Can positron emission tomography work in the African tuberculosis epidemic?

Abstract

Much is written about the transfer of technology from developed to developing countries. In the area of health care, not only the issue of poverty within the developing countries is there but also the pattern and epidemiology of disease that can be very different. South Africa is in a unique position in which it has an affluent middle class with access to some of the best health care that can be bought; however, there is also much poverty that affects the majority of the population. Access to health care may depend on a number of factors including the educational level and expectations of the patients themselves. South Africa suffered the epidemic of HIV/AIDS later than eastern Africa, but now has some of the highest rates of HIV infection in the world with no clear evidence of the present epidemic abating. In addition, tuberculosis (TB) has re-emerged, a disease that was earlier thought to have been declined. Coexistent infection often with multidrug-resistant TB, and HIV has become, for many, the defining illness in southern Africa in the early 21st century. Therefore, in the scenario where resources are limited such as South Africa, is there a place for an expensive high technology tool such as PET? Is PET essential for these patients or is it seen as an extravagance, which should be reserved only for the rich.