Potential impact of the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) on the Tuberculosis/HIV co-epidemic in selected Sub-Sahara African countries.

2013 | J Infect Dis

Abstract:

Background: There is limited data measuring the impact of expanded HIV prevention activities on the tuberculosis (TB) epidemic at the country level. Here, we characterized the potential impact of PEPFAR on the TB epidemic in sub-Saharan Africa.Methods. We selected 12 focus countries (countries receiving the greatest US government investments) and 29 non-focus (or 'control') countries. We used TB incidence and mortality rates and relative risks to compare time periods before and after PEPFAR's inception, and a TB/HIV indicator to calculate the rate of change in TB incidence relative to the HIV prevalence.Results. Comparing the periods before and after PEPFAR's implementation, both TB incidence and mortality rates have diminished significantly and to a higher degree in focus countries. The relative risk for developing TB, comparing those with and without HIV, was 22.5 for control and 20.0 for focus countries. In most focus countries, the TB epidemic is slowing down despite some regions still experiencing an increase in HIV prevalence.Conclusions. This ecological study showed that PEPFAR had a more consistent and substantial effect on HIV and TB in focus countries, highlighting the likely link between high levels of HIV investment and broader effects on related diseases like TB.

BC Centre for Excellence in HIV/AIDS

Search form

Potential impact of the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) on the Tuberculosis/HIV co-epidemic in selected Sub-Sahara African countries.

Search form