World TB Day on Sunday; Co-Infection With HIV Increases by 800 Times Risk of Developing Active TB, CDC Reports

The 20th annual World TB Day will be observed on Sunday. In observance, the CDC has devoted this week's Morbidity and Mortality Weekly Report to the disease, which is the second-leading infectious cause of death among adults and the leading cause of AIDS-related deaths worldwide. The CDC reports that tuberculosis cases in the United States increased by 20% from 1985 to 1992, but declined to an all-time low of 15,991 cases in 2001 (MMWR, 3/22). In addition to general information on the disease and World TB Day, the MMWR contains two reports on TB prevalence in the United States. The first report notes that 50% of all U.S. TB cases occur among people who have immigrated from other countries; Indian immigrants account for 10% of U.S. cases. According to the CDC, migrations due to poverty and drought complicate treatment in India. In addition, India's high prevalence of HIV, an infection that raises a person's risk of developing TB symptoms, contributes to the problem. A second CDC report found that medical providers within the Native American health system are not adequately equipped to deal with TB (Jacobs, Reuters, 3/21). A list of other TB facts and resources appears below:

• The World Health Organization on Wednesday issued a warning that TB was a "major culprit behind poverty" in eastern Asia and the Pacific region. The highest levels of TB are found in Cambodia, China, Laos, Mongolia, Papua New Guinea, the Philippines and Vietnam. The poor are most likely to be adversely affected because they live in situations marred by "overcrowding, inadequate ventilation and malnutrition" -- all factors that assist the spread of TB. They are also less likely to receive adequate health care (Agence France-Presse, 3/20).
• TB is reaching "epidemic" proportions in Ukraine, where 32,000 new cases were recorded last year, according to the state tuberculosis institute, the New York Times reports. The new cases bring the nation's total to nearly 700,000. The nation's rising HIV prevalence could further worsen the epidemic because people with weakened immune systems are more susceptible to the disease (Wines, New York Times, 3/22). The CDC reports that the risk of developing active TB is 800 times greater in people with both HIV and TB than in those who are not infected with HIV (CDC, TB Elimination: Now is the Time! fact sheet, 3/22).
• The CDC's Division of TB Elimination has assembled a TB awareness campaign titled, "TB Elimination: Now is the Time!" The report contains facts about the disease, tracking data and strategies for eliminating TB from the United States (Division of TB Elimination Web site, 3/22). Posters are also available online.
• The Stop TB Partnership has a Web site devoted to World TB Day. The theme for this year is "Stop TB, fight poverty," and the Web site provides viewers with facts about the disease, materials about TB, a list of World TB Day events and a list of links to other TB organizations (Stop TB Partnership Web site, 3/22).