title: Integrating tuberculosis screening in Kenyan Prevention of Mother-To-Child Transmission programs.
abstract: Tuberculosis (TB) screening in Prevention of Mother-To-Child Transmission (PMTCT) programs is important to improve TB detection, prevention and treatment.
  
  
  
  As part of a national PMTCT program evaluation, mother-infant pairs attending 6-week and 9-month immunization visits were enrolled at 141 maternal and child health clinics throughout Kenya. Clinics were selected using population-proportion-to-size sampling with oversampling in a high human immunodeficiency virus (HIV) prevalence region. The World Health Organization (WHO) TB symptom screen was administered to HIV-infected mothers, and associations with infant cofactors were determined.
  
  
  
  Among 498 HIV-infected mothers, 165 (33%) had a positive TB symptom screen. Positive maternal TB symptom screen was associated with prior TB (P = 0.04). Women with a positive TB symptom screen were more likely to have an infant with HIV infection (P = 0.02) and non-specific TB symptoms, including cough (P = 0.003), fever (P = 0.05), and difficulty breathing (P = 0.01). TB exposure was reported by 11% of the women, and 15% of the TB-exposed women received isoniazid preventive therapy.
  
  
  
  Postpartum HIV-infected mothers frequently had a positive TB symptom screen. Mothers with a positive TB symptom screen were more likely to have infants with HIV or non-specific TB symptoms. Integration of maternal TB screening and prevention into PMTCT programs may improve maternal and infant outcomes.
authors.affiliation: Emory University School of Medicine and Children's Hospital of Atlanta, Atlanta, Georgia, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: Cranmer
authors.affiliation: Centers for Disease Control and Prevention, Nairobi, Kenya.
authors.forename: A
authors.initials: A
authors.lastname: Langat
authors.affiliation: University of Washington, Seattle, Washington.
authors.forename: K
authors.initials: K
authors.lastname: Ronen
authors.affiliation: University of Texas Medical Branch, Galveston, Texas, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: McGrath
authors.affiliation: University of Washington, Seattle, Washington.
authors.forename: S
authors.initials: S
authors.lastname: LaCourse
authors.affiliation: University of Washington, Seattle, Washington.
authors.forename: J
authors.initials: J
authors.lastname: Pintye
authors.affiliation: University of Washington, Seattle, Washington.
authors.forename: B
authors.initials: B
authors.lastname: Odeny
authors.affiliation: Kenya Medical Research Institute, Nairobi.
authors.forename: B
authors.initials: B
authors.lastname: Singa
authors.affiliation: Centers for Disease Control and Prevention, Nairobi, Kenya.
authors.forename: A
authors.initials: A
authors.lastname: Katana
authors.affiliation: Centers for Disease Control and Prevention, Nairobi, Kenya.
authors.forename: L
authors.initials: L
authors.lastname: Nganga
authors.affiliation: Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: J
authors.initials: J
authors.lastname: Kinuthia
authors.affiliation: University of Washington, Seattle, Washington.
authors.forename: G
authors.initials: G
authors.lastname: John-Stewart
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007538:Isoniazid / Q000008:administration & dosage; D007630:Kenya; D008297:Male; D008403:Mass Screening / Q000379:methods*; D049590:Postpartum Period; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000382:microbiology / Q000517:prevention & control; D015995:Prevalence; D014376:Tuberculosis / Q000175:diagnosis* / Q000517:prevention & control / Q000635:transmission; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid