The Intersection Between Tuberculosis and Maternal and Newborn Health

Presentation at the Global Maternal Newborn Health Conference, October 21, 2015

Background: Tuberculosis (TB) is estimated to be responsible for up to 15% of maternal mortality worldwide. While there is no evidence that pregnancy increases the likelihood of new TB infection or TB activation, pregnancy can mask TB symptoms. It is essential to address all prevalent contributors to maternal morbidity & mortality; and TB disease detection in maternal-newborn health (MNH) programs may be warranted in high burden countries.

Methodology: Vertical approaches to caring for pregnant women presenting with non-specific clinical symptoms contributes to delayed access to appropriate diagnosis and treatment of common and serious illnesses. A review of the current literature and progress in implementation of TB-MNH integrated programs will be explored. Challenges and best practices will be reviewed, with a particular focus on country examples with different epidemics with regards to incidence of TB and prevalence of HIV.

Results: The minimum package of care, the prevalence of disease, the yield of a screening test specific to a population (i.e. HIV), human resource availability, and diagnostic accessibility contribute to the feasibility and success of decreasing maternal and newborn morbidity and mortality due to tuberculosis.

Conlusion: A strategy to improve TB case detection throughout pregnancy and the post-partum period, through interventions focused on strengthening the basic package of healthcare services, needs to be considered, particularly in countries with a high incidence of TB and/or high prevalence of HIV.