Use of the Xpert(®) MTB/RIF assay for diagnosing pulmonary tuberculosis comorbidity and multidrug-resistant TB in obstetrics and gynaecology inpatient wards at the University Teaching Hospital, Lusaka, Zambia.
Bottom Line: HIV infection was linked with a 3-fold increase in risk of TB, accounting for 87.5% (21/24) of TB cases. 50% of cases presented as comorbidities with other communicable diseases (CDs) and non-communicable diseases (NCDs).TB and HIV comorbidities with other communicable and non-communicable diseases were also common.More proactive screening for TB comorbidity is required in obstetric and gynaecological wards.
Affiliation: Center for Clinical Microbiology, University College, London, UK.Show MeSH
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Mentions: Ninety-eight inpatients consented to take part in the study and provided sputum for microbiological TB analysis. Four patients were excluded from the analysis (two specimens misplaced, and two cultures were contaminated), and so, the results from a total of 94 patients were analysed (Figure 1). 67.0% (63/94) of recruited women were pregnant or <6 weeks post-natal when recruited, and 33.0% (31/94) were not pregnant or post-natal. Median age was 28 years (IQR: 24–32). HIV status was available for 84 patients, and HIV prevalence was 73.8%. 11 patients had a history of TB treatment, 10 of whom were HIV positive and one was of unknown HIV status (Table 1). The primary admission diagnosis given by the attending physician was recorded. Suspicion of TB alone was noted for 25.5% (24/94) of patients, with an additional 30.9% (29/94) having an admission diagnosis of pneumonia and suspected TB. The remaining 41 patients presented with a range of admission diagnoses including 29.8% (28/94) with other communicable disease conditions and 13.8% (13/94) with non-communicable conditions (11 with clearly defined NCDs, the majority of which were cancer) (Table 2).
Affiliation: Center for Clinical Microbiology, University College, London, UK.