Best practices for the care of pregnant people living with TB

Author:

Maugans C.1,Loveday M.2,Hlangu S.2,Waitt C.3,Van Schalkwyk M.4,van de Water B.5,Salazar-Austin N.6,McKenna L.7,Mathad J. S.8,Kalk E.9,Hurtado R.10,Hughes J.11,Eke A. C.12,Ahmed S.13,Furin J.14

Affiliation:

1. Sentinel Project on Pediatric Drug Resistant Tuberculosis, Boston, MA, USA

2. HIV and other Infectious Diseases Research Unit (HIDRU), South African Medical Research Council, Durban, South Africa

3. Department of Pharmacology and Therapeutics, University of Liverpool, UK, and the Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda

4. Division of Adult Infectious Diseases, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa

5. Boston College Connell School of Nursing, Chestnut Hill, MA, USA

6. Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA

7. Treatment Action Group, New York, NY, USA

8. Departments of Medicine and Obstetrics & Gynecology, Center for Global Health, Weill Cornell Medicine, New York, NY, USA

9. Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, South Africa

10. Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, Global Health Committee, Boston, MA, USA

11. Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

12. Division of Maternal Fetal Medicine, Department of Gynecology & Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA

13. Interactive Research and Development, Karachi, Pakistan

14. Harvard Medical School, Department of Global Health and Social Medicine, Boston, MA, USA

Abstract

BACKGROUND: Each year more than 200,000 pregnant people become sick with TB, but little is known about how to optimize their diagnosis and therapy. Although there is a need for further research in this population, it is important to recognize that much can be done to improve the services they currently receive.METHODS: Following a systematic review of the literature and the input of a global team of health professionals, a series of best practices for the diagnosis, prevention and treatment of TB during pregnancy were developed.RESULTS: Best practices were developed for each of the following areas: 1) screening and diagnosis; 2) reproductive health services and family planning; 3) treatment of drug-susceptible TB; 4) treatment of rifampicin-resistant/multidrug-resistant TB; 5) compassionate infection control practices; 6) feeding considerations; 7) counseling and support; 8) treatment of TB infection/TB preventive therapy; and 9) research considerations.CONCLUSION: Effective strategies for the care of pregnant people across the TB spectrum are readily achievable and will greatly improve the lives and health of this under-served population.

Publisher

International Union Against Tuberculosis and Lung Disease

Subject

Infectious Diseases,Pulmonary and Respiratory Medicine

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