The increasing burden of tuberculosis in pregnant women, newborns and infants under 6 months of age in Durban, Kwazulu Natal
Objectives. In spite of the global epidemic of tuberculosis (TB) which has been exacerbated by HIV, the impact of these coinfections on maternal and perinatal health has been limited. We document new evidence from Durban, KwaZulu- Natal, on the increasing effects of TB in pregnant women, neonates and infants.
Method. Women with TB were prospectively tudied at the antenatal clinics and obstetric and labour ward at King Edward VIII Hospital, Durban, between 1996 and 1998. The incidence of TB was calculated, and the populationattributable fraction of TB due to HIV infection in pregnancy was estimated. Concurrently, culture-confirmed cases of Mycobacterium tuberculosis in neonates and infants under 6 months of age at the hospital were documented.
Results. One hundred and forty-six cases of maternal TB were detected. TB occurred in 0.1% and 0.6% of matemities in 1996 and 1998 respectively. Overall, TB rate for HIV non-infected matemities was 72.9/1<f, and for HIV-infected maternities, 774.5/10'. The attributable fraction of TB related to HIV in pregnancy was 71.7%; 10.3% of these mother died. There was a 2.2-fold increase in the caseload of culture-confirmed TB in neonates and young infants at the hospital.
Conclusion. In regions where TB and HIV prevalence is high, efforts to improve maternal and perinatal health must include the detection of TB in pregnancy.
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