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Author Notes:

Corresponding author: Lisa M. Cranmer, MD, MPH, Division of Pediatric Infectious Diseases, Emory University School of Medicine, 2015 Uppergate Drive NE, Atlanta, Georgia 30322. Telephone: (404) 727-2905, Fax: (206) 727-9223, lisa.cranmer@emory.edu

LC and AL contributed equally to this work.

LC and GJ-S designed the study.

AL, CM, BS, AK, LN, JK implemented the study.

KR performed data analysis.

LC drafted the manuscript.

AL, CM, JP, BO, BS, AK, LN, JK, SL and GJ-S revised the manuscript.

We thank participants of the study and clinical and laboratory staff at CDC-KEMRI.

We appreciate critical review of the manuscript by Dr. David Horne.

The findings and conclusions in this paper are those of the author(s) and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention/Government of Kenya.

The authors have no other funding or conflicts of interest to disclose.

Subjects:

Research Funding:

This study was supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through U.S. Centers for Disease Control and Prevention, Division of Global HIV/AIDS [5U2GPS002047-09].

This work was also supported by the National Institute of Allergy and Infectious Diseases and the National Institute of Child Health and Human Development at the National Institutes of Health [K24 HD054314-06 to GJS, K12 HD000850 to LMC, T32 AI07140 to SML, T32 AI007140 to CM, T32 CA080416 to KR].

LC was a Fellow of the Pediatric Scientist Development Program (PSDP) supported by an American Pediatric Society and American Academy of Pediatrics grants.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Infectious Diseases
  • Respiratory System
  • tuberculosis screening
  • PMTCT
  • HIV
  • INFECTED PREGNANT-WOMEN
  • ACTIVE TUBERCULOSIS
  • HIGH PREVALENCE
  • SOUTH-AFRICA
  • RISK
  • INFANTS
  • COINFECTION
  • MORTALITY
  • SERVICES

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

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Journal Title:

International Journal of Tuberculosis and Lung Disease

Volume:

Volume 21, Number 3

Publisher:

, Pages 256-262

Type of Work:

Article | Post-print: After Peer Review

Abstract:

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-tosize sampling with oversampling in a high human immunodeficiency virus (HIV) prevalence region. The World Health Organization (WHO) TB symptom screen was administered to HIV-infected mothers, and associations with infant cofactors were determined. R E SULT S : 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 the women, and 15% of the TBexposed women received isoniazid preventive therapy. CONCLUS IONS : 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.

Copyright information:

© 2017 The Union.

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