Latent tuberculosis among pregnant mothers in a resource poor setting in Northern Tanzania: a cross-sectional study.
Latent tuberculosis among pregnant mothers in a resource poor setting in Northern Tanzania: a cross-sectional study.
复制标题
DOI：
10.1186/1471-2334-10-52
复制
发表时间：
2010-03-07
影响因子：
3.7
通讯作者：
Karimjee TS
中科院分区：
文献类型：
--
作者：
Sheriff FG;Manji KP;Manji MP;Chagani MM;Mpembeni RM;Jusabani AM;Alwani ZR;Karimjee TS
未经治疗的潜伏性结核感染（LTBI）是活动性肺结核的一个重要危险因素，因此易导致不良妊娠结局和母婴传播。评估了妊娠期潜伏性结核病的患病率及其与各种社会人口统计学、产科和临床特征的相关性（如有）。选择坦桑尼亚北方作为研究地点。在一项横断面研究中，共对286名孕龄12周至足月的孕妇进行了评估。筛查采用的算法包括结核菌素皮肤试验、问卷形式的症状筛查、痰液抗酸杆菌检测，然后根据需要进行屏蔽式胸部X线检查。还对知情同意的参与者进行了HIV血清学检查。潜伏感染率为26.2%~ 37.4%，血清感染率为4.5%。多因素Logistic回归分析发现，年龄、产次、体重指数、孕龄和HIV血清状态与结核菌素皮试结果无显著相关性。然而，与其他种族相比，某些种族群体对LTBI的易感性较低（卡方= 10.55，p = 0.03）。所有痰涂片抗酸杆菌均为阴性。与一般人群相比，孕妇潜伏性结核病的发病率相对较高。在结核病流行地区，仅凭社会人口学参数很少足以确定易感染结核病的妇女;因此，应对所有活化风险高的孕妇（特别是艾滋病毒阳性妇女）进行有针对性的筛查。与目前被动发现病例的政策相反，似乎迫切需要转向主动筛查。种族可能提供了重要的线索，遗传和文化差异，易患潜伏性结核病，值得进一步探讨。
Untreated latent TB infection (LTBI) is a significant risk factor for active pulmonary tuberculosis, hence predisposing to adverse pregnancy outcomes and mother to child transmission. The prevalence of latent tuberculosis in pregnancy and its association, if any, with various socio-demographic, obstetric and clinical characteristics was evaluated. Northern Tanzania was chosen as the study site. In a cross-sectional study, a total of 286 pregnant women from 12 weeks gestational age to term were assessed. Screening was undertaken using an algorithm involving tuberculin skin testing, symptom screening in the form of a questionnaire, sputum testing for acid fast bacilli followed by shielded chest X-rays if indicated. HIV serology was also performed on consenting participants. Prevalence of latent infection ranged between 26.2% and 37.4% while HIV sero prevalence was 4.5%. After multivariate logistic analysis it was found that age, parity, body mass index, gestational age, and HIV sero status did not have any significant association with tuberculin skin test results. However certain ethnic groups were found to be less vulnerable to LTBI as compared to others (Chi square = 10.55, p = 0.03). All sputum smears for acid fast bacilli were negative. The prevalence of latent tuberculosis in pregnant women was found to be relatively high compared to that of the general population. In endemic areas, socio-demographic parameters alone are rarely adequate in identifying women susceptible to TB infection; therefore targeted screening should be conducted for all pregnant women at high risk for activation (especially HIV positive women). As opposed to the current policy of passive case detection, there appears to be an imminent need to move towards active screening. Ethnicity may provide important clues into genetic and cultural differences which predispose to latent tuberculosis, and is worth exploring further.
登录
查看更多内容
影响因子：
7.7
作者：
Smith, B;Ryan, MAK;Trump, DH
通讯作者：
Trump, DH
影响因子：
3.7
作者：
Nguyen, Tuan H.;Odermatt, Peter;Barennes, Hubert
通讯作者：
Barennes, Hubert
DOI：
10.1016/0020-7292(94)90064-7
发表时间：
1994-02-01
影响因子：
3.8
作者：
JANA, N;VASISHTA, K;GHOSH, K
通讯作者：
GHOSH, K
影响因子：
3.8
作者：
Chum, HJ;OBrien, RJ;Rieder, HL
通讯作者：
Rieder, HL
影响因子：
3.8
作者：
Bucher, HC;Griffith, LE;Battegay, M
通讯作者：
Battegay, M