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| Name | Class |
|---|---|
| Centre for Infectious Disease Research in Zambia | OTHER |
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This is a pilot pulmonary TB screening program done in three antenatal care clinics in Lusaka, Zambia to determine the prevalence of culture-confirmed pulmonary tuberculosis and to determine the sensitivity and specificity of symptom-based TB screening.
5000 pregnant women attending antenatal clinics will be evaluated by piloting a TB symptom questionnaire as part of the general health screening done at each visit. Due to the atypical and subclinical presentation of TB in HIV infected patients, culture will be performed on all HIV-infected pregnant women, with or without symptoms, and on all symptomatic HIVnegative women. Referrals for TB treatment in accordance with current national guidelines will be offered.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| HIV negative pregnant women | Other | Pregnant women who are HIV negative attending their first ANC visit |
|
| HIV positive pregnant women | Other | Pregnant women who are HIV positive accessing antenatal care. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TB screening Questionnaire | Other | All subjects will be screened with the questionnaire which assesses TB symptoms. |
|
| Measure | Description | Time Frame |
|---|---|---|
| number of positive pulmonary tuberculosis (PTB) tests | The prevalence of culture confirmed PTB among HIV positive and HIV negative pregnant women will be measured to determine if there is a substantial amount of undiagnosed TB in the HIV positive population accessing antenatal care. | 1 day of screening (first antenatal visit) |
| Measure | Description | Time Frame |
|---|---|---|
| Sensitivity and specificity of symptom-based TB screening | To determine the sensitivity and specificity of symptom based TB screening (compared to TB culture), enrollees will have TB symptoms assessed by administration of a questionnaire. Culture will then be performed on all HIV infected pregnant women, with or without symptoms, and on all symptomatic HIV negative women. | 1 day of screening visit |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Stewart Reid, MD | Centre for Infectious Disease Research in Zambia | Principal Investigator |
| Nzali Kancheya, MMED, MPH | Centre for Infectious Disease Research in Zambia | Principal Investigator |
| Michael Saag, MD | Professor, University of Alabama | Principal Investigator |
| German Henostroza, MD | Centre for Infectious Disease Research in Zambia | Principal Investigator |
| Annika Kruuner, MD | Centre for Infectious Disease Research in Zambia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre for Infectious Disease Research in Zambia | Lusaka | Zambia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Global tuberculosis control: Epidemiology, Strategy, Financing. WHO report 2009. 2009, World Health Organization: Geneva, Switzerland. | ||
| 19622990 | Background | Black V, Brooke S, Chersich MF. Effect of human immunodeficiency virus treatment on maternal mortality at a tertiary center in South Africa: a 5-year audit. Obstet Gynecol. 2009 Aug;114(2 Pt 1):292-299. doi: 10.1097/AOG.0b013e3181af33e6. | |
| 12640889 |
| Label | URL |
|---|---|
| University of North Carolina website | View source |
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| ID | Term |
|---|---|
| D014397 | Tuberculosis, Pulmonary |
| D014376 | Tuberculosis |
| ID | Term |
|---|---|
| D009164 | Mycobacterium Infections |
| D000193 | Actinomycetales Infections |
| D016908 | Gram-Positive Bacterial Infections |
| D001424 | Bacterial Infections |
Not provided
Not provided
| ID | Term |
|---|---|
| D046508 | Culture Techniques |
| D012847 | Single Person |
| ID | Term |
|---|---|
| D066298 | In Vitro Techniques |
| D008919 | Investigative Techniques |
| D017533 | Marital Status |
| D005191 | Family Characteristics |
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|
| Sputum smear and culture (only in HIV negative women who are symptomatic) | Other | specimens for sputum microscopy and culture collected and processed in accordance with WHO TB Infection Control Guidelines |
|
| Background |
| Mwaba P, Maboshe M, Chintu C, Squire B, Nyirenda S, Sunkutu R, Zumla A. The relentless spread of tuberculosis in Zambia--trends over the past 37 years (1964-2000). S Afr Med J. 2003 Feb;93(2):149-52. |
| Background | WHO. TB Country Profile for Zambia: Surveillance and Epidemiology. 2009 [cited; Available from: http://apps.who.int/globalatlas/predefinedReports/TB/PDF_Files/zmb.pdf |
