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Lv H, Zhang X, Zhang X, Bai J, You S, Li X, Li S, Wang Y, Zhang W, Xu Y. Global prevalence and burden of multidrug-resistant tuberculosis from 1990 to 2019. BMC Infect Dis 2024; 24:243. [PMID: 38388352 PMCID: PMC10885623 DOI: 10.1186/s12879-024-09079-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/31/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Tuberculosis(TB) remains a pressing public health challenge, with multidrug-resistant tuberculosis (MDR-TB) emerging as a major threat. And healthcare authorities require reliable epidemiological evidence as a crucial reference to address this issue effectively. The aim was to offer a comprehensive epidemiological assessment of the global prevalence and burden of MDR-TB from 1990 to 2019. METHODS Estimates and 95% uncertainty intervals (UIs) for the age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), age-standardized disability-adjusted life years rate (ASR of DALYs), and age-standardized death rate (ASDR) of MDR-TB were obtained from the Global Burden of Disease (GBD) 2019 database. The prevalence and burden of MDR-TB in 2019 were illustrated in the population and regional distribution. Temporal trends were analyzed by using Joinpoint regression analysis to calculate the annual percentage change (APC), average annual percentage change (AAPC) and its 95% confidence interval(CI). RESULTS The estimates of the number of cases were 687,839(95% UIs: 365,512 to 1223,262), the ASPR were 8.26 per 100,000 (95%UIs: 4.61 to 15.20), the ASR of DALYs were 52.38 per 100,000 (95%UIs: 22.64 to 97.60) and the ASDR were 1.36 per 100,000 (95%UIs: 0.54 to 2.59) of MDR-TB at global in 2019. Substantial burden was observed in Africa and Southeast Asia. Males exhibited higher ASPR, ASR of DALYs, and ASDR than females across most age groups, with the burden of MDR-TB increasing with age. Additionally, significant increases were observed globally in the ASIR (AAPC = 5.8; 95%CI: 5.4 to 6.1; P < 0.001), ASPR (AAPC = 5.9; 95%CI: 5.4 to 6.4; P < 0.001), ASR of DALYs (AAPC = 4.6; 95%CI: 4.2 to 5.0; P < 0.001) and ASDR (AAPC = 4.4; 95%CI: 4.0 to 4.8; P < 0.001) of MDR-TB from 1990 to 2019. CONCLUSIONS This study underscored the persistent threat of drug-resistant tuberculosis to public health. It is imperative that countries and organizations worldwide take immediate and concerted action to implement measures aimed at significantly reducing the burden of TB.
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Affiliation(s)
- Hengliang Lv
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Xin Zhang
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Xueli Zhang
- Changchun University of Chinese Medicine, Changchun, China
| | - Junzhu Bai
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Shumeng You
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Xuan Li
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Shenlong Li
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Yong Wang
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Wenyi Zhang
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China.
- Chinese PLA Center for Disease Control and Prevention, Beijing, China.
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.
| | - Yuanyong Xu
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China.
- Chinese PLA Center for Disease Control and Prevention, Beijing, China.
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Wang L, Lv H, Zhang X, Zhang X, Bai J, You S, Li X, Wang Y, Du J, Su Y, Huang W, Dai Y, Zhang W, Xu Y. Global prevalence, burden and trend in HIV and drug-susceptible tuberculosis co-infection from 1990 to 2019 and prediction to 2040. Heliyon 2024; 10:e23479. [PMID: 38205310 PMCID: PMC10776929 DOI: 10.1016/j.heliyon.2023.e23479] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 01/12/2024] Open
Abstract
Objectives The purpose of this study is to describe the current situation and forecast the trends of co-infection between the human immunodeficiency virus (HIV) and drug-susceptible tuberculosis (DS-TB) in different countries, across various age groups and genders. Methods We obtained data on the number of cases, age-standardized incidence rate, age-standardized prevalence rate, age-standardized rate of disability-adjusted life years (DALYs), and age-standardized death rate from the Global Burden of Disease (GBD) 2019 database. These data were used to describe the distribution and burden of co-infection between the human immunodeficiency virus (HIV) and DS-TB in different regions, genders, and age groups. We employed joinpoint regression analysis to analyze the temporal trends from 1990 to 2019. Additionally, an age-period-cohort model was established to forecast the future trends of co-infection up to 2040. Results The prevalence and burden of co-infection varied across different age groups and genders. The territories with the higher disease burden were distributed in some Asian and African countries. In terms of temporal trends, the age-standardized incidence rate and age-standardized prevalence rate of HIV and DS-TB co-infection exhibited an overall increasing trend from 1990 to 2019, and the prediction indicated a slow downward trend from 2019 to 2040. Conclusions The co-infection of HIV and DS-TB posed a grave threat to public health and economic development. What's more, there existed a significant disparity between the actual state of co-infection and the desired goals for prevention and control.
