Division of Neonatology, Department of Paediatrics and Child Health, Faculty of Health Science, Stellenbosch University, Cape Town, South Africa.
Int J Tuberc Lung Dis. 2012 Aug;16(8):1040-6. doi: 10.5588/ijtld.11.0821. Epub 2012 Jun 12.
Maternal and neonatal tuberculosis (TB) are under-recognised, particularly in settings with a high burden of human immunodeficiency virus (HIV) infection.
Retrospective audit of neonates routinely screened for TB in a South African hospital during 2009. Surveillance sources reviewed included routine clinical, laboratory and pharmacy records.
Among 70 neonates (60% HIV-exposed) screened for TB, the median gestational age was 35.5 weeks (IQR 33-38), and the median birth weight was 2000 g (IQR 1530-2484). The neonates were grouped according to a history of documented TB exposure: maternal TB in 41/70 (59%), suspected maternal TB in 9/70 (13%), other documented household TB exposure in 5/70 (7%), and no known TB exposure 15/70 (21%). Of the 50 neonates exposed to confirmed or suspected maternal TB, 36 (72%) were initiated on TB chemoprophylaxis, 5 (10%) received TB treatment and 9 (18%) received no intervention. Eight (8/50, 16%) were diagnosed with TB, all of whom were born to mothers with suspected or proven TB.
Maternal TB, primarily among HIV-infected women, was the main indication for TB screening of neonates. Routine TB screening of pregnant women and TB care in mothers and infants should be improved in settings with a high burden of TB and HIV.
孕产妇和新生儿结核病（TB）未得到充分认识，尤其是在艾滋病毒（HIV）感染负担沉重的环境中。
对南非一家医院 2009 年常规筛查 TB 的新生儿进行回顾性审核。审查的监测来源包括常规临床、实验室和药房记录。
在筛查的 70 名（60%HIV 暴露）新生儿中，中位孕龄为 35.5 周（IQR 33-38），中位出生体重为 2000 克（IQR 1530-2484）。新生儿根据有记录的 TB 暴露史分组：41/70（59%）的母亲患有 TB，9/70（13%）的母亲疑似患有 TB，5/70（7%）的母亲有其他记录的家庭 TB 暴露史，15/70（21%）的母亲无已知 TB 暴露史。在 50 名接触确诊或疑似母亲 TB 的新生儿中，36 名（72%）接受了 TB 化学预防，5 名（10%）接受了 TB 治疗，9 名（18%）未接受任何干预。8 名（8/50，16%）新生儿被诊断为 TB，均为母亲患有疑似或确诊 TB 的新生儿。
孕产妇 TB（主要发生在 HIV 感染的妇女中）是新生儿 TB 筛查的主要指征。在结核病和 HIV 负担沉重的环境中，应改进对孕妇的常规 TB 筛查以及对母婴的 TB 护理。
