Treatment and pregnancy outcomes of pregnant women exposed to second-line anti-tuberculosis drugs in South Africa
Abstract Background Multi-drug resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) in pregnant women is a cause for concern globally; few data have described the safety of second-line anti-TB medications during pregnancy. We aim to describe TB treatment and pregnancy outcomes among pregnant...
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| Format: | Article |
| Language: | English |
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BMC
2021-06-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-021-03956-6 |
| _version_ | 1818966488128684032 |
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| author | Idah Mokhele Nelly Jinga Rebecca Berhanu Thandi Dlamini Lawrence Long Denise Evans |
| author_facet | Idah Mokhele Nelly Jinga Rebecca Berhanu Thandi Dlamini Lawrence Long Denise Evans |
| author_sort | Idah Mokhele |
| collection | DOAJ |
| description | Abstract Background Multi-drug resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) in pregnant women is a cause for concern globally; few data have described the safety of second-line anti-TB medications during pregnancy. We aim to describe TB treatment and pregnancy outcomes among pregnant women receiving second-line anti-tuberculosis treatment for MDR/RR-TB in Johannesburg, South Africa. Methods We conducted a retrospective record review of pregnant women (≥ 18 years) who received treatment for MDR/RR-TB between 01/2010–08/2016 at three outpatient treatment sites in Johannesburg, South Africa. Demographic, treatment and pregnancy outcome data were collected from available medical records. Preterm birth (< 37 weeks), and miscarriage were categorized as adverse pregnancy outcomes. Results Out of 720 women of child-bearing age who received MDR/RR-TB treatment at the three study sites, 35 (4.4%) pregnancies were identified. Overall, 68.7% (24/35) were HIV infected, 83.3% (20/24) were on antiretroviral therapy (ART). Most women, 88.6% (31/35), were pregnant at the time of MDR/RR-TB diagnosis and four women became pregnant during treatment. Pregnancy outcomes were available for 20/35 (57.1%) women, which included 15 live births (11 occurred prior to 37 weeks), 1 neonatal death, 1 miscarriage and 3 pregnancy terminations. Overall, 13/20 (65.0%) women with known pregnancy outcomes had an adverse pregnancy outcome. Of the 28 women with known TB treatment outcomes 17 (60.7%) completed treatment successfully (4 were cured and 13 completed treatment), 3 (10.7%) died and 8 (28.6%) were lost-to-follow-up. Conclusions Pregnant women with MDR/RR-TB suffer from high rates of adverse pregnancy outcomes and about 60% achieve a successful TB treatment outcome. These vulnerable patients require close monitoring and coordinated obstetric, HIV and TB care. |
| first_indexed | 2024-12-20T13:33:42Z |
| format | Article |
| id | doaj.art-c00c7c56d95d4604a4834dc3d07a10ad |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-20T13:33:42Z |
| publishDate | 2021-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-c00c7c56d95d4604a4834dc3d07a10ad2022-12-21T19:39:02ZengBMCBMC Pregnancy and Childbirth1471-23932021-06-0121111110.1186/s12884-021-03956-6Treatment and pregnancy outcomes of pregnant women exposed to second-line anti-tuberculosis drugs in South AfricaIdah Mokhele0Nelly Jinga1Rebecca Berhanu2Thandi Dlamini3Lawrence Long4Denise Evans5Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the WitwatersrandHealth Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the WitwatersrandHealth Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the WitwatersrandRight To CareHealth Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the WitwatersrandHealth Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the WitwatersrandAbstract Background Multi-drug resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) in pregnant women is a cause for concern globally; few data have described the safety of second-line anti-TB medications during pregnancy. We aim to describe TB treatment and pregnancy outcomes among pregnant women receiving second-line anti-tuberculosis treatment for MDR/RR-TB in Johannesburg, South Africa. Methods We conducted a retrospective record review of pregnant women (≥ 18 years) who received treatment for MDR/RR-TB between 01/2010–08/2016 at three outpatient treatment sites in Johannesburg, South Africa. Demographic, treatment and pregnancy outcome data were collected from available medical records. Preterm birth (< 37 weeks), and miscarriage were categorized as adverse pregnancy outcomes. Results Out of 720 women of child-bearing age who received MDR/RR-TB treatment at the three study sites, 35 (4.4%) pregnancies were identified. Overall, 68.7% (24/35) were HIV infected, 83.3% (20/24) were on antiretroviral therapy (ART). Most women, 88.6% (31/35), were pregnant at the time of MDR/RR-TB diagnosis and four women became pregnant during treatment. Pregnancy outcomes were available for 20/35 (57.1%) women, which included 15 live births (11 occurred prior to 37 weeks), 1 neonatal death, 1 miscarriage and 3 pregnancy terminations. Overall, 13/20 (65.0%) women with known pregnancy outcomes had an adverse pregnancy outcome. Of the 28 women with known TB treatment outcomes 17 (60.7%) completed treatment successfully (4 were cured and 13 completed treatment), 3 (10.7%) died and 8 (28.6%) were lost-to-follow-up. Conclusions Pregnant women with MDR/RR-TB suffer from high rates of adverse pregnancy outcomes and about 60% achieve a successful TB treatment outcome. These vulnerable patients require close monitoring and coordinated obstetric, HIV and TB care.https://doi.org/10.1186/s12884-021-03956-6Multi-drug-resistant tuberculosisRifampicin resistanceSouth AfricaPregnancyHIVSecond-line anti-TB treatment |
| spellingShingle | Idah Mokhele Nelly Jinga Rebecca Berhanu Thandi Dlamini Lawrence Long Denise Evans Treatment and pregnancy outcomes of pregnant women exposed to second-line anti-tuberculosis drugs in South Africa BMC Pregnancy and Childbirth Multi-drug-resistant tuberculosis Rifampicin resistance South Africa Pregnancy HIV Second-line anti-TB treatment |
| title | Treatment and pregnancy outcomes of pregnant women exposed to second-line anti-tuberculosis drugs in South Africa |
| title_full | Treatment and pregnancy outcomes of pregnant women exposed to second-line anti-tuberculosis drugs in South Africa |
| title_fullStr | Treatment and pregnancy outcomes of pregnant women exposed to second-line anti-tuberculosis drugs in South Africa |
| title_full_unstemmed | Treatment and pregnancy outcomes of pregnant women exposed to second-line anti-tuberculosis drugs in South Africa |
| title_short | Treatment and pregnancy outcomes of pregnant women exposed to second-line anti-tuberculosis drugs in South Africa |
| title_sort | treatment and pregnancy outcomes of pregnant women exposed to second line anti tuberculosis drugs in south africa |
| topic | Multi-drug-resistant tuberculosis Rifampicin resistance South Africa Pregnancy HIV Second-line anti-TB treatment |
| url | https://doi.org/10.1186/s12884-021-03956-6 |
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