TB preventive treatment among pregnant women with HIV.

TB preventive treatment among pregnant women with HIV.
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DOI:
10.5588/ijtld.21.0477
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发表时间:
2022-08-01
期刊:
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
影响因子:
--
通讯作者:
Rangaka MX
Rangaka MX
中科院分区:
其他
文献类型:
--
作者:
DeAtley T;Hamada Y;Baddeley A;Werner P;Kanchar A;Zignol M;Rangaka MX

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世界卫生组织建议对包括孕妇在内的艾滋病毒感染者进行结核病预防治疗。目前尚不清楚该亚人群是否接受这一政策建议,以及国家是否与世卫组织的指导意见保持一致。我们在38个世卫组织结核病和结核病-艾滋病毒高负担国家进行了一项政策审查,以评估感染艾滋病毒的孕妇接受TPT政策是否符合世卫组织2018年LTBI规划管理更新和综合指南。数据来源包括结核病国家指南和艾滋病毒/艾滋病/抗逆转录病毒药物国家指南,并辅以世卫组织以前就政策接受情况进行的调查结果。世卫组织为获得产前保健的感染艾滋病毒的妇女提供结核病预防治疗的政策得到了适度采纳:64%(36个国家中的23个)明确建议至少一项关于在感染艾滋病毒的孕妇中筛查、检测或治疗LTBI的临床指南或政策建议。各国在应提供破伤风三联疗法的怀孕阶段有相当大的差异。两个国家(5%)为孕妇提供临床监测建议。感染艾滋病毒的孕妇适度接受TPT政策。未能将TPT作为产前或预防母婴服务的一部分提供,错失了控制结核病的机会。
The WHO recommends TB preventive treatment (TPT) for people living with HIV, including pregnant women. Uptake of this policy recommendation in this subpopulation and country alignment with WHO guidance is unclear. We conducted a policy review in 38 WHO high TB and TB-HIV burden countries to assess if the uptake of TPT policy among pregnant women living with HIV was in line with the WHO’s 2018 Updated and Consolidated Guidelines for Programmatic Management for LTBI. Data sources included TB national guidelines and HIV/AIDS/ART national guidelines, complemented by results from a previous survey on policy uptake held at the WHO. Uptake of WHO policy to provide TB preventive treatment among women with HIV accessing antenatal care was moderate: 64% (23 of 36 countries) explicitly recommended at least one clinical guideline or policy recommendation on screening, testing or treatment of LTBI among pregnant women living with HIV. There was considerable variation between countries on the stages in pregnancy that TPT should be provided. Two countries (5%) provided clinical monitoring recommendations for pregnant women. There is moderate uptake of TPT policy for pregnant women with HIV. Failure to provide TPT as part of antenatal or prevention of mother-to-child services is a missed opportunity for TB control.
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