Idemyor Vincent
J Natl Med Assoc. 2007 Dec;99(12):1414-9.
In sub-Saharan Africa, human immunodeficiency virus (HIV) and Mycobacterium tuberculosis (TB) are among the leading causes of morbidity and mortality. Sub-Saharan Africa has seen the woeful failure of World Health Organization (WHO) targets of detecting 70% of the infectious cases of tuberculosis and curing > or =85%. Current treatment of Mycobacterium tuberculosis in most resource limited settings is comprised of a four-drug initial antituberculosis regimen for two months, followed by either a two-drug continuation phase of antituberculosis regimen for four months or six months depending on the medications. Many countries in sub-Saharan Africa are scaling up with highly active antiretroviral therapy (HAART), using one of the first-line regimens that consist of two nucleoside reverse transcriptase inhibitors (NRTI) and one non-nucleoside reverse transcriptase inhibitor (NNRTI). Our current HAART regimen and antituberculosis drugs continue to give us a therapeutic challenge in terms of adverse effects, drug-drug interactions and immune reconstitution inflammatory syndromes. Scientific research is needed in the areas of diagnosis, treatment and prevention of tuberculosis in sub-Saharan Africa. Such research could be facilitated due to greater availability of funding than a decade ago.
在撒哈拉以南非洲地区，人类免疫缺陷病毒（HIV）和结核分枝杆菌（TB）是发病和死亡的主要原因之一。撒哈拉以南非洲地区未能实现世界卫生组织（WHO）检测70%的结核病感染病例并治愈≥85%病例的目标，令人遗憾。在大多数资源有限的环境中，目前对结核分枝杆菌的治疗包括为期两个月的四种药物初始抗结核治疗方案，随后根据所用药物进行为期四个月或六个月的两种药物抗结核治疗持续阶段。撒哈拉以南非洲的许多国家正在扩大高效抗逆转录病毒疗法（HAART）的使用，采用由两种核苷类逆转录酶抑制剂（NRTI）和一种非核苷类逆转录酶抑制剂（NNRTI）组成的一线治疗方案之一。我们目前的HAART治疗方案和抗结核药物在不良反应、药物相互作用和免疫重建炎症综合征方面仍然给我们带来治疗挑战。撒哈拉以南非洲地区在结核病的诊断、治疗和预防领域需要开展科学研究。由于资金比十年前更容易获得，此类研究可能会得到促进。