| 19440346 | Background | Ayles H, Schaap A, Nota A, Sismanidis C, Tembwe R, De Haas P, Muyoyeta M, Beyers N; Peter Godfrey-Faussett for the ZAMSTAR Study Team. Prevalence of tuberculosis, HIV and respiratory symptoms in two Zambian communities: implications for tuberculosis control in the era of HIV. PLoS One. 2009;4(5):e5602. doi: 10.1371/journal.pone.0005602. Epub 2009 May 19. |
| 12628525 | Background | Tripathy SN, Tripathy SN. Tuberculosis and pregnancy. Int J Gynaecol Obstet. 2003 Mar;80(3):247-53. doi: 10.1016/s0020-7292(02)00393-4. |
| 9142060 | Background | Murray CJ, Lopez AD. Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet. 1997 May 3;349(9061):1269-76. doi: 10.1016/S0140-6736(96)07493-4. |
| 9432391 | Background | Harries AD, Parry C, Nyongonya Mbewe L, Graham SM, Daley HM, Maher D, Salaniponi FM, Nyangulu DS. The pattern of tuberculosis in Queen Elizabeth Central Hospital, Blantyre, Malawi: 1986-1995. Int J Tuberc Lung Dis. 1997 Aug;1(4):346-51. |
| 11579249 | Background | Khan M, Pillay T, Moodley JM, Connolly CA; Durban Perinatal TB HIV-1 Study Group. Maternal mortality associated with tuberculosis-HIV-1 co-infection in Durban, South Africa. AIDS. 2001 Sep 28;15(14):1857-63. doi: 10.1097/00002030-200109280-00016. |
| Background | WHO. Fact Sheet- Women and TB; 2009. 2009 [cited; Available from: http://www.stoptb.org/resource_center/assets/factsheets/womenandtb.pdf |
| 11847922 | Background | Pillay T, Khan M, Moodley J, Adhikari M, Padayatchi N, Naicker V, Pillay DG, Coovadia HM. The increasing burden of tuberculosis in pregnant women, newborns and infants under 6 months of age in Durban, KwaZulu-Natal. S Afr Med J. 2001 Nov;91(11):983-7. |
| Background | Celine R. Gounder, M., ScM*, Nikolas Wada, MPH*, Caroline Kensler, MHS*, Avy Violari, MD**, Richard E. Chaisson, MD*, James McIntyre, MBChB, FRCOG***, Neil Martinson, MBChB, MPH*,**, Provider-Initiated Screening for Tuberculosis (TB) among Pregnant Women in Antenatal Clinics in Soweto, South Africa, in 17th Conference on Retroviruses and Opportunistic Infections. 2010: San Francisco, CA. February 16 - 19 2010. |
| 16645548 | Background | Kali PB, Gray GE, Violari A, Chaisson RE, McIntyre JA, Martinson NA. Combining PMTCT with active case finding for tuberculosis. J Acquir Immune Defic Syndr. 2006 Jul;42(3):379-81. doi: 10.1097/01.qai.0000218434.20404.9c. |
| 17578786 | Background | Gupta A, Nayak U, Ram M, Bhosale R, Patil S, Basavraj A, Kakrani A, Philip S, Desai D, Sastry J, Bollinger RC; Byramjee Jeejeebhoy Medical College-Johns Hopkins University Study Group. Postpartum tuberculosis incidence and mortality among HIV-infected women and their infants in Pune, India, 2002-2005. Clin Infect Dis. 2007 Jul 15;45(2):241-9. doi: 10.1086/518974. Epub 2007 Jun 4. |
| 10460099 | Background | Ahmed Y, Mwaba P, Chintu C, Grange JM, Ustianowski A, Zumla A. A study of maternal mortality at the University Teaching Hospital, Lusaka, Zambia: the emergence of tuberculosis as a major non-obstetric cause of maternal death. Int J Tuberc Lung Dis. 1999 Aug;3(8):675-80. |
| 8190429 | Background | Margono F, Mroueh J, Garely A, White D, Duerr A, Minkoff HL. Resurgence of active tuberculosis among pregnant women. Obstet Gynecol. 1994 Jun;83(6):911-4. doi: 10.1097/00006250-199406000-00001. |
| 1209197 | Background | Bjerkedal T, Bahna SL, Lehmann EH. Course and outcome of pregnancy in women with pulmonary tuberculosis. Scand J Respir Dis. 1975;56(5):245-50. |
| 9643636 | Background | Figueroa-Damian R, Arredondo-Garcia JL. Pregnancy and tuberculosis: influence of treatment on perinatal outcome. Am J Perinatol. 1998 May;15(5):303-6. doi: 10.1055/s-2007-993948. |
| 7911094 | Background | Jana N, Vasishta K, Jindal SK, Khunnu B, Ghosh K. Perinatal outcome in pregnancies complicated by pulmonary tuberculosis. Int J Gynaecol Obstet. 1994 Feb;44(2):119-24. doi: 10.1016/0020-7292(94)90064-7. |
| 14998501 | Background | Pillay T, Khan M, Moodley J, Adhikari M, Coovadia H. Perinatal tuberculosis and HIV-1: considerations for resource-limited settings. Lancet Infect Dis. 2004 Mar;4(3):155-65. doi: 10.1016/S1473-3099(04)00939-9. |
| Background | Amita Gupta, N.G., Sandesh Patil, Pradeep Sambarey, Sandhya Khadse, Anju Kagal, Suvarna Joshi, Arun Jamkar, Robert Bollinger, and the SWEN India Study Group1Johns, Maternal TB is associated with increased risk of HIV mother-to-child transmission, in 17th Conference on Retroviruses and Opportunistic Infections. 2010: San Francisco, CA. February 16 - 19 2010 |
| D001423 | Bacterial Infections and Mycoses |
| D007239 | Infections |
| D012141 | Respiratory Tract Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D003710 |
| Demography |
| D011154 | Population Characteristics |
| D012959 | Socioeconomic Factors |