Foreword to second edition Foreword to first edition

Preface to second edition 13

Glossary and abbreviations 15

Introduction 21

1 Background information on tuberculosis and human immunodeficiency virus 23

1.1 Tuberculosis 23

1.1.1 Basic facts about TB 23

1.1.2 Pathogenesis of TB 25

1.2 Human immunodeficiency virus 27

1.2.1 Introduction: HIV and AIDS 27

1.2.2 HIV/AIDS epidemiology 28

1.2.3 HIV transmission 28

1.2.4 Prevention of HIV transmission in health units 29

1.2.5 Immunopathogenesis of HIV infection 30

1.2.6 Natural history of HIV infection 31

1.2.7 Clinical staging 32

1.2.8 Epidemiological surveillance of AIDS 35

1.3 HIV-related TB 36

1.3.1 Epidemiology of coinfection of HIV and M tuberculosis. . . 36

1.3.2 HIV infection and risk of TB 37

1.3.3 TB in the course of HIV progression 37

1.3.4 Consequence of HIV/M tuberculosis coinfection 37

1.3.5 Impact of HIV on TB control 37

1.3.6 Patterns of HIV-related TB 38

1.3.7 Impact of TB on HIV 39

2 An expanded framework for effective tuberculosis control 41

2.1 Introduction 41

2.2 Components of expanded TB control framework 41

2.2.1 Goals of TB control 42

2.2.2 Targets for TB control (cure and case detection) 42

2.2.3 TB control policy package (the DOTS strategy) 43

2.2.4 Key operations for DOTS implementation 44

2.2.5 Indicators to measure NTP progress in TB control 45

2.3 Directly observed treatment 45

2.5 DOTS-Plus 47

3 Diagnosis of pulmonary tuberculosis in adults. . . . 49

3.1 Diagnostic approach 49

3.2 Clinical features 50

3.3 Diagnostic sputum smear microscopy 51

3.4 Differential diagnosis of pulmonary TB 54

3.5 Chest X-ray in diagnosis 55

3.6 Radiographic abnormalities seen in pulmonary TB 55

3.7 Differential diagnosis of chest X-ray findings 56

3.8 The place of mycobacterial culture in the diagnosis of TB 57

3.9 Sepsis and concomitant TB 57

3.10 Distinguishing other HIV-related pulmonary diseases from pulmonary TB 58

4 Diagnosis of pulmonary tuberculosis in children . . 61

4.1 Epidemiology of childhood TB 61

4.2 How does TB in children differ from TB in adults? 62

4.3 Approach to diagnosis of TB 63

4.4 Score system for diagnosis of TB in children 66

4.5 Tuberculin skin test 67

4.6 The decision to start TB treatment in children 68

4.7 Impact of HIV on the diagnosis of TB in children 69

4.8 Differential diagnosis of pulmonary TB in

HIV-infected children 70

4.9 Management of child contacts of infectious adults 71

5 Diagnosis of extrapulmonary tuberculosis in adults and children 75

5.1 Diagnostic approach 75

5.2 Tuberculous lymphadenopathy 75

5.3 Miliary (disseminated) TB 78

5.4 Tuberculous serous effusions (pleural, pericardial, ascites) 79

5.5 Tuberculous meningitis 84

5.6 Other forms of extrapulmonary TB 87

5.7 Further information on spinal, gastrointestinal and hepatic TB 88

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