Tuberculosis (TB) is a
significant contributor to mortality in HIV-infected patients. Concurrent TB
infection is also a significant contributing factor to maternal mortality in
human immunodeficiency virus (HIV)-infected pregnant women. Studies addressing
the outcomes of TB and HIV co-infection among pregnant women are generally
infrequent.
Although limited, the records maintained by the Revised National
Tuberculosis Control Programme (RNTCP) and the National AIDS Control Programme
(NACP) in Karnataka State, Southern India provide information about the numbers
of pregnant women who are co-infected with TB and HIV and their pregnancy
outcomes. We reviewed the data and conducted this study to understand how
TB-HIV co-infection influences the outcomes of pregnancy in this setting. We
sought to determine the incidence and treatment and delivery outcomes of TB-HIV
co-infected pregnant women in programmatic settings in Karnataka State in
southern India.
The study participants were all the HIV-infected pregnant women
who were screened for tuberculosis under the NACP from 2008 to 2012. For the
purposes of this study, the program staff in the field gathered the data
regarding on treatment and delivery outcomes of pregnant women. A total of
seventeen pregnant women with TB-HIV co-infection were identified among
3,165,729 pregnant women (for an incidence of 5.4 per million pregnancies).
The
median age of these pregnant women was 24 years, and majority were primiparous
women with WHO HIV stage III disease and were on a stavudine-based ART regimen.
The maternal mortality rates were 18% before delivery and 24% after delivery.
The abortion rate was 24%, and the neonatal mortality rate was 10%. The
anti-tuberculosis treatment and anti-retroviral treatment outcome mortality
rates were 30% and 53%, respectively.
Although the incidence of TB among the
HIV-infected pregnant women was marginally less than that among the
non-HIV-infected women, the delivery outcomes were relatively poorer.
The
current strategy for the management of TB among the HIV-positive pregnant women
needs urgent review.
Purchase full article at: http://goo.gl/o4LGRn
By:
- 1State Tuberculosis Office, Bangalore, India.
- 2ESIC Medical College and PGIMSR, Bangalore, India. Electronic address: sharathbn@yahoo.com.
- 3St. John's Medical College Hospital, Bangalore, India.
- 4Karnataka State AIDS Prevention Society, Bangalore, India.
- 5School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
- 6National AIDS Control Organization, New Delhi, India.
More at: https://twitter.com/hiv
insight
No comments:
Post a Comment