Disease Prevention and Control / Communicable Diseases / Tuberculosis
TB/HIV: A Clinical Manual(2nd ed., World Health Organization Stop TB Department, Department of HIV/AIDS, and Department of Child and Adolescent Health and Development, 2004) | ||
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WHO E-Book (212 pp, PDF) Table of Contents PAHO TB/HIV Workshops: 2004 | 2003 |
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Preface to Second EditionRecognition of the impact of HIV on the clinical management of TB prompted WHO to publish the first edition of this manual in 1996. In response to popular demand, the manual was adapted for different regions and translated into many languages.The total number of copies distributed has run to well over 100,000. Recognition of the strengths and weaknesses of the first edition and developments in the TB/HIV field have now prompted a second edition. There is increasing attention to the need to ensure high-quality care of children with TB within National TB Programmes. Therefore, this second edition provides improved guidance on dealing with TB in children. HIV fuels the TB epidemic in populations where there is overlap between those infected with HIV and those infected with Mycobacterium tuberculosis. Intense transmission of M. tuberculosis increases the pool of HIV-infected people exposed to, and subsequently infected with, M. tuberculosis. In populations with high HIV prevalence, many people infected with HIV develop TB, and many TB patients are coinfected with HIV. Unfortunately, at present a very small proportion of all people infected with HIV have access to antiretroviral treatment. However, this proportion is sure to increase and clinicians involved in managing TB patients need to know about antiretroviral treatment. For these reasons, this edition includes a new chapter on antiretroviral drugs in the treatment of HIV infection. The new expanded framework for TB control and the strategic framework to control TB/HIV reflect the development of TB control policies since 1996. Chapter 2 incorporates these new policies. With the above changes, the manual provides up-to-date guidance on clinical management of patients with TB and HIV. This manual is mainly for doctors and other health professionals working in district hospitals and health centres in high HIV and TB prevalence countries. It deals mainly with sub-Saharan Africa, since this is the region most badly affected by HIV and HIV-related TB. However, we hope it will also be helpful in other parts of the world facing similar problems. Facilities vary from hospital to hospital and from health centre to health centre. In this manual we assume your hospital has a small laboratory and X-ray service. Even if you do not have these facilities, the manual should still be useful. Health professionals who care for TB patients now need to know how to diagnose and treat TB, the principles of diagnosis and treatment of HIV and other HIV-related diseases. This manual will help you in this task. The manual fits into a white coat pocket so you can use it on the ward, in the clinic and at home. There is not enough room in a pocket manual for all the possible information you may want to know about TB among HIV-infected people. So, at the end of each chapter, there are suggestions for further reading. These suggestions include relevant books, background material, reviews and recent articles in journals. Since English is not the first language of many of the people using this manual, the writing style is deliberately simple. You are welcome to send any comments on the manual to WHO. We will use your comments to help improve future editions. Many of the references in the manual are to WHO publications.To order copies of WHO publications, you should contact Marketing and Dissemination,World Health Organization, 1211 Geneva 27, Switzerland.
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