The twin epidemics of HIV and TB continue to cause untold damage to individuals, families and communities in sub-Saharan Africa. The massive scale up of antiretroviral therapy (ART) in this region has begun to reverse some of the trends in morbidity and mortality caused by these twin epidemics. Drug resistance appears as an inevitable consequence of the widespread use of antimicrobial agents. The past two decades has seen the emergence of drug-resistant strains of Mycobacterium tuberculosis which threaten basic TB control. Resistance to antiretroviral drugs is now an escalating threat in this region as we end the first decade of ART roll-out in Africa with over five million people receiving ART.
In order to confront this challenge we need to learn how to prevent and manage drug resistance, both at an individual and at a programmatic level. The aim of this book is to equip health care workers with the knowledge and skills to diagnose and manage cases of drug-resistant HIV and TB but also to learn how drug resistance might be prevented. The focus is on the interpretation of diagnostic tests related to drug resistance. The book is aimed primarily at doctors, nurses, and pharmacists but other readers might find information that is relevant for their own circumstances. The focus throughout most of the cases is on practice in the public health sector but there is also information relevant to private practitioners.
The book is equally suited to learning on your own or learning within a group - the cases could, for example, be used as teaching material for Nurse Initiation and Management of ART (NIM-ART) nurses at your clinic or hospital. The cases are also available online (www.bioafrica.net/saturn) - new cases will be added regularly to the online site and updated information about existing cases will also be added. We aim to compile a second edition of this book in the future as more cases are added to the website.
It has been a great pleasure putting together this book and we hope that you also enjoy the experience of reading and learning from the material. We ask that readers send us any feedback and comments so that we can improve the book in future editions. You can send your comments to us using our email addresses.
Theresa Rossouw MBChB, PhD, MPH
Richard J Lessells BSc(MedSci), MBChB, MRCP(UK), DTM&H, DipHIVMed
Tulio de Oliveira BSc, BSc (Hon), PhD
Searching for Virus PhylotypesPirate Science - 2013-01-22
Viral phylogenies have wide use: studying evolution, tracing the origin of epidemics, establishing dominant mode of transmission, identifying the apparition of drug resistance, even tracking individual body compartments.