ABSTRACT
Historically and today, tuberculosis (TB) has been associated with economic hardship, urbanization, and other socioeconomic factors linked to deprivation (1-5). Poverty and economic crises have been cited among the causes of the reemergence of TB in established market economies as well as its worsening in the developing world (6). The World Health Organization (WHO) estimates that 95% of the deaths due to TB occur in developing countries (7). Although case detection is improving, only 54% of all estimated infectious TB patients were registered in DOTSbased treatment programs in 2004. Coverage has accelerated but at too
slow a pace to meet the global 2005 TB control targets. It is hypothesized that problems associated with poverty contribute to deficiencies in patient access to, and the impact of, TB services. The HIV/AIDS pandemic and the rapid increase in HIV-associated TB is a further cause for concern, especially as HIV’s impact on poor, highly vulnerable and/or marginalized populations is well-documented.
