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S Sobhy, Zoe Babiker, J Zamora, K S Khan, H Kunst
BACKGROUND: There is a dearth of data on the clinical features and outcomes of active tuberculosis (TB) in pregnancy. Studies have shown varied results and the relationship between TB and adverse pregnancy outcomes remains unclear. OBJECTIVES: We conducted a systematic review and meta-analysis to evaluate pregnancy outcomes associated with TB. SEARCH STRATEGY: Major databases were searched from inception until December 2015 without restrictions using the terms: 'TB', 'pregnancy', 'maternal morbidity', 'mortality' and 'perinatal morbidity', 'mortality'...
November 11, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Adrie Bekker, Hendrik S Schaaf, Heather R Draper, Magdalena Kriel, Anneke C Hesseling
BACKGROUND: Tuberculosis during pregnancy and treatment outcomes are poorly defined in high prevalence tuberculosis and HIV settings. METHODS: A prospective cohort study of pregnant and postpartum women identified to be routinely on antituberculosis treatment was conducted at Tygerberg Hospital, Cape Town, South Africa, from January 2011 through December 2011. Maternal tuberculosis disease spectrum and tuberculosis-exposed newborns were characterized by maternal HIV status...
2016: PloS One
Graham H Bothamley, Cordula Ehlers, Irina Salonka, Alena Skrahina, Angels Orcau, Luigi R Codecasa, Maurizio Ferrarese, Dragica Pesut, Ivan Solovic, Andrii Dudnyk, Luis Anibarro, Claudia Denkinger, Lorenzo Guglielmetti, Inge Muylle, Marco Confalonieri
BACKGROUND: Objectives: To determine whether the incidence of tuberculosis with pregnancy is more common than would be expected from the crude birth rate; to see whether there is significant delay in the diagnosis of tuberculosis during pregnancy. METHOD: Design: A cross-sectional survey. SETTING: 13 tuberculosis clinics within different European countries and the USA. POPULATION/SAMPLE: All patients with tuberculosis seen at these clinics for a period > 1 year...
October 12, 2016: BMC Pregnancy and Childbirth
G Sulis, S Gnanou, A Roggi, A Konseimbo, P F Giorgetti, F Castelli, A Matteelli
Tuberculosis (TB) is a leading cause of death among women of childbearing age, and may be responsible for severe complications during pregnancy. Between August 2014 and March 2015, we conducted a pilot project to promote active TB case finding in antenatal care (ANC) clinics in the Central Region of Burkina Faso. Our results show very limited TB diagnostic practices and possible severe underdiagnosis of TB at ANC clinics, despite adequate screening practices. Integration of training and supervision of TB diagnosis and treatment into ANC services is required...
October 2016: International Journal of Tuberculosis and Lung Disease
Vijay Kodadhala, Alemeshet Gudeta, Aklilu Zerihun, Odene Lewis, Sohail Ahmed, Jhansi Gajjala, Alicia Thomas
Tuberculosis (TB) infection in pregnant women and newborn babies is always challenging. Appropriate treatment is pivotal to curtail morbidity and mortality. TB diagnosis or exposure to active TB can be emotionally distressing to the mother. Circumstances can become more challenging for the physician if the mother's TB status is unclear. Effective management of TB during pregnancy and the postpartum period requires a multidisciplinary approach including pulmonologist, obstetrician, neonatologist, infectious disease specialist, and TB public health department...
2016: Case Reports in Pulmonology
Seema Chopra, Sujata Siwatch, Neelam Aggarwal, Pooja Sikka, Vanita Suri
Our study sought to determine the characteristics of antenatal patients with tuberculosis (TB) and their pregnancy outcomes. Case records of 50 antenatal women with extra-pulmonary and pulmonary TB at a tertiary centre in India were compared to 150 antenatal women not suffering from TB, for adverse medical, obstetric and neonatal outcomes. The prevalence of TB was 1.16 per 1000 deliveries. Of these, 62% had extra-pulmonary TB. There were two maternal deaths. TB in pregnancy was associated with a five times higher risk of prematurity and three times higher risk of intrauterine growth restriction than the norm...
August 30, 2016: Tropical Doctor
Amira El-Messidi, Nicholas Czuzoj-Shulman, Andrea R Spence, Haim Arie Abenhaim
BACKGROUND: Worldwide, tuberculosis remains a major health concern, with an estimated 9.6 million people infected in the year 2014, of which one-third were women. Tuberculosis is estimated to be even more prevalent in pregnant women than the general population. To date there has been conflicting evidence on the maternal and neonatal complications of tuberculosis in pregnancy. OBJECTIVE: We sought to determine trends in the incidence of tuberculosis in pregnancy and to examine the associations between tuberculosis in pregnancy and maternal and fetal complications...
