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Integrating tuberculosis screening in Kenyan prevention of mother-to-child transmission programs
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Mar 01 2017
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Source: Int J Tuberc Lung Dis. 21(3):256-262
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Alternative Title:Int J Tuberc Lung Dis
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Description:Background
Tuberculosis (TB) screening in prevention of mother-to-child transmission (PMTCT) programs is important to improve TB detection, prevention and treatment.
Methods
As part of a national PMTCT program evaluation, mother-infant pairs attending 6-week and 9-month immunization visits were enrolled at 141 maternal and child health clinics throughout Kenya. Clinics were selected using population-proportion-to-size sampling with oversampling in a high HIV prevalence region. The World Health Organization (WHO) TB symptom screen was administered to HIV-infected mothers and associations with infant cofactors were determined.
Results
Among 498 HIV-infected mothers, 165 (33%) had a positive TB symptom screen. Positive maternal TB symptom screen was associated with prior TB (p=0.04). Women with a positive TB symptom screen were more likely to have an infant with HIV infection (p=0.02) and non-specific TB symptoms, including cough (p=0.003), fever (p=0.05), and difficulty breathing (p=0.01). TB exposure was reported by 11% of women, and 15% of TB-exposed women received isoniazid preventive therapy.
Conclusions
Postpartum HIV-infected mothers frequently had a positive TB symptom screen. Mothers with a positive TB symptom screen were more likely to have infants with HIV or non-specific TB symptoms. Integration of maternal TB screening and prevention into PMTCT programs may improve maternal and infant outcomes.
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Pubmed ID:28225335
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Pubmed Central ID:PMC5729039
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