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TB biggest cause of death

By SANJOY RAY
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GUWAHATI, June 13 � Tuberculosis (TB) has emerged as the most dreadful disease for HIV-infected adults with the bacteria accounting for 28 per cent of all deaths registered with the three anti-retroviral therapy (ART) centres in Assam, reveals the latest World Journal of AIDS (2015).

Among the 370 deaths of HIV-infected patients recorded in the ART centres of Assam from 2006 to 2012, TB alone was the cause of 105 deaths, the report says.

Experts believe that TB being a curable disease, such a trend has certainly posed serious questions on the screening, early detection and other interventions, besides awareness initiatives, in the health sector related to HIV/AIDS and TB.

The first-of-its-kind study done on the causes of death among HIV-infected adults registered in select ART centres in north-eastern India further found that the percentage of death due to AIDS related complex (signs and symptoms representing a less severe stage of HIV infection) was 11, followed by wasting syndrome and multiple infections, which recorded 9 per cent deaths of HIV-infected adults.

As a whole, AIDS-related causes which include TB, wasting syndrome and multiple infections, led to the death of 67 per cent HIV-infected patients on ART.

Significantly, although the cause of death of around 24 per cent HIV-infected patients is not known, the indicators of these deaths too largely resemble with those of deaths due to TB, prompting experts to believe that the actual deaths caused due to the bacteria (TB) could me more than what meets the eye.

Deaths due to select causes were significantly associated with patient�s use of alcohol, WHO clinical stage, CD4 count at the time of diagnosis, presence of opportunistic infections during treatment and ART adherence, Dr Chiranjeev Bhattacharjya, author of the journal told this reporter.

Median survival duration was found to be just shortest (2.9 months) among patients who had CD4 count below 50 at the start of ART and also patients who had multiple opportunistic infections during treatment (2.5 months).

The study has also brought to the fore an ascending order of deaths of HIV-infected adults, which rose from 22 in 2006 to 85 in 2012.

�As majority of deaths are due to AIDS-related complexes, it highlights the fact that we are still detecting cases at a later stage. There is a need to scale up HIV testing and awareness among the masses so that we can detect cases at an early stage and prevent AIDS-related deaths,� said Dr Bhattacharjya, who is also an epidemiologist of the Assam State AIDS Control Society, while talking to The Assam Tribune.

An official of the Revised National Tuberculosis Control Programme when contacted, opined that there was a great need to screen, detect and treat TB patients for which the existing infrastructure is falling short.

�As TB is curable, early detection could prevent or lessen deaths of HIV-infected patients due to TB. Although there is a provision of cross referral, follow-up services of such patients will have to be improved,� he said.

Altogether 5,612 patients were registered in the three ART centres of Assam including Gauhati Medical College and Hospital, Silchar Medical College and Hospital and Assam Medical College and Hospital.

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TB biggest cause of death

GUWAHATI, June 13 � Tuberculosis (TB) has emerged as the most dreadful disease for HIV-infected adults with the bacteria accounting for 28 per cent of all deaths registered with the three anti-retroviral therapy (ART) centres in Assam, reveals the latest World Journal of AIDS (2015).

Among the 370 deaths of HIV-infected patients recorded in the ART centres of Assam from 2006 to 2012, TB alone was the cause of 105 deaths, the report says.

Experts believe that TB being a curable disease, such a trend has certainly posed serious questions on the screening, early detection and other interventions, besides awareness initiatives, in the health sector related to HIV/AIDS and TB.

The first-of-its-kind study done on the causes of death among HIV-infected adults registered in select ART centres in north-eastern India further found that the percentage of death due to AIDS related complex (signs and symptoms representing a less severe stage of HIV infection) was 11, followed by wasting syndrome and multiple infections, which recorded 9 per cent deaths of HIV-infected adults.

As a whole, AIDS-related causes which include TB, wasting syndrome and multiple infections, led to the death of 67 per cent HIV-infected patients on ART.

Significantly, although the cause of death of around 24 per cent HIV-infected patients is not known, the indicators of these deaths too largely resemble with those of deaths due to TB, prompting experts to believe that the actual deaths caused due to the bacteria (TB) could me more than what meets the eye.

Deaths due to select causes were significantly associated with patient�s use of alcohol, WHO clinical stage, CD4 count at the time of diagnosis, presence of opportunistic infections during treatment and ART adherence, Dr Chiranjeev Bhattacharjya, author of the journal told this reporter.

Median survival duration was found to be just shortest (2.9 months) among patients who had CD4 count below 50 at the start of ART and also patients who had multiple opportunistic infections during treatment (2.5 months).

The study has also brought to the fore an ascending order of deaths of HIV-infected adults, which rose from 22 in 2006 to 85 in 2012.

�As majority of deaths are due to AIDS-related complexes, it highlights the fact that we are still detecting cases at a later stage. There is a need to scale up HIV testing and awareness among the masses so that we can detect cases at an early stage and prevent AIDS-related deaths,� said Dr Bhattacharjya, who is also an epidemiologist of the Assam State AIDS Control Society, while talking to The Assam Tribune.

An official of the Revised National Tuberculosis Control Programme when contacted, opined that there was a great need to screen, detect and treat TB patients for which the existing infrastructure is falling short.

�As TB is curable, early detection could prevent or lessen deaths of HIV-infected patients due to TB. Although there is a provision of cross referral, follow-up services of such patients will have to be improved,� he said.

Altogether 5,612 patients were registered in the three ART centres of Assam including Gauhati Medical College and Hospital, Silchar Medical College and Hospital and Assam Medical College and Hospital.

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