PRISMA flow diagram.
<div><p>Pregnancy may be associated with risk of developing tuberculosis (TB) in those infected with <i>Mycobacterium tuberculosis</i> (<i>Mtb</i>). The perinatal period could provide opportunities for targeted screening and treatment. This study aims to synthesis...
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2024
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| _version_ | 1852024969953804288 |
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| author | Alison J. Morton (20314788) |
| author2 | Alexandra Roddy Mitchell (20314791) Richard E. Melville (20314794) Lisa Hui (524198) Steven Y. C. Tong (6849431) Sarah J. Dunstan (20314797) Justin T. Denholm (5710625) |
| author2_role | author author author author author author |
| author_facet | Alison J. Morton (20314788) Alexandra Roddy Mitchell (20314791) Richard E. Melville (20314794) Lisa Hui (524198) Steven Y. C. Tong (6849431) Sarah J. Dunstan (20314797) Justin T. Denholm (5710625) |
| author_role | author |
| dc.creator.none.fl_str_mv | Alison J. Morton (20314788) Alexandra Roddy Mitchell (20314791) Richard E. Melville (20314794) Lisa Hui (524198) Steven Y. C. Tong (6849431) Sarah J. Dunstan (20314797) Justin T. Denholm (5710625) |
| dc.date.none.fl_str_mv | 2024-11-22T18:30:41Z |
| dc.identifier.none.fl_str_mv | 10.1371/journal.pgph.0003578.g001 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/figure/PRISMA_flow_diagram_/27892188 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Medicine Cell Biology Biotechnology Immunology Cancer Science Policy Infectious Diseases Biological Sciences not elsewhere classified synthesise published literature serious adverse events searched ovid medline tuberculin skin test 19 – 0 0 – 100 mycobacterium tuberculosis </ tpt appears safe div >< p completing antenatal tst cochrane central register 47 studies met 4 %- 96 3 – 1 mycobacterium tuberculosis infection high screening adherence tb preventative treatment active tb disease developing tuberculosis test performance mtb </ irr 1 targeted screening october 3 infection screening 3 %, high tb study aims significant association release assay rates increasing optimise algorithms natural history maternal age make evidence interferon gamma informed decisions increased age inclusion criteria incidence settings four studies ensuring pregnant controlled trials chest radiograph |
| dc.title.none.fl_str_mv | PRISMA flow diagram. |
| dc.type.none.fl_str_mv | Image Figure info:eu-repo/semantics/publishedVersion image |
| description | <div><p>Pregnancy may be associated with risk of developing tuberculosis (TB) in those infected with <i>Mycobacterium tuberculosis</i> (<i>Mtb</i>). The perinatal period could provide opportunities for targeted screening and treatment. This study aims to synthesise published literature on <i>Mtb</i> infection in pregnancy, relating to prevalence, natural history, test performance, cascade of care, and treatment. We searched Ovid MEDLINE, Embase+Embase Classic, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) on October 3, 2023, and 47 studies met the inclusion criteria. The prevalence of <i>Mtb</i> infection was as high as 57.0% in some populations, with rates increasing with maternal age and in women from high TB-incidence settings. Five studies quantified perinatal progression from <i>Mtb</i> infection to active TB disease, with two demonstrating increased risk compared to non-pregnant populations (IRR 1.3–1.4 during pregnancy and IRR 1.9–2 postpartum). Concordance between Tuberculin Skin Test (TST) and Interferon Gamma-Release Assay (IGRA) ranged from 49.4%-96.3%, with k-values of 0.19–0.56. High screening adherence was reported, with 62.0–100.0% completing antenatal TST and 81.0–100.0% of those positive having chest radiograph. Four studies of TB preventative treatment (TPT) did not find a significant association with serious adverse events. The antenatal period could provide opportunities for contextualised <i>Mtb</i> infection screening and treatment. As women with increased age and from high TB-incidence settings demonstrate higher prevalence and risk of disease, this cohort should be prioritised. TPT appears safe and feasible; however, further studies are needed to optimise algorithms, ensuring pregnant and postpartum women can make evidence-informed decisions for effective TB prevention.</p></div> |
| eu_rights_str_mv | openAccess |
| id | Manara_0deae9a641cbbd16fe7cfde4eca3ec79 |
| identifier_str_mv | 10.1371/journal.pgph.0003578.g001 |
| network_acronym_str | Manara |
| network_name_str | ManaraRepo |
| oai_identifier_str | oai:figshare.com:article/27892188 |
