Tuberculosis and Sexual and Reproductive Health of Women in Four African Countries

Abstract

Tuberculosis (TB) is a major reason of maternal mortality in low-income countries, and it increases the probability of adverse sexual and reproductive health (SRH) outcomes, including ectopic pregnancy and perinatal mortality. The data presented here is from the TB Sequel observational cohort conducted in four African countries. For this sub-study, we selected only female participants, who were diagnosed with drug susceptible TB and followed-up until the end of anti-TB treatment. The data collection included questionnaires, clinical examination and laboratory tests at TB diagnosis, day 14, month 2, 4 and 6. A total of 486 women, with 88.3% being 18–49 years old, were included in the analysis. Around 54.7% were HIV positive. Most of the participants (416/486; 85.6%) in our cohort were considered cured at month 6. Only 40.4% of non-pregnant women of reproductive age used contraception at TB diagnosis. A total of 31 out of 486 women experienced pregnancy during TB treatment. Pregnancy outcomes varied between live birth (16/31; 51.6%), induced abortion (6/31; 19.4%), miscarriage (4/31; 12.9%) and stillbirth (3/31; 9.6%). Integration and linking of SRH services with TB programmes are vital to increase contraception use and protect women from obstetric risks associated with pregnancy during TB treatment.

Chest X-ray predicts cases of pulmonary tuberculosis among women of reproductive age with acute respiratory symptoms: A multi-center cross-sectional study

“…Tuberculosis (TB) is a leading infectious cause of morbidity and mortality, including in women of reproductive age (WRA) between the ages of 15 and 49, with an estimated 1.6 million deaths in 2021 [1] , [2] , [3] . Of all HIV-related TB deaths worldwide in 2020, about half are women [4] and almost 90% of HIV-related TB deaths in women occur in sub-Saharan Africa (SSA) [5] .…”

“…Of all HIV-related TB deaths worldwide in 2020, about half are women [4] and almost 90% of HIV-related TB deaths in women occur in sub-Saharan Africa (SSA) [5] . Although most TB cases are still diagnosed in men [1] , reported cases in WRA are increasing in SSA [2] , [6] . Most available anti-TB regimens are safe and effective even during pregnancy, with a good compliance rate reported [7] , [8] , Yet TB patients are often diagnosed late in the disease course, with 60% of the estimated number of cases going undiagnosed or unreported in 2021 [1] , [9] .…”