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Affiliation(s)
- Longhao Wang
- Department of Health Statistics, Faculty of Military Preventive Medicine, Army Medical University, Chongqing, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Hengliang Lv
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Xueli Zhang
- Changchun University of Chinese Medicine, Changchun, China
| | - Xin Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Junzhu Bai
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Shumeng You
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Xuan Li
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Yong Wang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Jingli Du
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China
| | - Yue Su
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China
| | - Weilin Huang
- College of Basic Medicine, Army Medical University, Chongqing, China
| | - Yingzhong Dai
- College of Basic Medicine, Army Medical University, Chongqing, China
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Yuanyong Xu
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
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Jinyi W, Zhang Y, Wang K, Peng P. Global, regional, and national mortality of tuberculosis attributable to alcohol and tobacco from 1990 to 2019: A modelling study based on the Global Burden of Disease study 2019. J Glob Health 2024; 14:04023. [PMID: 38175959 PMCID: PMC10767425 DOI: 10.7189/jogh.14.04023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024] Open
Abstract
Background Tuberculosis (TB) is expected to become the second leading single cause of death with several risk factors, but the related disease burden is currently unknown. We aimed to analyse the pre-coronavirus disease 2019 (COVID-19) changes in mortality of TB attributable to alcohol and tobacco worldwide from 1990 to 2019. Methods We obtained data of TB deaths and age-standardised death rates attributed to alcohol and cigarette in 204 countries and territories from the Global Burden of Disease 2019 public database. We performed a spatial-temporal analysis of age-standardised death rate and the average annual per cent change (AAPC), after which we analysed the effects of gender and socio-demographic index on age-standardised death rate using an age-period-cohort model. Finally, we built machine learning models to predict the TB age-standardised death rate in 2035. Results We found that the global age-standardised death rate of TB attributable to alcohol consumption declined from 5.35 (95% uncertainty interval (UI) = 3.51, 7.00) in 1990 to 2.54 (95% UI = 1.65, 3.33) in 2019, with significant declines in Andean Latin America (AAPC = -7.59; 95% confidence interval (CI) = -8, -7.16, P < 0.05), East Asia (AAPC = -7.32; 95% CI = -8.00, -6.62, P < 0.05), and Central Latin America (AAPC = -7.31; 95% CI = -7.63, -6.99, P < 0.05). However, there was an increase in a few regions, especially in parts of Central Asia. The age-standardised death rate for TB attributable to cigarette smoking declined more rapidly than that for TB attributable to alcohol, from 7.45 (95% UI = 6.17, 8.72) to 2.21 (95% UI = 1.78, 2.64), especially in East Asia (AAPC = -6.64; 95% CI = -7.07, -6.2, P < 0.05), North Africa and Middle East (AAPC = -6.47; 95% CI = -6.67, -6.28, P < 0.05), and Andean Latin America (AAPC = -6.31; 95% CI = -6.87, -5.75, P < 0.05). However, TB attributable to cigarette smoking increased in parts of Eastern Europe. In both TB attributable to alcohol consumption and to cigarette smoking, the age-standardised death rate was much higher in men than in women. The age-period-cohort model results showed that TB attributable to alcohol consumption was the highest in older adults aged 60-80 years, while TB attributable to cigarette smoking was the highest in adults aged 40-60 years. Machine learning models projected that by 2035, the age-standardised death rate for TB attributable to alcohol consumption would be 1.29 (per 100 000 population), while the age-standardised death rate for TB attributable to cigarette consumption would be 0.37 (per 100 000 population), which might not achieve the 2035 global target for eliminating TB. Conclusions Globally, the age-standardised death rate for TB attributable to alcohol consumption declined slower than that attributable to cigarette smoking. Controlling these two factors would help achieve the global goal of TB elimination, especially for the elderly who are at high risk.
