Integrating tuberculosis screening into antenatal visits to improve tuberculosis diagnosis and care: Results from a pilot project in Pakistan

Ali, Rozina Feroz; Siddiqi, Danya Arif; Malik, Amyn A.; Shah, Mubarak Taighoon; Khan, Aamir; Hussain, Hamidah; Chandir, Subhash

doi:10.1016/j.ijid.2021.05.072

Cited by 6 publications

(2 citation statements)

References 28 publications

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“… 23–25 38 39 45 50–52 58 59 63–69 72–75 78 80 Other TB-related maternal outcomes included deaths, 19 21 28 30 32 33 36 41 42 47–49 56 81 82 lost to follow-up, 41 83 TB treatment failure 57 or unknown. 18 22 26 44 Across 16 case series, 19 29 49 53 61 76 77 81 83 a case-control study 41 and cohort studies 31 33 42 62 82 84 that provided descriptive data of TB outcomes, there were a total of 402 cases. Of those, 259 (64%) had an outcome of treatment completed/cured, 49 (12%) were lost to follow-up, 29 (7%) died, 5 (1%) failed treatment, 4 (1%) deteriorated in clinical condition, 5 (1%) with unknown outcome and 46 were on treatment at the time of data collection.…”

Section: Resultsmentioning

confidence: 99%

Examining family planning and adverse pregnancy outcomes for women with active tuberculosis disease: a systematic review

et al. 2022

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Objectives(1) Summarise and evaluate the current evidence of tuberculosis (TB)-associated pregnancy outcomes, (2) evaluate the state of the science of family planning during TB treatment and (3) provide recommendations to move forward to improve care and outcomes during TB disease.DesignSystematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.Data sourcesPubMed, Embase, CINAHL, Cochrane, Web of Science and Scopus were searched from September 2009 to November 2021.Eligibility criteriaStudies were included if they assessed pregnant women with active TB, drug-resistant TB (DR-TB) or TB/HIV coinfection and examined pregnancy, maternal, fetal/birth and TB or TB/HIV coinfection outcomes. Studies were also included if they examined family planning services among women initiating TB treatment.Data extraction and synthesisTwo independent reviewers extracted data using PRISMA guidelines and conducted quality assessment using the Joanna-Briggs Institute Critical Appraisal Tools. The level of evidence was reported using the Johns Hopkins Evidence-Based Practice guidelines.Results69 studies were included in this review. Case reports, case series, case controls, cohort studies, secondary data analyses and a service delivery improvement project conducted in 26 countries made up the totality of the evidence. Most studies reported pregnancy complications for mothers (anaemia, postpartum haemorrhage, deaths) and fetuses or newborns (low birth weight, premature birth, and spontaneous or induced abortions). Few studies discussed the value of offering family planning to prevent adverse pregnancy outcomes. One study examined the effect of a provider training on contraceptive use with reported increased contraceptive use.ConclusionsIntegrating family planning services within a TB treatment programme is essential to reduce adverse TB-associated maternal-child outcomes. Despite well-established adverse pregnancy outcomes, little attention has been paid to family planning to prevent poor pregnancy outcomes for women with TB/DR-TB. Recommendations for clinicians, TB programmes and researchers are provided and reflect evidence presented in this review.

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Section: Resultsmentioning

confidence: 99%

Examining family planning and adverse pregnancy outcomes for women with active tuberculosis disease: a systematic review

et al. 2022

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“…For regions with a high disease burden, universal screening for TB among pregnant women is preferable, restricting screening to symptomatic women would reduce the yield as asymptomatic cases would not be tested [ 49 , 50 ]. For regions with a low disease burden, screening should be targeting selected at-risk pregnant women for early case finding and prevention of spread, as demonstrated in Denmark where >90% of TB in pregnancy and puerperium were diagnosed in immigrants, especially from Africa, with < 3 years’ median time of stay in Denmark [ 51 ], and in Sweden where increased risk was concentrated amongst women originating from countries with high TB incidence [ 52 ].…”

Section: Management Of Tb In Pregnant Womenmentioning

confidence: 99%