Tuberculosis is the leading cause of death by infection worldwide, globally there are about 10 million cases of active tuberculosis annually and 1.5 million deaths occurred due to Tuberculosis in 2018. People living with HIV(PLHIV) are 20 times more likely to develop Mycobacterium Tuberculosis Bacteria (MTB). Strategies are needed for ending TB, number one killer of PLHIV, crisis by 2025. In 2022, MTB was the second leading cause of death from a single infection and 7.5 million were newly diagnosed with MTB. Globally, TB contributed 1.3 million deaths. The hope is that MTB is controllable and at the same time treatable. However, estimated finances for TB support was less than 40 per cent of what was needed to prevent and treat TB in 2022. Approximately 20 per cent of the global population currently has latent TB. Tuberculosis is an old disease probably for over 1, 000 years within human population, but Mycobacterium Tuberculosis was discovered by Robert Coch on March 24, 1884. In Rwanda, progress is seen in controlling, preventing, detecting, and treating Tuberculosis because it is not on the global list of high-burden countries for TB, HIV-associated TB, and MDR/RR-TB in the period 2021-2025. However, concern is seen in patients with late detection of HIV who report low CD4(late presenters) during the initial diagnosis of HIV. Tuberculosis knows no borders and can affect anyone in any country. There is need to consider TB as a public health concern to prevent avoidable death due to TB. Suboptimal CD4 and Tuberculosis in both people living with HIV(PLHIV) and those without HIV are associated with death being bedridden, loss in weight, and reduced upper arm circumference. Decreasing Cd4 is associated with a 43 per cent increase in TB incidence.The following are top priorities educating staff and clients, screening TB in clinics, and prioritizing preventing and treating HIV/TB coinfection. The ten-point program is key to addressing the TB Crisis in HIV-infected patients. · Sufficient funding for prevention, epidemiology, testing, treatment, training, and research to conquer TB globally with a focus on the highest-burden countries. · Universal access to the best TB medications including those that shorten the term of treatment. · Drastically reduce the number of undiagnosed TB patients through full-scale point-of-care testing programs & tracing contacts · NGO participation in planning, outreach, and adhering programs at the local, national, and global level · Integration of TB services with HIV and primary care services · Universal TB training of all health care providers in high prevalence areas & production of high-quality educational materials · Implementation of universal TB infection control policies & procedures to protect staff & staff in health care settings. · Lunch specialized testing programs to address late TB presentation to reduce unnecessary deaths & Infections. · Implement short-term TB, prevention therapy for vulnerable populations & complete the course of Treatment. · Engage patients past and present to improve treatment adherence. Dr. Julius Kamwesiga is Medical Director, AIDS Healthcare Foundation (AHF).
