The Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine, Health Science Faculty, University of Cape Town, Cape Town, South Africa.
Clin Infect Dis. 2010 May 15;50 Suppl 3:S208-14. doi: 10.1086/651493.
Tuberculosis (TB) has proven to be difficult to control in regions with a high prevalence of human immunodeficiency virus (HIV) infection. We previously described high prevalence of HIV infection among adults (23%) and rapidly escalating TB notification rates in a peri-urban township, Site-M in Cape Town, South Africa. The combination of delineated boundaries, a well-characterized population, centralized TB record keeping, and high levels of HIV testing make this population uniquely suited for TB epidemiologic and transmission studies. The driver of the HIV and TB coepidemic appears to be a high annual risk of Mycobacterium tuberculosis infection in this community. A high annual risk of M. tuberculosis infection may be the result of unrecognized infections coupled with intense social interaction and crowding. New non-facility-based interventions will be required, with emphasis on community-based case finding and contact tracing to decrease the infective TB pool. There is a need for better understanding of the transmission dynamics of TB and the intensity of social interactions, which have exacerbated an HIV and TB epidemic in this community of hyperendemicity.
结核病（TB）在人类免疫缺陷病毒（HIV）感染高发地区已被证明难以控制。我们之前曾描述过，在南非开普敦的一个城市郊区，Site-M 镇的成年人中 HIV 感染率很高（23%），结核病报告率迅速上升。明确的边界、特征明确的人群、集中的结核病记录保存以及高水平的 HIV 检测，使该人群非常适合结核病流行病学和传播研究。HIV 和结核病共同流行的驱动因素似乎是该社区每年感染结核分枝杆菌的风险很高。这种高风险可能是由于未被发现的感染，加上强烈的社会互动和拥挤。需要新的非机构性干预措施，重点是基于社区的病例发现和接触者追踪，以减少传染性结核存量。需要更好地了解结核病的传播动态和社会互动的强度，这些因素加剧了该高度流行地区 HIV 和结核病的流行。
