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    Jan 16, 2021
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    Scale-Up of ART in Malawi Has Reduced Case Notification Rates in HIV-Positive and HIV-Negative Tuberculosis

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    Kanyerere H et al - 2016 - Scale ...
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    Authors
    Kanyerere, H
    Girma, B
    Mpunga, J
    Tayler-Smith, K
    Harries, A D
    Jahn, A
    Chimbwandira, FM
    Issue Date
    2016-12-21
    Submitted date
    2017-03-09
    
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    Journal
    Public Health Action
    Abstract
    Setting: For 30 years, Malawi has experienced a dual epidemic of human immunodeficiency virus (HIV) infection and tuberculosis (TB) that has recently begun to be attenuated by the scale-up of antiretroviral therapy (ART). Objective: To report on the correlation between ART scale-up and annual national TB case notification rates (CNR) in Malawi, stratified by HIV-positive and HIV-negative status, from 2005 to 2015. Design: A retrospective descriptive ecological study using aggregate data from national reports. Results: From 2005 to 2015, ART was scaled up in Malawi from 28 470 to 618 488 total patients, with population coverage increasing from 2.4% to 52.2%. During this time, annual TB notifications declined by 35%, from 26 344 to 17 104, and the TB CNR per 100 000 population declined by 49%, from 206 to 105. HIV testing uptake increased from 51% to 92%. In known HIV-positive TB patients, the CNR decreased from a high of 1247/100 000 to 710/100 000, a 43% decrease. In known HIV-negative TB patients, the CNR also decreased, from a high of 66/100 000 to 49/100 000, a 26% decrease. Conclusion: TB case notifications have continued to decline in association with ART scale-up, with the decline seen more in HIV-positive than HIV-negative TB. These findings have programmatic implications for national TB control efforts.
    Publisher
    International Union Against Tuberculosis and Lung Disease
    URI
    http://hdl.handle.net/10144/618834
    DOI
    10.5588/pha.16.0053
    PubMed ID
    28123962
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.5588/pha.16.0053
    Scopus Count
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