lastname@example.org>.
1.Chadborn TR, Baster K, Delpech VC, Sabin CA, Sinka K, Rice BD, et al. No time to wait: how many HIV-infected homosexual men are diagnosed late and consequently die? (England and Wales, 1993–2002). AIDS 2005; 19(5): 513-20.
2. Department of Health. On the State of the Public Health: Annual report of the Chief Medical Officer 2003 - No time to wait: the importance of early diagnosis of HIV. London: Department of Health, 28 July 2004.
3.Department of Health. The national strategy for sexual health and HIV. London: Department of Health, July 2001. Available at: