title: A model of tuberculosis screening for pregnant women in resource-limited settings using Xpert MTB/RIF.
abstract: Timely diagnosis and treatment of maternal tuberculosis (TB) is important to reduce morbidity and mortality for both the mother and child, particularly in women who are coinfected with HIV. The World Health Organization (WHO) recommends the integration of TB/HIV screening into antenatal services but available diagnostic tools are slow and insensitive, resulting in delays in treatment initiation. Recently the WHO endorsed Xpert MTB/RIF, a highly sensitive, real-time PCR assay for Mycobacterium tuberculosis that simultaneously detects rifampicin resistance directly from sputum and provides results within 100 minutes. We propose a model for same-day TB screening and diagnosis of all pregnant women at antenatal care using Xpert MTB/RIF. Pilot studies are urgently required to evaluate strategies for the integration of TB screening into antenatal clinics using new diagnostic technologies.
authors: Tuberculosis Department, Centre for Infectious Disease Research in Zambia, 5977 Benakale Road, P.O. Box 34681, Northmead, Lusaka, Zambia; Schools of Medicine and Public Health, University of Alabama at Birmingham, AL 35233, USA. eleanor.turnbull@cidrz.org
authors: Eleanor R
authors: ER
authors: Turnbull
authors: Nzali G
authors: NG
authors: Kancheya
authors: Jennifer B
authors: JB
authors: Harris
authors: Stephanie M
authors: SM
authors: Topp
authors: German
authors: G
authors: Henostroza
authors: Stewart E
authors: SE
authors: Reid
mesh_terms: D000904:Antibiotics, Antitubercular / Q000494:pharmacology; D004269:DNA, Bacterial / Q000032:analysis; D003661:Decision Support Techniques; D003906:Developing Countries; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000295:instrumentation / Q000379:methods*; D008826:Microbial Sensitivity Tests; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011295:Prenatal Care / Q000379:methods*; D011933:Reagent Kits, Diagnostic; D060888:Real-Time Polymerase Chain Reaction; D012293:Rifampin / Q000494:pharmacology; D014376:Tuberculosis / Q000175:diagnosis*
chemical_list: D000904:Antibiotics, Antitubercular; D004269:DNA, Bacterial; D011933:Reagent Kits, Diagnostic; D012293:Rifampin