December 2016: American Journal of Obstetrics and Gynecology
Lindsey K Reif, Vanessa Rivera, Bianca Louis, Rachel Bertrand, Mireille Peck, Benedict Anglade, Grace Seo, Elaine J Abrams, Jean W Pape, Daniel W Fitzgerald, Margaret L McNairy
Adolescents account for 40% of new HIV infections, and HIV testing strategies to increase uptake of testing are needed. A community-based adolescent and youth HIV and health testing campaign was conducted in seven slum neighborhoods of Port-au-Prince, Haiti, from December 2014 to September 2015. Community health workers provided community sensitization and recruited 10- to 24-year-olds to test for HIV, syphilis, gonorrhea/chlamydia, and to screen for tuberculosis (TB) and pregnancy. HIV-infected individuals were escorted to the GHESKIO HIV clinic for same-day enrollment in care...
August 2016: AIDS Patient Care and STDs
Sendhil Coumary Arumugam, Sharmila Murugesan, Sunitha Pradeep, Lopamudra John, Vasavi Kolluru
Occurrence of eclampsia before 20 weeks of pregnancy and after 48 hours of delivery in the absence of typical signs of hypertension and or proteinuria is termed as atypical eclampsia. Atypical or non-classic eclampsia will have some symptoms of eclampsia but without the usual proteinuria or hypertension. All patients with atypical onset should undergo neurological evaluation to rule out neurologic causes of seizures. Cerebral tuberculosis is a rare and serious form of disease secondary to haematogenous spread of Mycobacterium tuberculosis...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
A Franco-Sansaloni, J Vizcaíno-Torres, J Gaona-Morales, D Estellés-Morant, J Antonio-Serrano
BACKGROUND: In the last years has been an increase in cases of tu- berculosis, representing a global health problem that is also reflected in an increased of cases in pregnant population. Especially in developed countries has been observed a direct relation with VIH patients,and groups of immigrants from countries where the infection is endemic. Tuberculous disease during pregnancy presents good outcome if it is diagnosed and treated properly. CASE REPORT: We present the case of a romanian patient with uncon- trolled 23 weeks gestation that enters with the suspicion of chorioam- nionitis and after late septic miscarriage and clinical sepsis criteria, leaks out of the hospital reentering with signs of neurologic involvement and pelviperitonitis as a result of genital tuberculous...
May 2016: Ginecología y Obstetricia de México
Jai B Sharma, Neeta Singh, Sona Dharmendra, Urvashi B Singh, Vanamail P, Sunesh Kumar, K K Roy, Smriti Hari, V Iyer, S K Sharma
OBJECTIVE: To compare six months versus nine months anti-tuberculous therapy in patients of female genital tuberculosis. STUDY DESIGN: It was a randomized controlled trial in a tertiary referral center teaching institute on 175 women presenting with infertility and found to have female genital tuberculosis on clinical examination and investigations. Group I women (86 women) were given 9 months of intermitted anti-tuberculous therapy under directly observed treatment short course (DOTS) strategy while Group II (89 women) were given 6 months of anti-tuberculous therapy under DOTS...
August 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Gerd R Burmester, Robert Landewé, Mark C Genovese, Alan W Friedman, Nathan D Pfeifer, Nupun A Varothai, Ana P Lacerda
BACKGROUND: Adalimumab has been used in patients with moderately to severely active rheumatoid arthritis (RA) for over 10 years and has a well-established safety profile across multiple indications. OBJECTIVE: To update adverse events (AEs) of special interest from global adalimumab clinical trials in patients with RA. METHODS: This analysis includes 15 132 patients exposed to adalimumab in global RA clinical trials. AEs of interest included overall infections, laboratory abnormalities and AEs associated with influenza vaccination...
June 23, 2016: Annals of the Rheumatic Diseases
Tsutomu Shinohara, Kozo Kagawa, Yoshio Okano, Toru Sawada, Tooru Kobayashi, Masaya Takikawa, Yoshihito Iwahara, Fumitaka Ogushi
BACKGROUND: Early postpartum women are more likely to develop tuberculosis than nonpregnant women mainly due to immune reconstitution after delivery. Paradoxical response (PR) during antituberculosis treatment also arises via recovery from immunosuppression. However, no study focused on PR during antituberculosis treatment in a postpartum patient has been reported. CASE PRESENTATION: We present two sequential cases (Patient 1: 26-year-old; Patient 2: 29-year-old) of postpartum tuberculosis with pulmonary and extrapulmonary lesions (Patient 1: peritonitis; Patient 2: psoas abscess secondary to spondylitis)...
2016: BMC Infectious Diseases
Michael K Ghebremariam, V P M G Rutten, J C M Vernooij, K Uqbazghi, T Tesfaalem, T Butsuamlak, A M Idris, M Nielen, A L Michel
BACKGROUND: The prevalence of bovine tuberculosis (BTB) in dairy cattle in the three major milk producing regions of Eritrea was assessed by subjecting 15,354 dairy cattle, 50 % of Eritrea's dairy cattle population, to the single intradermal comparative tuberculin test (SICTT). Skin test results were interpreted according to guidelines of the World Organization for Animal Health (OIE) with >4 mm as cutoff in skin thickness increase. In addition, we studied the relation between 'physiological' variables related to pregnancy and lactation, and the variable 'region' on the probability to be skin test positive...
