Giving a voice to those who die young: the fatal impact of tuberculosis and HIV in South Africa

Abstract

Evaluation of: Cohen T, Murray M, Wallengren K, Alvarez GG, Samuel EY, Wilson D: The prevalence and drug sensitivity of tuberculosis among patients dying in hospital in KwaZulu-Natal, South Africa: a postmortem study. PLoS Med. 7(6), e1000296 (2010). The joint epidemic of HIV and TB in southern Africa is having a profound impact on the livelihood of the general population. This study of young people dying in a general hospital, serving a big conurbation in South Africa, points to a number of problems linked to disease control in the community. These include late presentation, low uptake of efforts to treat HIV and TB, a high frequency of people with infectious TB in the community and anti-TB drug resistance. The arguments are convincingly made for an improvement in case detection and earlier institution of adequate treatment. The investigative methodology used by the authors could be more widely applied to advocate for lifesaving measures in other settings sharing similar epidemiological challenges.