Operational challenges undermine the WHO TB symptom screen in pregnant women in India

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Open Forum Infectious Diseases

Background. Pregnancy increases both a woman's risk of developing tuberculosis (TB) and her likelihood to seek health care. A symptom screen that is effective during pregnancy would therefore be valuable. We assessed a World Health Organization (WHO)-recommended TB symptom screen in an antenatal setting in India.

Methods. This was a cross-sectional study of women presenting to the antenatal clinic at a government hospital in Pune, India. We collected medical history and administered the WHO TB symptom screen: cough of any duration, fever, weight loss, or night sweats. All HIV positive women, and HIV negative women with at least one symptom, provided sputum samples, which were analyzed by direct sputum smear and GeneXpert.

Results. From November 2014 to May 2015, 479 pregnant women enrolled. Median gestational age was 29 (IQR: 22-34) weeks. Of the 34 (7 %) HIV positive women, 33 (97 %) were on antiretroviral therapy with a median CD4 count of 547 (IQR: 403-707).

Akanksha Vaidya, Sanjaykumar Tambe, Ramesh Bhosale, Vidya Mave, Jessica Elf, Neeta Pradhan, Neetal Nevrekar, Sandesh Patil, Anju Kagal, Samir Joshi, Ajay Chandanwale, Amita Gupta, Jyoti S. Mathad, Operational Challenges Undermine World Health Organization Tuberculosis Symptom Screen in Pregnant Women, Open Forum Infectious Diseases, Volume 2, Issue suppl_1, December 2015, 557, https://doi.org/10.1093/ofid/ofv133.431