2016: BMC Veterinary Research
Isabelle Malhamé, Maxime Cormier, Jordan Sugarman, Kevin Schwartzman
BACKGROUND: In countries with low tuberculosis (TB) incidence, immigrants from higher incidence countries represent the major pool of individuals with latent TB infection (LTBI). The antenatal period represents an opportunity for immigrant women to access the medical system, and hence for potential screening and treatment of LTBI. However, such screening and treatment during pregnancy remains controversial. OBJECTIVES: In order to further understand the prevalence, natural history, screening and management of LTBI in pregnancy, we conducted a systematic literature review addressing the screening and treatment of LTBI, in pregnant women without known HIV infection...
2016: PloS One
Shilpa Bhandari, Priya Bhave, Ishita Ganguly, Asha Baxi, Pallavi Agarwal
BACKGROUND: The purpose of the study was to evaluate menstrual and reproductive outcome in patients diagnosed with Asherman's syndrome on hysteroscopy and to assess the role of hysteroscopic adhesiolysis. METHODS: A prospective study was performed for patients having intrauterine adhesion at a tertiary care teaching hospital, Indore, India for a period of 2 years. Findings at hysteroscopy, details of adhesiolysis, changes in menstrual pattern following adhesiolysis, need for repeat procedure and fertility outcome were prospectively collected...
October 2015: Journal of Reproduction & Infertility
(no author information available yet)
In this update, antiretroviral therapy (ART) is recommended for all patients infected by type 1 human immunodeficiency virus (HIV-1). The objective of ART is to achieve an undetectable plasma viral load (PVL). Initial ART should comprise 3 drugs, namely, 2 nucleoside reverse transcriptase inhibitors (NRTI), and 1 drug from another family. Four of the recommended regimens, all of which have an integrase strand transfer inhibitor (INSTI) as the third drug, are considered a preferred regimen; a further 6 regimens, which are based on an INSTI, a non-nucleoside reverse transcriptase inhibitor (NNRTI), or a protease inhibitor boosted with cobicistat or ritonavir (PI/COBI, PI/r), are considered alternatives...
August 2016: Enfermedades Infecciosas y Microbiología Clínica
Vilada Chansamouth, Syvilay Thammasack, Rattanaphone Phetsouvanh, Valy Keoluangkot, Catrin E Moore, Stuart D Blacksell, Josee Castonguay-Vanier, Audrey Dubot-Pérès, Jarasporn Tangkhabuanbutra, Narongchai Tongyoo, Phooksavanh Souphaphonh, Onanong Sengvilaipaseuth, Manivanh Vongsouvath, Koukeo Phommasone, Davanh Sengdethka, Amphayvanh Seurbsanith, Scott B Craig, Laura Hermann, Michel Strobel, Paul N Newton
INTRODUCTION: Laos has the highest maternal mortality ratio in mainland Southeast Asia and a high incidence of infectious diseases. Globally, malaria has been the pathogen most intensively investigated in relation to impact on pregnancy, but there has been relatively little research on the aetiology and impact of other diseases. We therefore aimed to determine the causes and impact of fever in pregnant women admitted to two central hospitals in Vientiane City, Lao PDR (Laos). MATERIALS AND METHODS: This hospital-based prospective study was conducted in Mahosot Hospital and the Mother and Child Hospital, Vientiane, between 2006 and 2010, with the aim to recruit 250 consenting pregnant women admitted with tympanic temperature ≥37...
April 2016: PLoS Neglected Tropical Diseases
Bey-Marrié Schmidt, Amber Abrams, Michele Tameris
BACKGROUND: The South African Tuberculosis Vaccine Initiative is based in Worcester where tuberculosis (TB) is endemic, and incidence rates are amongst the highest nationally. In high TB burden settings after an early childhood peak, incidence rates start to rise again in adolescents, therefore they are an important target group for tuberculosis vaccine research. In 2012, learners from a local school developed a one-off theatrical production out of an educational comic book Carina's Choice, developed by the South African Tuberculosis Vaccine Initiative in 2010...
2016: Trials
Kathryn Schnippel, Norbert Ndjeka, Francesca Conradie, Rebecca Berhanu, Zerilda Claasen, Shabir Banoo, Cynthia Firnhaber
Although there is substantial risk to maternal and neonatal health in the situation of pregnancy during treatment for rifampicin-resistant tuberculosis (RR-TB), there is little evidence to guide clinicians as to how to manage this complexity. Of the 49 680 patients initiated on RR-TB treatment from 2009 to 2014 in South Africa, 47% were women and 80% of them were in their reproductive years (15 - 44). There is an urgent need for increased evidence of the safety of RR-TB treatment during pregnancy, increased access to contraception during RR-TB treatment, and inclusion of reproductive health in research on the prevention and treatment of TB...
April 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
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