Huge and hidden levels of tuberculosis discovered in a South African province devastated by HIV are increasing concerns about the prevalence of drug-resistant tuberculosis in Africa.
As reported in PLoS Medicine, when researchers examined newly deceased patients at Edendale hospital in the province of KwaZulu-Natal, they discovered that 50% were infected with the bacterium M. tuberculosis, the causal agent of tuberculosis, with 17% of the infected individuals carrying a multi-drug resistant (MDR) strain.
Among those with TB, only 58% had been diagnosed and started on treatment before their death. A previous study had found that only 28% of patients admitted to the same hospital were diagnosed with active tuberculosis.
In the new study, 96% of those positive for M. tuberculosis were also HIV positive, and the alarming prevalence of tuberculosis may reflect the situation in other low-income countries plagued by HIV. With weakened immunity, HIV-positive individuals are extremely vulnerable to other infections.
"This report is extremely serious," says Mario Raviglione, director of the WHO Stop TB Department in Geneva, Switzerland. "It confirms that over the last few years, multidrug-resistant tuberculosis has become rampant in people living with HIV [in Africa]".