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November 13, 1996

Research Issues Involving HIV-Associated Tuberculosis in Resource-Poor Countries

Author Affiliations

From the London School of Hygiene and Tropical Medicine (Dr De Cock), London, United Kingdom; and the Division of Tuberculosis Elimination, National Center for HIV/STD/TB Prevention, Centers for Disease Control and Prevention, Atlanta, Ga (Drs Binkin, Zuber, Tappero, and Castro).

JAMA. 1996;276(18):1502-1507. doi:10.1001/jama.1996.03540180058033

Each year, there are an estimated 8 million new cases of tuberculosis (TB) and 3 million deaths due to TB, most of which occur in resource-poor countries. Tuberculosis incidence is increasing rapidly in countries with high rates of human immunodeficiency virus (HIV) infection, and despite the availability of effective interventions, many TB programs are failing to cope with the increased TB caseload. This report highlights gaps in current understanding of the interaction between TB and HIV that contribute to failure of optimal TB management and control; we focus on the diagnosis of TB, its epidemiology and transmission, preventive strategies, and programmatic issues in the integration of HIV and TB services. Research into how best to apply existing knowledge will be at least as important as searching for new knowledge. The global control of TB will also require increased resources, greater political commitment, and stronger international public health leadership.