Screening for tuberculosis infection in pregnancy
The national tuberculosis infection programme for migrants is poorly accessed by pregnant women and uptake of screening in primary care is low. We conducted a NIHR funded feasibility study of opt-out tuberculosis screening using an interferon gamma release assay. All women offered an IGRA test consented to screening with an uptake rate of 100% but offer of screening was low. Qualitative research identified some awareness of TB disease but a lack of prior knowledge about LTBI in pregnant migrant women. Healthcare professionals acknowledged the public health benefits of screening and that for many migrant women this may be the first regular contact with the NHS. Routine opt-out screening was viewed as a facilitator to uptake of screening. Common barriers to offering screening included time pressure and the lack of interpreters in antenatal clinics. Antenatal screening had lower cost per patient tested and per positive patient identified.
Outputs
- A feasibility study evaluating the uptake, effectiveness and acceptability of routine screening of pregnant migrants for latent tuberculosis infection in antenatal care: a research protocol.
- Rahman A, Thangaratinam S, Copas A, Zenner D, White PJ, Griffiths C, Abubakar I, McCourt C, Kunst H.BMJ Open. 2022 Apr 4;12(4):e058734. doi: 10.1136/bmjopen-2021-058734.PMID: 35379641
- Maternal and perinatal mortality and morbidity associated with tuberculosis during pregnancy and the postpartum period: a systematic review and meta-analysis.
- Sobhy S, Babiker Z, Zamora J, Khan KS, Kunst H. BJOG. 2017 Apr;124(5):727-733. doi: 10.1111/1471-0528.14408. Epub 2016 Nov 11. PMID: 27862893
- A case-control study of the risk of adverse perinatal outcomes due to tuberculosis during pregnancy. Asuquo B, Vellore AD, Walters G, Manney S, Mignini L, Kunst H.J Obstet Gynaecol. 2012 Oct;32(7):635-8. doi: 10.3109/01443615.2012.704436.
Projects
Uptake of screening for infectious diseases (HIV, Hepatitis, TB) in migrant women in high income countries: a systematic review and meta-analysis. PROSPERO CRD42021217864