BackgroundHIV-associated tuberculosis (TB) is a major cause of death among pregnant women in South Africa. Isoniazid prevention therapy (IPT) strategy was implemented in South Africa concurrently with life-long antiretroviral therapy (ART) to reduce the TB-associated morbidity and mortality in individuals living with HIV. This study assessed the extent of the implementation of IPT and the performance of the Mantoux test by geographic settings of health facilities and residences of pregnant women living with HIV in the Eastern Cape, South Africa.MethodsWe conducted a data analysis of 1709 pregnant women enrolled in the new electronic database of the prevention of mother-to-child transmission programme of the East London Prospective Cohort Study. Relevant data on place of residence and antenatal care, performance of the Mantoux test and subsequent initiation of IPT were obtained. Descriptive and inferential statistics were employed to analyse the geographical variations and accessibility to Mantoux test and IPT.ResultsThe analysis shows that Mantoux test was performed on 803 pregnant women (47%) with significant geographical variation. After controlling for relevant covariates, pregnant women who resided in rural areas (AOR:0.63; CI: 0.47–0.84) compared to those who resided in urban areas were significantly less likely to receive Mantoux test. The rate of uptake of IPT was 79% with significant geographic variations. In the unadjusted model, rural place of residence (UOR:0.68; CI: 0.49–0.96) was independently associated with lower likelihood of uptake of INH prophylaxis; however, the effect was not significant after controlling for important covariates.ConclusionsThe high uptake rate of isoniazid prevention therapy in pregnant women living with HIV at the study sites is commendable; however, concerted efforts are needed to address the inequality gaps in the roll-out of IPT. Poor performance of Mantoux test is a serious concern and requires the attention of TB programme managers and other relevant authorities.

Clinicians notify positive results of the severe acute respiratory syndrome coronavirus-2 polymerase chain reaction to patients and/or relatives, whilst short message service (SMS) has been adopted as a means of disseminating negative results. Therefore, clinicians should be adequately equipped to provide telephonic consultation whilst delivering a positive test result to patients. The news of the coronavirus disease 2019 (COVID-19) test result often invokes fear of impending death in patients, especially the elderlies and those with comorbidities. In addition, several survivors have reported persistent symptoms and COVID-19-related stigma, which precludes them from immediate re-integration into their workplaces. Consequently, COVID-19 results are perceived as bad news by the members of the public. This article justifies why COVID-19 test results are bad news and also discusses the notification steps to follow when delivering COVID-19 results, whilst also addressing patients’ immediate concerns. The article concludes by highlighting an important safety net for COVID-19 patients and the attending clinician.