| publishDate | 2024 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | PRISMA flow diagram.Alison J. Morton (20314788)Alexandra Roddy Mitchell (20314791)Richard E. Melville (20314794)Lisa Hui (524198)Steven Y. C. Tong (6849431)Sarah J. Dunstan (20314797)Justin T. Denholm (5710625)MedicineCell BiologyBiotechnologyImmunologyCancerScience PolicyInfectious DiseasesBiological Sciences not elsewhere classifiedsynthesise published literatureserious adverse eventssearched ovid medlinetuberculin skin test19 – 00 – 100mycobacterium tuberculosis </tpt appears safediv >< pcompleting antenatal tstcochrane central register47 studies met4 %- 963 – 1mycobacterium tuberculosis infectionhigh screening adherencetb preventative treatmentactive tb diseasedeveloping tuberculosistest performancemtb </irr 1targeted screeningoctober 3infection screening3 %,high tbstudy aimssignificant associationrelease assayrates increasingoptimise algorithmsnatural historymaternal agemake evidenceinterferon gammainformed decisionsincreased ageinclusion criteriaincidence settingsfour studiesensuring pregnantcontrolled trialschest radiograph<div><p>Pregnancy may be associated with risk of developing tuberculosis (TB) in those infected with <i>Mycobacterium tuberculosis</i> (<i>Mtb</i>). The perinatal period could provide opportunities for targeted screening and treatment. This study aims to synthesise published literature on <i>Mtb</i> infection in pregnancy, relating to prevalence, natural history, test performance, cascade of care, and treatment. We searched Ovid MEDLINE, Embase+Embase Classic, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) on October 3, 2023, and 47 studies met the inclusion criteria. The prevalence of <i>Mtb</i> infection was as high as 57.0% in some populations, with rates increasing with maternal age and in women from high TB-incidence settings. Five studies quantified perinatal progression from <i>Mtb</i> infection to active TB disease, with two demonstrating increased risk compared to non-pregnant populations (IRR 1.3–1.4 during pregnancy and IRR 1.9–2 postpartum). Concordance between Tuberculin Skin Test (TST) and Interferon Gamma-Release Assay (IGRA) ranged from 49.4%-96.3%, with k-values of 0.19–0.56. High screening adherence was reported, with 62.0–100.0% completing antenatal TST and 81.0–100.0% of those positive having chest radiograph. Four studies of TB preventative treatment (TPT) did not find a significant association with serious adverse events. The antenatal period could provide opportunities for contextualised <i>Mtb</i> infection screening and treatment. As women with increased age and from high TB-incidence settings demonstrate higher prevalence and risk of disease, this cohort should be prioritised. TPT appears safe and feasible; however, further studies are needed to optimise algorithms, ensuring pregnant and postpartum women can make evidence-informed decisions for effective TB prevention.</p></div>2024-11-22T18:30:41ZImageFigureinfo:eu-repo/semantics/publishedVersionimage10.1371/journal.pgph.0003578.g001https://figshare.com/articles/figure/PRISMA_flow_diagram_/27892188CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/278921882024-11-22T18:30:41Z |
| spellingShingle | PRISMA flow diagram. Alison J. Morton (20314788) Medicine Cell Biology Biotechnology Immunology Cancer Science Policy Infectious Diseases Biological Sciences not elsewhere classified synthesise published literature serious adverse events searched ovid medline tuberculin skin test 19 – 0 0 – 100 mycobacterium tuberculosis </ tpt appears safe div >< p completing antenatal tst cochrane central register 47 studies met 4 %- 96 3 – 1 mycobacterium tuberculosis infection high screening adherence tb preventative treatment active tb disease developing tuberculosis test performance mtb </ irr 1 targeted screening october 3 infection screening 3 %, high tb study aims significant association release assay rates increasing optimise algorithms natural history maternal age make evidence interferon gamma informed decisions increased age inclusion criteria incidence settings four studies ensuring pregnant controlled trials chest radiograph |
| status_str | publishedVersion |
| title | PRISMA flow diagram. |
| title_full | PRISMA flow diagram. |
| title_fullStr | PRISMA flow diagram. |
| title_full_unstemmed | PRISMA flow diagram. |
| title_short | PRISMA flow diagram. |
| title_sort | PRISMA flow diagram. |
| topic | Medicine Cell Biology Biotechnology Immunology Cancer Science Policy Infectious Diseases Biological Sciences not elsewhere classified synthesise published literature serious adverse events searched ovid medline tuberculin skin test 19 – 0 0 – 100 mycobacterium tuberculosis </ tpt appears safe div >< p completing antenatal tst cochrane central register 47 studies met 4 %- 96 3 – 1 mycobacterium tuberculosis infection high screening adherence tb preventative treatment active tb disease developing tuberculosis test performance mtb </ irr 1 targeted screening october 3 infection screening 3 %, high tb study aims significant association release assay rates increasing optimise algorithms natural history maternal age make evidence interferon gamma informed decisions increased age inclusion criteria incidence settings four studies ensuring pregnant controlled trials chest radiograph |