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Related Experiment Videos

Combining PMTCT with active case finding for tuberculosis.

Paula B N Kali1, Glenda E Gray, Avy Violari

  • 1Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa.

Journal of Acquired Immune Deficiency Syndromes (1999)
|April 29, 2006
PubMed
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Tuberculosis (TB) is common in pregnant women with HIV. Screening for TB during antenatal care is crucial in high HIV prevalence areas to protect mothers and newborns.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Maternal Health

Background:

  • Tuberculosis (TB) is a major complication of HIV infection, significantly increasing maternal mortality and morbidity in high HIV prevalence regions.
  • Active TB during pregnancy poses severe risks to both the fetus and the newborn.
  • In Soweto, South Africa, HIV affects nearly one-third of pregnant women attending antenatal care, highlighting the need for integrated screening programs.

Purpose of the Study:

  • To determine the prevalence of undiagnosed active tuberculosis (TB) among HIV-infected pregnant women in Soweto, South Africa.
  • To evaluate the feasibility of screening for TB symptoms during routine antenatal care post-test counseling sessions.
  • To identify key symptoms indicative of active TB in this population.

Main Methods:

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  • A screening program was implemented for 370 HIV-infected pregnant women during their post-test counseling sessions for prevention of mother-to-child transmission.
  • Lay counselors initially screened women for TB symptoms.
  • Symptomatic women were referred to nurses for further investigation, including smear microscopy and culture confirmation for TB.

Main Results:

  • Eight cases of previously undiagnosed, smear-negative, culture-confirmed TB were identified, indicating a prevalence of 2160 per 100,000 women.
  • Women with active TB had a lower mean CD4 count (276 x 10^6 cells/L) compared to those without TB (447 x 10^6 cells/L), P=0.051.
  • Hemoptysis and fever were the symptoms most strongly associated with active TB in HIV-infected pregnant women.

Conclusions:

  • Active TB is highly prevalent among HIV-infected pregnant women in high HIV prevalence settings like Soweto.
  • Integrating TB screening into routine antenatal care, specifically during post-test counseling, is a viable strategy.
  • Early detection and management of TB in pregnant women are essential to reduce maternal and infant morbidity and mortality.