Dual Infection: The Challenge of HIV/AIDS and Tuberculosis in Ethiopia

Background: Since the early 1990s, the HIV/AIDS epidemic has dramatically escalated in Ethiopia, such that few families, particularly in urban areas, have been unaffected. In describing the symptoms to others, particularly in the early days of the epidemic, reference frequently was made to samba, or lungs. This connection illustrates the tight interaction of HIV infection with tuberculosis (TB) in populations with an already high prevalence of TB, such as those in Ethiopia and others in the developing world, as well as in poor communities in industrialized countries.

Objectives: To discuss the biological interactions of HIV and TB in the human host, how the HIV epidemic has affected the rates of TB disease, and how the increase in tuberculosis cases also has a deleterious impact on TB control and general health services.

Results: While TB is increasing in nearly all occupational groups in Ethiopia, it is disproportionately affecting people in their 20s and 30s, the primary age group that is dying of AIDS. Some novel community-based approaches to TB control in rural areas, however, seem to be yielding positive results in terms of increasing drug compliance and treatment completion rates.

Recommendations: Innovative approaches to strengthen the national TB control program at the community level must be taken by the Ministry of Health in order to moderate the twin scourges of TB and HIV.