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Swaziland has one of the highest HIV prevalence rates in the world - 26 percent for those between the ages of 15 and 29. But to deal with the epidemic, health officials must do more than increase treatment, care and prevention efforts. They must also address another disease that's targeting HIV-positive people more and more often - tuberculosis.
Much progress has been made in extending the lives of people living with HIV, the AIDS virus. Anti-retroviral drugs - or ARVs - can literally pull people back from death's door.
It's estimated that about five million people worldwide are currently receiving the drugs. However, it's believed as many as 10 million people actually need them. Without ARVs, HIV can weaken or destroy the immune system, leaving the body defenseless against many opportunistic infections.
One of them is tuberculosis, which can often kill much more quickly than HIV. So health officials now look at HIV and TB in combination in dealing with the AIDS pandemic.
Dr. Mary Kathryn Linde, who recently visited Swaziland, says, "Because of the prominence of AIDS in that country, the resistance to organisms like TB is much lowered in the general population. And so it is transmitted more easily. And then once an individual has it they don't have the immune resistance to be able to combat it. And so it's taken a terrible toll."
To help Swaziland deal with the growing TB threat, hundreds of thousands of dollars are being spent to renovate a TB testing facility in Mbabane. It's a joint effort by the American Society for Clinical Pathology (ASCP), the U.S. Centers for Disease Control and Doctors Without borders.
Dr. Linde, who represents the pathology group, says a high quality lab plays a vital role in controlling the spread of TB.
"It's so important to have the correct diagnosis and a very rapid, timely diagnosis so that the patient can be treated. The patient[s] can't be treated until they are diagnosed," she says.
A lab that meets standards set by the Centers for Disease Control also makes it much easier for patients.
Linde says, "Another problem is that the people have to travel to get to the laboratory. And they don't have the money to actually do that. And then if they have to come back they may not be able to afford to come back or may not be physically able to come back. They need to be diagnosed as rapidly as possible and be treated as rapidly as possible."