MERAFONG, South Africa, Sept 10 (AFP) - Tuberculosis is the number one killer among South Africans suffering from HIV and AIDS, an international expert said Wednesday.

Patrick Bertrand, regional coordinator of the Swiss-based Massive Effort Campaign, a non-profit organisation specialising in fusing efforts to combat TB, AIDS and malaria, said the likelihood of HIV/AIDS sufferers contracting TB was 10 times higher than for those who are HIV-negative.

"Tuberculosis is now the most important killer of people with HIV/AIDS in South Africa," he told AFP after a three-day meeting of experts to look at ways of creating a greater awareness of the disease.

"Yet, it is an easily treated and curable disease -- the drugs and diagnosis are free and accessible everywhere in the country," Bertrand said during a visit to clinics at Merafong, a mining community about 80 kilometres (50 miles) southwest of Johannesburg.

South Africa is the country with the highest co-infection rate of HIV and TB in the world, with more than half of those suffering from TB also suffering from HIV/AIDS, Bertrand added.

It is ranked as the country with the seventh-highest number of TB cases globally, following India, China, Indonesia, Bangladesh, Nigeria and Pakistan, according to the UN World Health Organisation's 2003 report on the global spread of the disease.

Health workers at Merafong, surrounded by some of the country's richest gold mines and which has one of the country's highest rates of TB infection, said they were facing an uphill battle against the disease.

Sister Thembi Kariyeni, a health worker in the dusty Khutsong township, told AFP the rate of patients defaulting on their treatment was high.

"Because you deal with migrant mine workers, they often go back to their homes elsewhere in southern Africa and then for various reasons don't take their medication, including giving it to other relatives who suffer from the same disease.

"This gives rise to strains of drug-resistant tuberculosis, which is a lot more expensive and a lot more difficult to treat," she said.

Treating a patient with the drug-resistant strain could cost an estimated 10,000 dollars a year, as opposed to around 10 dollars a year for treating a patient with normal TB, experts said.

Field workers said they believed that the infrastructure already put in place by South Africa's health authorities to treat TB could also be used in the rollout of anti-retroviral drugs (ARVs) to treat AIDS.

The South African government ended years of denial last month by recognising the efficacy of ARVs and launched a plan to provide the drugs to its five million HIV-positive citizens, but has yet to give details on how the rollout will take place.

"We believe that because there is such a strong link between HIV/AIDS and TB, they can both be treated at the same time," said one field worker, who asked not to be named.

But she added: "With HIV/AIDS there has been a lot of publicity and we haven't seen a lot of drugs. With TB, there are a lot of drugs and treatment available for free, but there has not been a lot of publicity around it."

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