RESUMO
HIV and Mycobacterium tuberculosis (MTB) are two widespread and highly successful microbes whose synergy in pathogenesis has created a significant threat for human health globally. In acknowledgement of this fact, the European Union (EU) has funded a multinational support action, the European Network for global cooperation in the field of AIDS and TB (EUCO-Net), that brings together experts from Europe and those regions that bear the highest burden of HIV/MTB co-infection. Here, we summarise the main outcome of the EUCO-Net project derived from an expert group meeting that took place in Stellenbosch (South Africa) (AIDS/TB Workshop on Research Challenges and Opportunities for Future Collaboration) and the subsequent discussions, and propose priority areas for research and concerted actions that will have impact on future EU calls.
Assuntos
Fármacos Anti-HIV/uso terapêutico , Antituberculosos/uso terapêutico , Infecções por HIV/tratamento farmacológico , Mycobacterium tuberculosis/efeitos dos fármacos , Tuberculose Pulmonar/tratamento farmacológico , Vacinas contra a AIDS/uso terapêutico , Comorbidade , Congressos como Assunto , Europa (Continente) , Feminino , Processos Grupais , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Diretrizes para o Planejamento em Saúde , Humanos , Masculino , Mycobacterium tuberculosis/isolamento & purificação , Vacinas contra a Tuberculose/uso terapêutico , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologiaRESUMO
The potential risk of acquiring a transfusion-transmitted infection by the human immunodeficiency virus (HIV), hepatitis B (HBV) virus, hepatitis C (HCV) virus, or Trypanosoma cruzi was estimated for seven South American and five Central American countries during the period 1994-1997. The estimates were based on official national reports of the number of donors, blood screening coverage, and prevalence of serologic markers for infectious diseases. Coverage of screening in 1997 was 100% in 12 and 11 countries for HIV and HBV respectively. Complete screening for HCV was reported by only one country in 1994 and by six in 1997. For T. cruzi, the number of countries with 100% screening coverage increased from two in 1994 to four in 1997. In 1994, three countries showed risk of transfusion-transmitted infections for HIV, seven for HBV, eight for HCV, and seven for T. cruzi. The risk of receiving an infected blood unit and acquiring a transfusion-transmitted infection has been reduced with time in 10 of the 12 countries due to improvements in screening coverage. In Uruguay, the risk was theoretically nil from 1994-1997 because at the beginning of the study period they already had 100% blood donor screening for all infectious diseases transmitted by blood. In 1994, Colombia and Venezuela had the highest health risk associated with blood transfusion (spreading index of 101 and 62, respectively); during the period 1996-1997, Costa Rica presented the highest figures (spreading index of 53 and 83, respectively). The analysis of the potential risk associated with transfusion of tainted blood highlights the need for continuous monitoring of the safety of blood supply.
Assuntos
Transfusão de Sangue/estatística & dados numéricos , Doença de Chagas/transmissão , Transmissão de Doença Infecciosa/estatística & dados numéricos , Reação Transfusional , Viroses/transmissão , Doadores de Sangue/estatística & dados numéricos , Infecções por HIV/transmissão , Hepatite B/transmissão , Hepatite C/transmissão , Humanos , Prevalência , Fatores de Risco , América do Sul/epidemiologiaRESUMO
This study compares participation rates and reasons for nonresponse in surveys conducted in five countries of Latin America and the Caribbean. The objective of the surveys was to measure the prevalence of risk behaviors affecting the transmission of human immunodeficiency virus. The surveys were based on probability samples of the population of both sexes between 15 and 49 years old, except in Mexico, where only men were included. Proportions of three components of participation were estimated: residences interviewed, interviewed residences with eligible persons, and eligible persons who completed the interview. In addition, an overall index that combined the three components was calculated. The overall response rate ranged from 35.6% in Mexico to 81.4% in Chile. The component with the greatest variability was the participation of eligible persons, which ranged from 50% in Mexico to 95% in Cuba. These values were lower than what had been expected, especially among men, and will serve to guide future surveys, since rejection rates higher than the ones expected in the protocol should be considered. The results make it possible to infer the validity of the prevalence estimates for the various observed risk behaviors. The results also establish a benchmark to calculate the sample size in future surveys and to improve research methodology.
Assuntos
Inquéritos Epidemiológicos , Saúde Pública , Adolescente , Adulto , Chile , Costa Rica , Cuba , República Dominicana , Feminino , Infecções por HIV/transmissão , Humanos , Entrevistas como Assunto , Masculino , México , Pessoa de Meia-Idade , Distribuição Aleatória , Pesquisa , Projetos de Pesquisa , Fatores de Risco , Comportamento Sexual , Inquéritos e QuestionáriosRESUMO
AIDS: In Latin America and the Caribbean, the AIDS pandemic is comprised of groupings of different epidemics, varying in transmission routes and in populations affected. Primary modes of HIV transmission in Latin America, the Caribbean, and South America are outlined, and vary from type of sexual contact to intravenous drug use, depending on the subregion. Overall, the epidemic is progressing into younger, more impoverished, and more rural populations. Efforts to stem the spread of the epidemic should meet the prevention needs of marginalized and impoverished populations and be consistent with the type and characteristics of the epidemics found at the country level. Timely surveillance is a key component in alleviating the epidemic. Strategies targeting at-risk populations should empower women, educate youth, and disseminate messages.^ieng
Assuntos
Síndrome da Imunodeficiência Adquirida/epidemiologia , Infecções por HIV/epidemiologia , Síndrome da Imunodeficiência Adquirida/prevenção & controle , Síndrome da Imunodeficiência Adquirida/transmissão , Região do Caribe/epidemiologia , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Humanos , América Latina/epidemiologia , Vigilância da População , Comportamento Sexual , Fatores Socioeconômicos , Abuso de Substâncias por Via IntravenosaRESUMO
At present, human immunodeficiency virus (HIV) is thought to have infected over 17 million people worldwide, over 1 million in North America and roughly 2 million in Latin America and the Caribbean. By comparison, infection with the tuberculosis (TB) agent Mycobacterium tuberculosis is far more common, current estimates indicating that roughly one-third of the world's population is infected. These two infections tend to aggravate each other. That is, HIV leads to a progressive immune system depression that favors reactivation of TB in people with latent tuberculous infections; it promotes progression of TB primary infections or reinfections to full-blown tuberculous disease; and it fosters TB transmission, because those simultaneously infected with HIV and M. tuberculosis tend to develop a bacilliferous and contagious TB that can be transmitted to other susceptible individuals, even though the latter are HIV-negative. In addition, this coinfection tends to promote circulation of drug-resistant M. tuberculosis and to produce peculiar manifestations that complicate TB diagnosis, treatment, and control. Overall, it seems clear that the growing threat posed by these associated agents demands effective action in the form of well-coordinated measures involving throughgoing participation by all countries.