Document Detail

Vertical transmission of Mycobacterium tuberculosis in KwaZulu Natal: impact of HIV-1 co-infection.
MedLine Citation:
PMID:  14974747     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Increases in perinatal TB have paralleled the exacerbation of the TB epidemic in KwaZulu Natal. The exact risks for vertical transfer of Mycobacterium tuberculosis (VTRTB) to the baby are unknown, as is the impact of HIV-1 co-infection, which frequently accompanies maternal TB disease in the region. DESIGN: Prospective case series study of 82 HIV-1-infected and 25 non-infected pregnant mothers, King Edward VIII Hospital, KwaZulu Natal, South Africa. RESULTS: Perinatal mortality in HIV-1/TB diseased mothers was 85/1000 and associated with maternal anaemia (P = 0.02); 46% of newborns were premature, 66% low birth weight and 49% intrauterine growth restricted. These were significantly higher than overall hospital rates (P < 0.01, OR 4.8, 95%CI 3.2-7.0). Sites of detection of maternal TB, distribution of bacteriologically-proven TB, obstetric comorbidity and perinatal morbidity were similar in HIV-1-infected and non-infected mothers. VTRTB was detected in 16 newborns (16%), occurring similarly in bacteriologically-proven and suspected maternal TB disease, with no difference between HIV-1-infected and non-infected mothers. Eleven newborns with VTRTB were HIV-1 exposed; 64% acquired HIV-1 and died from rapidly progressive disease by 10 months of age. HIV-1-infected mothers and their exposed newborns had significantly lower CD4 counts. No association between perinatal maternal viral load, CD4 count or VTRTB was detected. CONCLUSION: Mothers with TB disease in pregnancy are at risk for significant perinatal morbidity, mortality and VTRTB.
T Pillay; A W Sturm; M Khan; M Adhikari; J Moodley; C Connolly; D Moodley; N Padayatchi; A Ramjee; H M Coovadia; J L Sullivan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease     Volume:  8     ISSN:  1027-3719     ISO Abbreviation:  Int. J. Tuberc. Lung Dis.     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-02-20     Completed Date:  2004-05-19     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9706389     Medline TA:  Int J Tuberc Lung Dis     Country:  France    
Other Details:
Languages:  eng     Pagination:  59-69     Citation Subset:  IM    
Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
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MeSH Terms
AIDS-Related Opportunistic Infections / diagnosis,  epidemiology,  transmission*
Confidence Intervals
Developing Countries
Infant, Newborn
Infectious Disease Transmission, Vertical / statistics & numerical data*
Mycobacterium tuberculosis / isolation & purification
Odds Ratio
Pregnancy Complications, Infectious / diagnosis*,  epidemiology
Pregnancy Outcome*
Prenatal Care
Risk Assessment
South Africa / epidemiology
Tuberculosis / diagnosis,  epidemiology,  transmission*
Grant Support
R03 TW0 1006-01/TW/FIC NIH HHS

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