An appropriate combination of drugs must be used when treating tuberculosis (TB) in order to prevent the development of resistance. These drugs must then be prescribed in the right dosage and taken regularly by the patient under supervision for an adequate period of time. Isoniazid, rifampicin, ethambutol, pyrazinamide, streptomycin, and thiacetazone are the most commonly used first-line anti-tuberculosis drugs. Some of these drugs are available in combined preparations. Treatment regimens which combine both isoniazid and rifampicin are the most effective. Rifampicin is a useful anti-TB drug, so its use in treating diseases other than TB should be carefully limited. Although the standard treatment regimen has been 12-18 months, the course of treatment can be shortened to 6-8 months if the regimen includes rifampicin. Such regimens are known as Short Course Chemotherapy (SCC). SCC results in a higher incidence of completed treatment and higher cure rates at only slightly higher drug cost. The treatment of people with smear positive TB should always include an initial intensive phase followed by a continuation phase. The article describes how to assess cure, pregnant women and young infants, the failure to respond, and the side effects of drug therapy.
CARE International's SIDA en Exode (AIDS and Migration) Project trains community leaders including male migrants, their wives, bus drivers, sex workers, and Muslim religious leaders as peer educators carrying out AIDS awareness. Since 1993, nearly 500 peer educators have been trained. Between them they have reached nearly 120,000 migrants in promoting HIV prevention, distributed condoms to people along migration routes, and referred suspected sexually transmitted infection cases to health clinics. The project's success was dependent on the innovative educational tools that were used by peer educators such as the colorful and funny posters, flip charts, and a wooden model of a penis to demonstrate the proper use of a condom.
The Hlabisa project based in northern KwaZulu/Natal, South Africa, studied the prevalence of HIV and sexually transmitted infection (STI) in migrant and nonmigrant couples. The study participants were screened for HIV and STI, counseled, and given health education. The findings show that migrant couples have a much higher HIV discordance and prevalence than nonmigrant couples. However, according to the findings, only women were HIV positive, while their migrant partners were HIV negative. Thus, all migrants and their partners were treated for STI and given health education. Access to health services, is crucial, as is creating sustainable rural development programs that offer local employment.
In developing countries, mother-to-child (vertical) HIV transmission is responsible for 5-10% of all new HIV infections. Most children born to HIV-positive mothers are not HIV positive, but 25-35% are. Mothers can transmit HIV to their children during pregnancy, childbirth, and through breast-feeding. Mother-to-child HIV transmission in pregnancy and childbirth is also called perinatal transmission. Such HIV transmission can be reduced by reducing the risk of HIV infection in women and their partners by promoting safer sex, providing anti-HIV drugs to women before and during delivery, avoiding unnecessary invasive procedures, avoiding the risk of HIV transmission through breast milk whenever alternate infant feeding methods are available, and reducing the risk of HIV transmission through contaminated blood transfusions to women and their children. The provision of anti-HIV drugs and avoiding HIV transmission through breast milk are discussed.
