TY - JOUR

T1 - The looming epidemic of diabetes-associated tuberculosis

T2 - learning lessons from HIV-associated tuberculosis

AU - Harries, A D

AU - Lin, Y

AU - Satyanarayana, S

AU - Lönnroth, K

AU - Li, L

AU - Wilson, N

AU - Chauhan, L S

AU - Zachariah, R

AU - Baker, M A

AU - Jeon, C Y

AU - Murray, M B

AU - Maher, D

AU - Bygbjerg, I C

AU - Enarson, D A

AU - Billo, N E

AU - Kapur, A

PY - 2011

Y1 - 2011

N2 - The prevalence of diabetes mellitus is increasing at a dramatic rate, and countries in Asia, particularly India and China, will bear the brunt of this epidemic. Persons with diabetes have a significantly increased risk of active tuberculosis (TB), which is two to three times higher than in persons without diabetes. In this article, we argue that the epidemiological interactions and the effects on clinical presentation and treatment resulting from the interaction between diabetes and TB are similar to those observed for human immunodeficiency virus (HIV) and TB. The lessons learned from approaches to reduce the dual burden of HIV and TB, and especially the modes of screening for the two diseases, can be adapted and applied to the screening, diagnosis, treatment and prevention of diabetes and TB. The new World Health Organization (WHO) and The Union Collaborative Framework for care and control of TB and diabetes has many similarities to the WHO Policy on Collaborative Activities to reduce the dual burden of TB and HIV, and aims to guide policy makers and implementers on how to move forward and combat this looming dual epidemic. The response to the growing HIV-associated TB epidemic in the 1980s and 1990s was slow and uncoordinated, despite clearly articulated warnings about the scale of the forthcoming problem. We must not make the same mistake with diabetes and TB. The Framework provides a template for action, and it is now up to donors, policy makers and implementers to apply the recommendations in the field and to 'learn by doing'.

AB - The prevalence of diabetes mellitus is increasing at a dramatic rate, and countries in Asia, particularly India and China, will bear the brunt of this epidemic. Persons with diabetes have a significantly increased risk of active tuberculosis (TB), which is two to three times higher than in persons without diabetes. In this article, we argue that the epidemiological interactions and the effects on clinical presentation and treatment resulting from the interaction between diabetes and TB are similar to those observed for human immunodeficiency virus (HIV) and TB. The lessons learned from approaches to reduce the dual burden of HIV and TB, and especially the modes of screening for the two diseases, can be adapted and applied to the screening, diagnosis, treatment and prevention of diabetes and TB. The new World Health Organization (WHO) and The Union Collaborative Framework for care and control of TB and diabetes has many similarities to the WHO Policy on Collaborative Activities to reduce the dual burden of TB and HIV, and aims to guide policy makers and implementers on how to move forward and combat this looming dual epidemic. The response to the growing HIV-associated TB epidemic in the 1980s and 1990s was slow and uncoordinated, despite clearly articulated warnings about the scale of the forthcoming problem. We must not make the same mistake with diabetes and TB. The Framework provides a template for action, and it is now up to donors, policy makers and implementers to apply the recommendations in the field and to 'learn by doing'.

KW - AIDS-Related Opportunistic Infections

KW - Antitubercular Agents

KW - Coinfection

KW - Cooperative Behavior

KW - Diabetes Complications

KW - Epidemics

KW - Health Policy

KW - Humans

KW - International Cooperation

KW - Mass Screening

KW - Prevalence

KW - Risk Factors

KW - Time Factors

KW - Tuberculosis

KW - World Health

U2 - 10.5588/ijtld.11.0503

DO - 10.5588/ijtld.11.0503

M3 - Journal article

C2 - 21902876

VL - 15

SP - 1436-44, i

JO - International Journal of Tuberculosis and Lung Disease

JF - International Journal of Tuberculosis and Lung Disease

SN - 1027-3719

IS - 11

ER -