Screening for tuberculosis in pregnancy: do we need more than a symptom screen? Experience from western Kenya
Screening for tuberculosis in pregnancy: do we need more than a symptom screen? Experience from western Kenya
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DOI：
10.5588/pha.13.0073
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发表时间：
2013-12-21
影响因子：
1.4
通讯作者：
Carter, E. J.
中科院分区：
文献类型：
--
作者：
Kosgei, R. J.;Szkwarko, D.;Carter, E. J.
目的：1）探讨结核病症状筛查对结核病患者的诊断价值。2周的持续时间在常规设置，和2）比较人类免疫缺陷病毒（HIV）感染和非HIV感染的孕妇在肯尼亚西部的结核病诊断的差异。设计：比较横断面研究中的孕妇与已知的艾滋病毒状态筛查结核病从2010年到2012年，在肯尼亚西部埃尔多雷特。在2983名参与者中，分别有34名（1%）、1488名（50.5%）和1461名（49.5%）的HIV状态未知、阳性和阴性。HIV感染者和非感染者的中位年龄分别为30岁（四分位距[IQR] 26-35）和26岁（IQR 24-31）。在HIV感染和未感染的妇女中，分别有8%（119/1488）和5%（67/1461）的妇女出现阳性症状筛查。HIV感染妇女入组时的中位CD 4计数为377个细胞/μ l（IQR 244-530）。1例非HIV感染者出现抗HIV抗体阳性。在感染艾滋病毒的妇女中，根据临床症状和胸部X光检查，1%（16/1488）的结核病患者被推定接受了治疗。累计，抗结核治疗提供给0.6%（17/2949）的participator.Conclusion：这项研究似乎并没有证明结核病症状筛查问卷的效用在常规设置中的孕妇，无论是HIV感染或非感染，在肯尼亚西部。
Objectives: 1) To explore the utility of tuberculosis (TB) symptom screening for symptoms of. 2 weeks' duration in a routine setting, and 2) to compare differences in TB diagnosis between human immunodeficiency virus (HIV) infected and non-HIV-infected pregnant women in western Kenya.Design: Comparative cross-sectional study among pregnant women with known HIV status screened for TB from 2010 to 2012, in Eldoret, western Kenya.Results: Of 2983 participants, respectively 34 (1%), 1488 (50.5%) and 1461 (49.5%) had unknown, positive and negative HIV status. The median age was respectively 30 years (interquartile range [IQR] 26-35) and 26 years (IQR 24-31) in HIV-infected and non-infected participants. A positive symptom screen was found in respectively 8% (119/1488) and 5% (67/1461) of the HIV-infected and non-infected women. The median CD4 count at enrolment was 377 cells/mu l (IQR 244-530) for HIV-infected women. One non-HIV-infected patient was sputump ositive. For HIV-infected women, TB was presumptively treated in 1% (16/1488) based on clinical symptoms and chest X-ray. Cumulatively, anti-tuberculosis treatment was offered to 0.6% (17/2949) of the participants.Conclusion: This study does not seem to demonstrate the utility of TB symptom screening questionnaires in a routine setting among pregnant women, either HIV-infected or non-infected, in western Kenya.