A Model of Tuberculosis Screening for Pregnant Women in Resource-Limited Settings Using Xpert MTB/RIF

Timely diagnosis and treatment of maternal tuberculosis (TB) is important to reduce morbidity and mortality for both the mother and child, particularly in women who are coinfected with HIV. The World Health Organization (WHO) recommends the integration of TB/HIV screening into antenatal services but...

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Bibliographic Details
Published in:Journal of Pregnancy 2012-01, Vol.2012 (2012), p.219-223
Main Authors: Turnbull, Eleanor R., Kancheya, Nzali G., Harris, Jennifer B., Topp, Stephanie M., Henostroza, German, Reid, Stewart E.
Format: Article
Language:English
Subjects:
Antibiotics, Antitubercular - pharmacology
Decision Support Techniques
Developing Countries
DNA, Bacterial - analysis
Drug Resistance, Bacterial
Female
Humans
Mass Screening - instrumentation
Mass Screening - methods
Microbial Sensitivity Tests
Mycobacterium tuberculosis - drug effects
Mycobacterium tuberculosis - genetics
Mycobacterium tuberculosis - isolation & purification
Pregnancy
Pregnancy Complications, Infectious - diagnosis
Prenatal Care - methods
Reagent Kits, Diagnostic
Real-Time Polymerase Chain Reaction
Review
Rifampin - pharmacology
Tuberculosis - diagnosis
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Summary:Timely diagnosis and treatment of maternal tuberculosis (TB) is important to reduce morbidity and mortality for both the mother and child, particularly in women who are coinfected with HIV. The World Health Organization (WHO) recommends the integration of TB/HIV screening into antenatal services but available diagnostic tools are slow and insensitive, resulting in delays in treatment initiation. Recently the WHO endorsed Xpert MTB/RIF, a highly sensitive, real-time PCR assay for Mycobacterium tuberculosis that simultaneously detects rifampicin resistance directly from sputum and provides results within 100 minutes. We propose a model for same-day TB screening and diagnosis of all pregnant women at antenatal care using Xpert MTB/RIF. Pilot studies are urgently required to evaluate strategies for the integration of TB screening into antenatal clinics using new diagnostic technologies.
ISSN:2090-2727
2090-2735
DOI:10.1155/2012/565049