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MAKING PREGNANCY A MISSED OPPORTUNITY FOR TREATMENT OF TUBERCULOSIS INFECTION : A SYSTEMATIC REVIEW

Medical and Health Science Journal

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Title MAKING PREGNANCY A MISSED OPPORTUNITY FOR TREATMENT OF TUBERCULOSIS INFECTION : A SYSTEMATIC REVIEW
 
Creator Atmaja, Sardjana
Gumilar, Gulam
 
Subject TB infection (TBI)
HIV-infected
Tuberculin Skin Test (TST)
 
Description Background : Eleven million Americans, representing 4% of the U.S. general population, are estimated to have latent tuberculosis infection (LTBI). In countries with low TB incidence, immigrant from higher incidence countries form the major pool of infected individuals. To understand the prevalence, screening and management of TBI in pregnancy.
Methods : A systematic review of 4 databases (Embase, Embase Classic, Medline, Cochrane Library) covering articles published from January 1st 2010 to April 30th 2018. Articles in English with relevant information on prevalence, screening strategies and treatment of TBI during pregnancy were eligible for inclusion.
Results : Of 193 titles initially identified, 108 abstracts were eligible for review. Of these, 86 articles qualified for full text review and 22 were retained: 3 cohort studies, 2 case-control studies, and 17 cross-sectional studies. In the USA, the estimated prevalence of TBI ranged from 14 to 48% in women tested, and tuberculin skin test (TST) positivity was associated with ethnicity. The proportion of women who attended follow-up visits after positive tuberculin tests varied from 14 to 69%, while 5 to 42% of those who attended follow-up visits completed a minimum of 6 months of isoniazid treatment. One study raised the possibility of an association of pregnancy/post-partum state with INH hepatitis (risk ratio 2,5, 95% CI 0.8–8.2) and fatal hepatotoxicity (rate ratio 4.0, 95% CI 0.2–258). One study deemed INH safe during breastfeeding based on peak concentrations in plasma and breast milk after INH administration.
Conclusion : Pregnancy is an opportunity to screen for TBI. Interferongamma release assays are likely comparable to tuberculin skin tests and may be used during pregnancy. Efforts should be made to improve adherence with follow-up and treatment post-partum. Further data are needed with respect to safety and feasibility of antepartum INH therapy, and with respect to alternative treatment regimens.
 
Publisher UNUSA Press
 
Date 2021-09-23
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Peer-reviewed Article
 
Format application/pdf
 
Identifier https://journal2.unusa.ac.id/index.php/MHSJ/article/view/2081
10.33086/mhsj.v5i2.2081
 
Source Medical and Health Science Journal; Vol. 5 No. 2 (2021): AUGUST; 57-70
Jurnal Ilmu Kesehatan dan Kesehatan; Vol 5 No 2 (2021): AUGUST; 57-70
2549-7596
2549-7588
10.33086/mhsj.v5i2
 
Language eng
 
Relation https://journal2.unusa.ac.id/index.php/MHSJ/article/view/2081/1487
 
Rights Copyright (c) 2021 Sardjana Atmaja, Gulam Gumilar
https://creativecommons.org/licenses/by-sa/4.0