Review

. 2023 May 1;27(5):357-366.

doi: 10.5588/ijtld.23.0031.

Best practices for the care of pregnant people living with TB

C Maugans¹, M Loveday², S Hlangu², C Waitt³, M Van Schalkwyk⁴, B van de Water⁵, N Salazar-Austin⁶, L McKenna⁷, J S Mathad⁸, E Kalk⁹, R Hurtado¹⁰, J Hughes¹¹, A C Eke¹², S Ahmed¹³, J Furin¹⁴

Affiliations

¹ Sentinel Project on Pediatric Drug Resistant Tuberculosis, Boston, MA, USA.
² HIV and other Infectious Diseases Research Unit (HIDRU), South African Medical Research Council, Durban, South Africa.
³ Department of Pharmacology and Therapeutics, University of Liverpool, UK, and the Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda.
⁴ Division of Adult Infectious Diseases, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
⁵ Boston College Connell School of Nursing, Chestnut Hill, MA, USA.
⁶ Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁷ Treatment Action Group, New York, NY, USA.
⁸ Departments of Medicine and Obstetrics & Gynecology, Center for Global Health, Weill Cornell Medicine, New York, NY, USA.
⁹ Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, South Africa.
¹⁰ Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, Global Health Committee, Boston, MA, USA.
¹¹ Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
¹² Division of Maternal Fetal Medicine, Department of Gynecology & Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
¹³ Interactive Research and Development, Karachi, Pakistan.
¹⁴ Harvard Medical School, Department of Global Health and Social Medicine, Boston, MA, USA.

PMID: 37143222
PMCID: PMC10171489
DOI: 10.5588/ijtld.23.0031

Review

Best practices for the care of pregnant people living with TB

C Maugans et al. Int J Tuberc Lung Dis. 2023.

. 2023 May 1;27(5):357-366.

doi: 10.5588/ijtld.23.0031.

Authors

Affiliations

¹ Sentinel Project on Pediatric Drug Resistant Tuberculosis, Boston, MA, USA.
² HIV and other Infectious Diseases Research Unit (HIDRU), South African Medical Research Council, Durban, South Africa.
³ Department of Pharmacology and Therapeutics, University of Liverpool, UK, and the Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda.
⁴ Division of Adult Infectious Diseases, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
⁵ Boston College Connell School of Nursing, Chestnut Hill, MA, USA.
⁶ Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁷ Treatment Action Group, New York, NY, USA.
⁸ Departments of Medicine and Obstetrics & Gynecology, Center for Global Health, Weill Cornell Medicine, New York, NY, USA.
⁹ Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, South Africa.
¹⁰ Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, Global Health Committee, Boston, MA, USA.
¹¹ Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
¹² Division of Maternal Fetal Medicine, Department of Gynecology & Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
¹³ Interactive Research and Development, Karachi, Pakistan.
¹⁴ Harvard Medical School, Department of Global Health and Social Medicine, Boston, MA, USA.

PMID: 37143222
PMCID: PMC10171489
DOI: 10.5588/ijtld.23.0031

Abstract
in English, French

BACKGROUND: Each year more than 200,000 pregnant people become sick with TB, but little is known about how to optimize their diagnosis and therapy. Although there is a need for further research in this population, it is important to recognize that much can be done to improve the services they currently receive.METHODS: Following a systematic review of the literature and the input of a global team of health professionals, a series of best practices for the diagnosis, prevention and treatment of TB during pregnancy were developed.RESULTS: Best practices were developed for each of the following areas: 1) screening and diagnosis; 2) reproductive health services and family planning; 3) treatment of drug-susceptible TB; 4) treatment of rifampicin-resistant/multidrug-resistant TB; 5) compassionate infection control practices; 6) feeding considerations; 7) counseling and support; 8) treatment of TB infection/TB preventive therapy; and 9) research considerations.CONCLUSION: Effective strategies for the care of pregnant people across the TB spectrum are readily achievable and will greatly improve the lives and health of this under-served population.

CONTEXTE :: Chaque année, environ 200 000 femmes enceintes contractent la TB, mais peu de données sont disponibles pour savoir comment optimiser leur expérience diagnostique et thérapeutique. Si davantage d’études doivent être réalisées dans cette population, beaucoup peut être fait pour améliorer les services dont elle bénéficie.

MÉTHODES :: Une série de « bonnes pratiques » pour le diagnostic, la prévention et le traitement de la TB pendant la grossesse a été élaborée en prenant appui sur une revue systématique de la littérature, ainsi que grâce à la contribution d’une équipe internationale de professionnels de la santé travaillant sur les questions relatives à la TB chez les femmes enceintes.

RÉSULTATS :: Des bonnes pratiques ont été élaborées dans chacun des domaines suivants : 1) dépistage et diagnostic ; 2) services de santé génésique et planification familiale ; 3) traitement de la TB pharmacosensible ; 4) traitement de la TB résistante à la rifampicine et multirésistante ; 5) pratiques compatissantes de contrôle des infections ; 6) considérations relatives à l’alimentation ; 7) conseil et soutien ; 8) traitement de l’infection tuberculeuse/traitement préventif de la TB ; et 9) considérations relatives à la recherche.

CONCLUSION :: Des stratégies efficaces pour améliorer la prise en charge des femmes enceintes tout au long du spectre de la TB sont à la portée des prestataires et des programmes et sont susceptibles d’améliorer considérablement la vie et la santé de cette population mal prise en charge.

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Figures

**Figure**
Treatment journey, barriers and best practices for pregnant people with TB

See this image and copyright information in PMC

References

1. World Health Organization Geneva, Switzerland: WHO; 2022. Global TB Report, 2022.
1. Sugarman J, et al. Tuberculosis in pregnancy: an estimate of the global burden of disease. Lancet Glob Health. 2014;2(12):e710–e716. - PubMed
1. Grange J, et al. Tuberculosis in association with HIV/AIDS emerges as a major nonobstetric cause of maternal mortality in Sub-Saharan Africa. Int J Gynaecol Obstet. 2010;108:181–183. - PubMed
1. Zumla A, Bates M, Mwaba P. The neglected global burden of tuberculosis in pregnancy. Lancet Glob Health. 2014;2(12):e675–676. - PubMed
1. Gupta A, et al. Toward earlier inclusion of pregnant and postpartum women in tuberculosis drug trials: consensus statements from an International Expert Panel. Clin Infect Dis. 2016;62(6):761–769. - PMC - PubMed

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Best practices for the care of pregnant people living with TB

Affiliations

Best practices for the care of pregnant people living with TB

Authors

Affiliations

Abstract
in English, French

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Medical

Abstract in English, French

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References

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MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Abstract
in English, French