Perspectives on tuberculosis in pregnancy

Bates, Matthew; Ahmed, Yusuf; Kapata, Nathan; Maeurer, Markus; Mwaba, Peter; Zumla, Alimuddin

doi:10.1016/j.ijid.2014.12.014

Cited by 77 publications

(69 citation statements)

References 50 publications

(57 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Early TB symptoms are often non-specific [23], and overlap with pregnancy symptoms [11]. Poor performance of TB symptom-screening tools has been noted in two recent studies in HIV-infected pregnant women, reporting a sensitivity of 28% and 54%, respectively [24–25].…”

Section: Discussionmentioning

confidence: 99%

“…A two-fold risk of delivering premature (<37 weeks gestational age) and low birth weight (LBW; <2500 grams) infants, and a six-fold increase in perinatal deaths have been reported in women with TB [10]. Limited data are available for TB treatment outcomes in pregnant women with TB, despite both pregnancy and TB linked to poor outcomes [11]. …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Tuberculosis Disease during Pregnancy and Treatment Outcomes in HIV-Infected and Uninfected Women at a Referral Hospital in Cape Town

et al. 2016

View full text Add to dashboard Cite

BackgroundTuberculosis during pregnancy and treatment outcomes are poorly defined in high prevalence tuberculosis and HIV settings.MethodsA prospective cohort study of pregnant and postpartum women identified to be routinely on antituberculosis treatment was conducted at Tygerberg Hospital, Cape Town, South Africa, from January 2011 through December 2011. Maternal tuberculosis disease spectrum and tuberculosis-exposed newborns were characterized by maternal HIV status. Maternal tuberculosis treatment outcomes were documented and a multivariable regression model identified predictors of unfavourable tuberculosis treatment outcomes. Infant outcomes were also described.ResultsSeventy-four women with tuberculosis, 53 (72%) HIV-infected, were consecutively enrolled; 35 (47%) were diagnosed at delivery or postpartum and 22 (30%) of women reported previous antituberculosis treatment. HIV-infected women were 5.67 times more likely to have extrapulmonary tuberculosis (95% CI 1.18–27.25, p = 0.03). All 5 maternal deaths were amongst HIV-infected women. Birth outcomes were available for 75 newborns (2 sets of twins, missing data for 1 stillbirth). Of the 75 newborns, 49 (65%) were premature and 44 (59%) were low birth weight (LBW; <2500 grams). All 6 infants who died and the 4 stillbirths were born to HIV-infected women. Unfavourable tuberculosis treatment outcomes were documented in 33/74 (45%) women. Unfavourable maternal tuberculosis outcome was associated with delivery of LBW infants (OR 3.83; 95% CI 1.40–10.53, p = 0.009).ConclusionsA large number of pregnant women with tuberculosis presented at a provincial referral hospital. All maternal and infant deaths occurred in HIV-infected women and their newborns. Maternal tuberculosis treatment outcomes were poor.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tuberculosis Disease during Pregnancy and Treatment Outcomes in HIV-Infected and Uninfected Women at a Referral Hospital in Cape Town

et al. 2016

View full text Add to dashboard Cite

show abstract

“…[4] One should also not forget tuberculosis (TB), which is still present in population nowadays. [5] It is the time of recession; unemployment is relatively high and poverty is a good base for spreading contagious diseases, especially in population infected by HIV and other immunodeficiency diseases. Some of viruses like cytomegalovirus (CMV) can be transmitted to foetus causing hearing loss and neurological changes.…”

Section: Discussionmentioning

confidence: 99%

Demands of pregnant employees towards clinical hospital centre administration

Lalić¹

2019

JHA

View full text Add to dashboard Cite

The healthcare sector in Croatia is predominantly composed of female employees across all levels. The Clinical Hospital Centre Rijeka with 3,000 employees is no exception. The Republic of Croatia is populated by a little over 4 million inhabitants and the numbers have been in a constant decline due to multiple factors, which include aging of the population and economic migrations. These two factors significantly impact the healthcare workforce and specifically medical personnel. In the era where there are less and less new marriages and newborns, the government struggles for every child and thus offers families exceptional parental benefits. For hospitals, which are mainly staffed by women, confronting the government politics that seek to advantage the pregnant employees’ presents a problem and a significant financial burden. This is due to the fact that they are entitled to the full salary whilst staying at home from the very early stage of pregnancy. Theoretically, if the hospital management offered their pregnant employees all the benefits that law provides, the hospital would soon be left without sufficient number of nurses and particularly doctors, because they would very soon after becoming pregnant simply stop working. The Health and Safety Law states that if the employer in health care, i.e. in a hospital, cannot provide a safe working environment for their pregnant employees, prior to their regular maternity leave financed by the state, they are not obliged to work and are entitled to a full salary, which is financed by the hospital itself. A female medical doctor found the article in the law that allows a full salary when she stopped working. She claimed such a benefit at the very beginning of her otherwise regular pregnancy and soon after that other cases followed. The occupational medicine doctors, after this first claim were soon put in a position to issue another 15 certificates of work incapacity to women at the very early stages of their pregnancy. That seriously exhausts modest hospital funds due to the prevalence of female employees. Thus, in the Clinical Hospital Centre, urgent action is needed to prevent future “epidemic” compensation claims. Occupational Medicine in cooperation with the Health and Safety Service together with the hospital management found a solution to the problem to the mutual benefit of all the parties involved. The personalized work post for pregnant medical staff was to be created, one without the exposure to biotic agents. Pregnant employees can hold administrative or educational work places, and should they feel unwell, they can always take regular sick leave, organised by their family doctor or gynaecologist and paid for by the Croatian Institute for Health Insurance. Pregnancy is not an illness; women can work and help the work of the hospital which is extraordinarily important especially when medical doctors are concerned for their absence is very expensive and hard to compensate. Although the sick leave pays less than the regular salary, the compromise is necessary to maintain the hospital solvent.

show abstract

“…The authors try to gather evidence that there should be special provision made for screening, timely diagnosis and management of pregnant women with TB. 1 …”

Section: Introductionmentioning

confidence: 99%