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Affiliation(s)
- Wu Jinyi
- Wuhan Fourth Hospital, Wuhan, China
| | - Yue Zhang
- Shanxi Medical University, Taiyuan, China
| | - Kai Wang
- Wuhan Fourth Hospital, Wuhan, China
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Preuc C, Humayun M, Yang Z. Varied trends of tuberculosis and HIV dual epidemics among different countries during 2000-2020: lessons from an ecological time-trend study of 9 countries. Infect Dis (Lond) 2023; 55:567-575. [PMID: 37345429 DOI: 10.1080/23744235.2023.2223272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/05/2023] [Accepted: 06/05/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND While Human Immunodeficiency Virus (HIV) infection is a well-established risk factor for tuberculosis (TB), the effect of HIV infection on TB incidence varies across countries given differences in local epidemiological factors and disparate progress with respect to TB elimination goals. METHODS In this descriptive epidemiological study, we explored the country-specific associations between HIV prevalence and TB incidence in nine countries representing four WHO regions using data between 2000 and 2020. For each of these countries, we (1) described the trends of TB incidence and HIV prevalence, and (2) examined country-level associations between TB incidence and HIV prevalence, using negative binomial regression. RESULTS The trends of TB incidence and HIV prevalence, and the country-level associations, varied across the study countries. Angola, Thailand and Zimbabwe showed parallel TB incidence and HIV prevalence trends while the two trends diverged in Brazil, Liberia and Indonesia during the study period. Additionally, the strength of association between HIV prevalence and TB incidence varied widely between countries, with the risk ratio ranging from 0.42 (95% CI: 0.36, 0.49) in Indonesia to 2.78 (95% CI: 2.57, 3.02) in Thailand. CONCLUSIONS The association of HIV infection with TB incidence varied across high burden settings, suggesting that HIV is not a ubiquitous driver of TB incidence. Without acknowledging the local drivers of TB epidemics across countries, the END TB Strategy cannot be adapted at the country level. The findings from this analysis can inform the design of future studies to identify country-specific drivers of TB using individual-level data.
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Affiliation(s)
- Chelsi Preuc
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Maheen Humayun
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Zhenhua Yang
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Zhang T, Zhang J, Wei L, Liang H, Zhang J, Shi D, Wang Z. The global, regional, and national burden of tuberculosis in 204 countries and territories, 1990-2019. J Infect Public Health 2023; 16:368-375. [PMID: 36702011 DOI: 10.1016/j.jiph.2023.01.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/09/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Tuberculosis (TB) is the leading cause of death from a single infectious disease and ranks 13th among the leading causes of death worldwide. In this study, we aimed to report the burden of TB in 204 countries and territories from 1990 to 2019 by sex, age, and socio-demographic index (SDI). METHODS Annual death number, age-standardized mortality rates (ASMR), and age-standardized disability-adjusted life year (DALY) rates (ASDR) with a 95% uncertainty interval (UI) of TB were derived from the global burden of disease (GBD) 2019 for the time period between 1990 and 2019. The association between the burden of TB and SDI was also investigated. RESULTS The total death number related to TB decreased by 33.6%, from 1777.5 in 1990-1179.8 in 2019, per 1000 individuals. The global ASMR and ASDR for TB were 14.64 (13.39-16.03) and 590.42 (536.85-646.42), which were 63.5% and 62.8% lower than in 1990, respectively. South Asia, Eastern Sub-Saharan Africa, Southeast Asia, and Western Sub-Saharan Africa had the largest number of TB deaths in 2019. Central Sub-Saharan Africa was the region with the highest ASMR and ASDR in 2019. India had the highest number of TB deaths, and the Central African Republic and Switzerland had the highest and lowest ASMR per 100,000 individuals, respectively. The number of deaths and DALYs were higher in males than in females and the ASDR significantly increased from the 10-14-year-old age group to the 80-84-year-old age group in both sexes. Most cases of TB were caused by drug-susceptible TB. A negative association between the regional SDI and the ASDR of TB was found. CONCLUSIONS From 1990-2019, TB death number, ASMR, and ASDR decreased. It is important to note that, despite the decreasing burden of TB, it remains a major public health problem, especially in low SDI countries. It is necessary to design and implement suitable strategies to address the current situation.
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Affiliation(s)
- Ting Zhang
- Department of Thoracic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China
| | - Jinyu Zhang
- Department of Thoracic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China
| | - Li Wei
- Department of Thoracic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China
| | - Hongsen Liang
- Department of Thoracic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China
| | - Junhang Zhang
- Department of Thoracic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China
| | - Donglei Shi
- Department of Thoracic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China.
| | - Zhaojun Wang
- Department of Thoracic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China.
