Mycobacterium tuberculosis Infection in Pregnant and Nonpregnant Women Infected With HIV in the Women and Infants Transmission Study

Mofenson, Lynne; Rodriguez, Evelyn M.; Hershow, Ronald C.; Fox, H.; Landesman, Sheldon; Tuomala, Ruth; Díaz, Clemente; Daniels, Elaine; Brambilla, Donald

doi:10.1001/archinte.1995.00430100094011

Cited by 26 publications

(16 citation statements)

References 20 publications

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“…BCG vaccination can also lead to TST positive results in healthy women [11],[28]. In a high HIV prevalence setting, other tests and clinical symptoms should therefore be taken into account in diagnosing TB [41] and the TST and anergy skin tests (the latter is used to evaluate whether the immune system is functioning properly or not and can indicate whether the results of the other skin test are reliable) are recommended as a TB screening method in the prenatal care procedures [31]. In populations in which the majority of people are BCG vaccinated or their vaccination status is uncertain, TST is discouraged and IGRA is recommended for TB screening and diagnosis [11],[28].…”

Section: Resultsmentioning

confidence: 99%

“…Results are therefore not solid enough to be applicable to a larger population. Another limitation was that few studies had control groups; some used comparison groups that were not fully comparable with the study group [16]-[18],[20],[25],[28],[31],[39]. Furthermore, the study designs were weak, since no randomised controlled trials were present.…”

Section: Discussionmentioning

confidence: 99%

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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: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Tuberculosis care for pregnant women: a systematic review

et al. 2014

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“…We found that the risk of both LTBI and active TB was greatest among PLHIV from ethnic minorities; particularly those of black African, South Asian or Hispanic ethnicity. 13,15,17,19,23,25,31,32,37,43,44,46,49,52,53 Similarly, PLHIV who were born in, or long-term residents of, countries with high TB incidence had higher rates of LTBI and active TB. [10][11][12][13]17,18,[22][23][24]26,45,56 Few studies examined the effects of country of birth and ethnicity independently of each other; those that did found no independent associations between ethnicity and country of birth and active TB 34,46 or LTBI.…”

Section: Ethnicity and Country Of Birthmentioning

confidence: 99%

Tuberculosis infection and disease in people living with HIV in countries with low tuberculosis incidence

Winter

et al. 2018

int j tuberc lung dis

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In countries with low tuberculosis (TB) incidence, TB is concentrated in vulnerable populations, including people living with the human immunodeficiency virus (PLHIV), who have a substantially greater risk of TB than people without HIV. We searched PubMed, EMBASE and Web of Science for studies evaluating the risk factors for latent tuberculous infection (LTBI) or active TB in PLHIV in countries with TB incidence 10 per 100 000 population. Due to the number of risk factors evaluated and heterogeneity in study designs, we present summary data and a narrative synthesis. We included 45 studies: 17 reported data on the risk factors for LTBI and 32 on active TB. Black, Asian or Hispanic ethnicity, birth or long-term residence in a country with high TB incidence, and HIV acquisition via injecting drug use (IDU) or heterosexual sex were strong predictors of both LTBI and active TB. History of contact, a greater degree of immunosuppression at diagnosis or higher viral load increased the TB risk. Early HIV diagnosis to allow timely initiation of antiretroviral therapy is essential for the prevention of TB in PLHIV. Screening and treating PLHIV for LTBI to reduce the risk of progression to active TB disease should also be considered to further reduce the burden of active TB in low TB incidence settings. Research to support the expansion of TB and HIV prevention and treatment globally is essential to eliminate TB in low-incidence settings.

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“…Prolonged debility, nutritional deficiency, lack of social support, complications of TB and need for prolonged anti-TB medications put an enormous pressure on maternal physical and mental health. 5,8,10,11,32 Although most studies suggest that pregnancy does not alter the course and outcome of TB, [35][36][37][38][39][40] the quality of controls in these studies is questionable because of the practical difficulties of finding non-pregnant controls, who could be adequately matched for the severity of disease. Progress of TB is rare during pregnancy provided the women are compliant to drug therapy.…”

Section: Diagnosis Of Tb In Pregnancymentioning

confidence: 99%

Tuberculosis in pregnancy: The challenges for South Asian countries

Jana

Barik²,

Arora

et al. 2012

J of Obstet and Gynaecol

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Abstractj og_1856 1125..1136Aim: Despite tuberculosis (TB) being a global problem, maternal TB remains an unrecognized and underestimated tragedy, especially in South Asian countries. Therefore, we performed a non-systematic review regarding implications of maternal TB on obstetric and perinatal outcomes in the South Asian context. Material and Methods:We reviewed original studies, both descriptive and analytical, that originated from South Asian countries following an electronic search supplemented by a manual search. Although relevant studies from developed countries were reviewed, they were not included in the tabulation process because those studies had different socioeconomic/epidemiological background. Results: Diagnosis of TB is often delayed during pregnancy, because of its non-specific symptoms, and overlapping presentation with other infectious diseases. Poverty, undernutrition, lack of social support and poor health infrastructure along with complications of TB and need for prolonged medications lead to increased maternal morbidity and mortality. Maternal TB in general (except lymphadenitis), is associated with an increased risk of small-for-gestational age, preterm and low-birthweight neonates, and high perinatal mortality. These adverse perinatal outcomes are even more pronounced in women with advanced disease, late diagnosis, and incomplete or irregular drug treatment. There could be a synergy of TB, socioeconomic and nutritional factors, which might have contributed to adverse perinatal effects, especially in low-income countries. Conclusions: As active TB poses grave maternal and perinatal risks, early, appropriate and adequate anti-TB treatment is a mainstay for successful pregnancy outcome. The current knowledge gaps in perinatal implications of maternal TB can be addressed by a multicenter comparative cohort study.

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Mycobacterium tuberculosis Infection in Pregnant and Nonpregnant Women Infected With HIV in the Women and Infants Transmission Study

Cited by 26 publications

References 20 publications

Tuberculosis care for pregnant women: a systematic review

Tuberculosis care for pregnant women: a systematic review

Tuberculosis infection and disease in people living with HIV in countries with low tuberculosis incidence

Tuberculosis in pregnancy: The challenges for South Asian countries

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