Combining PMTCT with active case finding for tuberculosis

Paula B N Kali, Glenda E. Gray, Avy Violari, Richard E Chaisson, James A. McIntyre, Neil A. Martinson

Research output: Contribution to journalArticle

Abstract

Tuberculosis (TB) is the preeminent manifestation of HIV infection and has become a leading cause of maternal mortality and morbidity in high HIV-prevalence settings. Active TB in pregnant women has potentially serious consequences for fetuses and newborns. In Soweto, South Africa, there is a more than 90% uptake of voluntary counseling and HIV testing during routine antenatal care, and almost one third of pregnant women are HIV-infected. The posttest counseling session of the prevention of mother-to-child transmission program provides an opportunity to screen HIV-infected pregnant women for TB. In this study, 370 HIV-infected pregnant women were screened for symptoms of active TB by lay counselors at the posttest counseling session. If symptomatic, they were referred to nurses who investigated them further. Eight women were found to have previously undiagnosed, smear-negative, culture-confirmed TB (2160/100,000). The mean CD4 count in those with active TB compared to those without TB was 276 × 106 cells per liter vs 447 × 106 cells per liter (P = 0.051). Symptoms most associated with active TB were hemoptysis and fever. We conclude that rates of TB in HIV-infected pregnant women are high, and screening for TB during routine antenatal care should be implemented in high HIV-prevalence settings.

Original languageEnglish (US)
Pages (from-to)379-381
Number of pages3
JournalJournal of Acquired Immune Deficiency Syndromes
Volume42
Issue number3
DOIs
StatePublished - Jul 2006

Fingerprint

Tuberculosis
HIV
Pregnant Women
Counseling
Prenatal Care
Hemoptysis
Maternal Mortality
CD4 Lymphocyte Count
South Africa
HIV Infections
Fetus
Fever
Nurses
Mothers
Newborn Infant
Morbidity

Keywords

  • Africa
  • HIV
  • Opportunistic infections
  • Pregnant
  • Tuberculosis
  • VCT

ASJC Scopus subject areas

  • Virology
  • Immunology

Cite this

Combining PMTCT with active case finding for tuberculosis. / Kali, Paula B N; Gray, Glenda E.; Violari, Avy; Chaisson, Richard E; McIntyre, James A.; Martinson, Neil A.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 42, No. 3, 07.2006, p. 379-381.

Research output: Contribution to journalArticle

Kali, Paula B N ; Gray, Glenda E. ; Violari, Avy ; Chaisson, Richard E ; McIntyre, James A. ; Martinson, Neil A. / Combining PMTCT with active case finding for tuberculosis. In: Journal of Acquired Immune Deficiency Syndromes. 2006 ; Vol. 42, No. 3. pp. 379-381.
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