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Plata-Casas L, Gutierrez-Lesmes O, Cala-Vitery F. Tuberculosis Disability Adjusted Life Years, Colombia 2010-2018. Trop Med Infect Dis 2022; 7:250. [PMID: 36136661 PMCID: PMC9505559 DOI: 10.3390/tropicalmed7090250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
Estimating the burden of tuberculosis disease is relevant for assessing and identifying population health status and progress in policies and programs aimed at epidemic control. The objective of this study was to estimate disability-adjusted life years attributable to Tuberculosis in Colombia 2010-2018. A longitudinal descriptive study was conducted. The variables, sex, age groups and origin were studied. This study included 110,475 cases of morbidity and 8514 cases of mortality. Indicators of years of life lost, years of life with disability and disability-adjusted life years at the subnational level were determined using the methodology of the World Health Organization. With the results of this last indicator, an epidemiological risk stratification was carried out. The DALY rate of the study period was 684 (95% CI 581.2-809.1) per 100,000 inhabitants. According to sex, 68.4% occurred in men; for every DALY in women, 2.21 occur in men. People of productive age (15 to 69 years) account for 56% of DALYs. Amazonas (1857.1 CI 95% 1177.1-2389.6) was the territorial entity with the highest rate. A total of 51.5% of the territorial entities of departmental order of the country are of high burden for Tuberculosis. For the first time in Colombia, a comprehensive assessment of the status of the disease burden at a subnational (departmental) territorial level attributable to Tuberculosis is being carried out using the updated World Health Organization methodology. The results obtained allow us to specify that there is a knowledge gap in terms of the realization and clear understanding of the burden of the disease in Colombia. There are territorial gaps that are necessary to know in order to plan, develop, implement and redirect policies to improve health and eliminate disparities according to the territorial context.
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Affiliation(s)
- Laura Plata-Casas
- Faculty of Natural Sciences and Engineering, University Jorge Tadeo Lozano, Bogota 111711, Colombia
| | - Oscar Gutierrez-Lesmes
- School of Public Health, Faculty of Health Sciences, University of the Llanos, Villavicencio 500003, Colombia
| | - Favio Cala-Vitery
- Faculty of Natural Sciences and Engineering, University Jorge Tadeo Lozano, Bogota 111711, Colombia
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The Role of NRF2 in Mycobacterial Infection. Antioxidants (Basel) 2021; 10:antiox10121861. [PMID: 34942964 PMCID: PMC8699052 DOI: 10.3390/antiox10121861] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/11/2021] [Accepted: 11/22/2021] [Indexed: 02/04/2023] Open
Abstract
The incidence of pulmonary nontuberculous mycobacterial (NTM) infection is increasing worldwide, and its clinical outcomes with current chemotherapies are unsatisfactory. The incidence of tuberculosis (TB) is still high in Africa, and the existence of drug-resistant tuberculosis is also an important issue for treatment. To discover and develop new efficacious anti-mycobacterial treatments, it is important to understand the host-defense mechanisms against mycobacterial infection. Nuclear erythroid 2 p45-related factor-2 (NRF2) is known to be a major regulator of various antioxidant response element (ARE)-driven cytoprotective gene expressions, and its protective role has been demonstrated in infections. However, there are not many papers or reviews regarding the role of NRF2 in mycobacterial infectious disease. Therefore, this review focuses on the role of NRF2 in the pathogenesis of Mycobacterium tuberculosis and Mycobacterium avium infection.
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Leveraging HIV Care Infrastructures for Integrated Chronic Disease and Pandemic Management in Sub-Saharan Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010751. [PMID: 34682492 PMCID: PMC8535610 DOI: 10.3390/ijerph182010751] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 12/31/2022]
Abstract
In Sub-Saharan Africa, communicable and other tropical infectious diseases remain major challenges apart from the continuing HIV/AIDS epidemic. Recognition and prevalence of non-communicable diseases have risen throughout Africa, and the reimagining of healthcare delivery is needed to support communities coping with not only with HIV, tuberculosis, and COVID-19, but also cancer, cardiovascular disease, diabetes, and depression. Many non-communicable diseases can be prevented or treated with low-cost interventions, yet implementation of such care has been limited in the region. In this Perspective piece, we argue that deployment of an integrated service delivery model is an urgent next step, propose a South African model for integration, and conclude with recommendations for next steps in research and implementation. An approach that is inspired by South African experience would build on existing HIV-focused infrastructure that has been developed by Ministries of Health with strong support from the U.S. President’s Emergency Response for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria. An integrated chronic healthcare model holds promise to sustainably deliver infectious disease and non-communicable disease care. Integrated care will be especially critical as health systems seek to cope with the unprecedented challenges associated with COVID-19 and future pandemic threats.
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