Tuberculosis in pregnancy

Mnyani, Coceka Nandipha; Ja, McIntyre

doi:10.1111/j.1471-0528.2010.02771.x

Cited by 65 publications

(43 citation statements)

References 45 publications

(70 reference statements)

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“…Some major controversial issues in TB care during pregnancy remain that require further research, such as the safety, reliability, and feasibility of TB screening methods used in the prenatal period [7], drug therapy for pregnant MDR women [8], and delay of treatment until the post partum period in case of latent tuberculosis infection (LTBI) [9]. LTBI is a condition in which a person is infected with Mycobacterium tuberculosis, but does not currently have active tuberculosis disease.…”

Section: Introductionmentioning

confidence: 99%

Tuberculosis care for pregnant women: a systematic review

et al. 2014

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BackgroundTuberculosis (TB) during pregnancy may lead to severe consequences affecting both mother and child. Prenatal care could be a very good opportunity for TB care, especially for women who have limited access to health services. The aim of this review was to gather and evaluate studies on TB care for pregnant women.MethodsWe used a combination of the terms “tuberculosis” and “pregnancy”, limited to human, to search for published articles. Studies reflecting original data and focusing on TB care for pregnant women were included. All references retrieved were collected using the Reference Manager software (Version 11).ResultsThirty five studies were selected for review and their data showed that diagnosis was often delayed because TB symptoms during pregnancy were not typical. TB prophylaxis and anti-TB therapy appeared to be safe and effective for pregnant women and their babies when suitable follow up and early initiation were present, but the compliance rate to TB prophylaxis is still low due to lack of follow up and referral services. TB care practices in the reviewed studies were in line in principle with the WHO International Standards for Tuberculosis Care (ISTC).ConclusionsIntegration of TB care within prenatal care would improve TB diagnosis and treatment for pregnant women. To improve the quality of TB care, it is necessary to develop national level guidelines based on the ISTC with detailed guidelines for pregnant women.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0617-x) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Tuberculosis care for pregnant women: a systematic review

et al. 2014

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“…8 TB case notifi cation data are not stratifi ed for pregnancy, but women of reproductive age bear a higher burden of TB in sub-Saharan Africa than their male counterparts. 1,9 Data from Western Cape, South Africa, indicate that there is a 24.2-fold higher incidence of TB disease among infants born to HIV-infected mothers, diagnosed at a mean age of 6 months, than among those of HIV-negative mothers. 10 This suggests probable (PMTCT) clinic in Eldoret, Western Kenya.…”

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confidence: 99%

Screening for tuberculosis in pregnancy: do we need more than a symptom screen? Experience from western Kenya

Kosgei¹,

Szkwarko²,

Callens³

et al. 2013

public health action

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underdiagnosis of active TB disease during the antenatal and postnatal periods. HIV and TB co-infection during pregnancy have a multiplier effect on maternal morbidity and mortality, and result in poorer pregnancy outcomes. 1,11 In Pune, India, TB increased the probability of death by 2.2-fold among HIV-infected women who developed TB and by 3.4-fold for their infants compared to women who did not develop TB. 11 In Johannesburg, South Africa, 70% of obstetric deaths in HIV-infected women were mainly attributed to TB. 12 These fi gures suggest that routine screening of pregnant women for TB in endemic settings would be helpful, particularly those who are HIV-infected.The World Health Organization (WHO) recommends ruling out active TB and identifying those in need of further testing among HIV-infected adults using specifi c symptoms (current cough of any duration, fever, weight loss or night sweats). 13 Although these recommendations were not specifi c for pregnancy, Gupta et al. used this recommendation and found a 1.4% (11/799) prevalence of active TB among HIVi nfected pregnant women who were part of a clinical trial in India. 14 Another study of cough of >2 weeks, performed in Kenya by the same clinical team and by the same fi rst author in a routine setting similar to the target population for this study, failed to identify those with TB disease (n = 187). 15 The current study differs from the earlier one in its larger sample size and because it compares HIV-infected and non-infected pregnant women.Data on the utilization of symptom screening among pregnant women in routine settings are scarce. This has been attributed to signifi cant fi nancial and logistical challenges in the implementation of screening in this group of patients. 1 The objectives of the present study were 1) to explore the utility of TB symptom screening using symptoms of ⩾2 weeks' duration in a routine setting, and 2) to compare differences in diagnosis of TB among HIV-infected and non-infected pregnant women in western Kenya. METHODS Study designThis was a descriptive cohort study among HIV-infected and non-infected pregnant women. R eduction of tuberculosis (TB) transmission, morbidity and mortality relies largely on intensifi ed case fi nding, with consequent early initiation of adequate treatment. 1,2 This is particularly important among pregnant women in resource-limited settings where TB is a cause of non-obstetrical (indirect) maternal deaths. 3,4 This burden is higher in settings with a high prevalence of human immunodefi ciency virus (HIV) infection. 5,6 Kenya has an adult HIV prevalence of 6.2%, 7 with an unacceptably high maternal mortality ratio of 488 per 100 000 live births; 25% of these deaths are attributed to indirect causes such as TB, anaemia, HIV and malaria. 8 TB case notifi cation data are not stratifi ed for pregnancy, but women of reproductive age bear a higher burden of TB in sub-Saharan Africa than their male counterparts. 1,9 Data from Western Cape, South Africa, indicate that there is a 24.2-fold higher incidenc...

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“…Исходя из этого ясно, что ранняя диагностика и лечение как ВИЧ, так и туберкулеза имеет решающее значение для улучшения как материнского, так и детского здоровья. ВОЗ рекомендует включить лечение туберкулеза и ВИЧ в дородовые услуги и скрининг на туберкулез всех беременных женщин в районах с высокой распространенностью ВИЧ-инфекции [12]. Хотя наибольшее бремя заражения туберкулеза происходит в странах с низким социальным статусом, сообщается, что в развитых странах наблюдается возрождение туберкулеза за последние несколько лет, главным образом в результате увеличения числа иммигрантов в этих странах.…”

Section: Methodsunclassified