Scale-Up of ART in Malawi Has Reduced Case Notification Rates in HIV-Positive and HIV-Negative Tuberculosis
MetadataShow full item record
JournalPublic Health Action
AbstractSetting: 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.
- Declining tuberculosis case notification rates with the scale-up of antiretroviral therapy in Zimbabwe.
- Authors: Takarinda KC, Harries AD, Sandy C, Mutasa-Apollo T, Zishiri C
- Issue date: 2016 Sep
- Decline in national tuberculosis notifications with national scale-up of antiretroviral therapy in Malawi.
- Authors: Kanyerere H, Mganga A, Harries AD, Tayler-Smith K, Jahn A, Chimbwandira FM, Mpunga J
- Issue date: 2014 Jun 21
- The rise and fall of tuberculosis in Malawi: associations with HIV infection and antiretroviral therapy.
- Authors: Kanyerere H, Harries AD, Tayler-Smith K, Jahn A, Zachariah R, Chimbwandira FM, Mpunga J
- Issue date: 2016 Jan
- Temporal trends in TB notification rates during ART scale-up in Cape Town: an ecological analysis.
- Authors: Hermans S, Boulle A, Caldwell J, Pienaar D, Wood R
- Issue date: 2015
- Reduced tuberculosis case notification associated with scaling up antiretroviral treatment in rural Malawi.
- Authors: Zachariah R, Bemelmans M, Akesson A, Gomani P, Phiri K, Isake B, van den Akker T, Philips M, Mwale A, Gausi F, Kwanjana J, Harries AD
- Issue date: 2011 Jul