In the developing world, tuberculosis (TB) is the leading cause of death among people infected with HIV. Efforts to control the disease are failing in regions where HIV infection is common, particularly in sub-Saharan Africa, partly because advanced HIV foils tests used to diagnose tuberculosis.
The HIV pandemic represents a massive challenge to the control of TB. About fifteen million of an estimated forty million HIV sufferers also have TB. Diagnosing the disease can be difficult.
HIV infection is commonly accompanied by other respiratory infections which can easily be confused for tuberculosis. Similarly, tuberculosis can exist in otherwise-healthy patients and be wrongly associated with HIV infection.
HIV infection increases a person’s risk of developing tuberculosis by weakening the body’s immune system, enabling latent tuberculosis to become actively aggressive.
Both tuberculosis and HIV are pandemic in Rwanda. Every month, approximately five hundred new cases of any form of tuberculosis are diagnosed in Rwanda – approximately one hundred in Butare alone.
The official HIV seroprevalence rate now stands at 5%, putting an estimated forty thousand people at risk to concomitant development of tuberculosis as their immune systems weaken.
The World Health Organisation (WHO) estimates approximately 36% of tuberculosis patients are also HIV positive.
Crude data produced by Rwanda’s National Programme for Leprosy and Tuberculosis Control (PNILT) indicates up to 44% of all cases registered with sputum smear positive tuberculosis were HIV positive, and 66% registered for other forms of tuberculosis were HIV positive during this past year.
However, this data is based solely on patients who visited doctors. No information is available regarding the prevalence of either disease in the broader population, leaving the true number of infected patients unknown and thus far untreatable.