Integrating tuberculosis screening in Kenyan Prevention of Mother-To-Child Transmission programs

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Maternal and Child Health

Background:

• Tuberculosis (TB) screening is vital within Prevention of Mother-To-Child Transmission (PMTCT) programs to enhance TB detection, prevention, and treatment.
• Integrating TB screening into PMTCT services is a key strategy for improving health outcomes for mothers and infants.

Purpose of the Study:

• To evaluate the effectiveness of TB screening in a national PMTCT program in Kenya.
• To determine the association between maternal TB symptom screen results and infant cofactors, including HIV infection and TB symptoms.

Main Methods:

• Mother-infant pairs were enrolled at 141 clinics across Kenya during a national PMTCT program evaluation.
• The World Health Organization (WHO) TB symptom screen was administered to 498 HIV-infected mothers.
• Statistical analyses were performed to identify associations between maternal TB symptoms and infant characteristics.

Main Results:

• 33% of HIV-infected mothers screened positive for TB symptoms.
• Positive maternal TB symptom screens were significantly associated with prior TB diagnosis (P = 0.04).
• Mothers with positive TB screens were more likely to have infants with HIV infection (P = 0.02) and non-specific TB symptoms like cough and fever.

Conclusions:

• Postpartum HIV-infected mothers frequently exhibit symptoms suggestive of TB.
• Maternal TB screening in PMTCT programs can identify mothers at higher risk for TB and those with infants showing concerning symptoms.
• Integrating TB screening and prevention into PMTCT programs holds potential for improved maternal and infant health outcomes.