{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:18:02Z","timestamp":1787840282942,"version":"build-2784847793"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,1]]},"abstract":"\n Objective\/Background:<\/jats:title>\n To determine the prevalence of undiagnosed active pulmonary tuberculosis (PTB) cases and sensitivity, specificity, and positive and negative predictive values of symptom combinations for undiagnosed TB infection in human immunodeficiency virus (HIV)-positive and HIV-negative pregnant mothers attending antenatal care (ANC) clinics. Mycobacterium TB and HIV are the leading causes of death among women of reproductive age worldwide. Symptom screening is the first step in the World Health Organization (WHO)-recommended TB intensified case finding algorithm for people living with HIV. However, the symptom-based PTB screening method for pregnant mothers is suboptimal and needs further optimization as some of the symptoms are obscured by the physiological changes during pregnancy.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n This was a cross-sectional study, which was conducted from June 2014 to May 2015 at 16 public health institutions in Mekelle and its surrounding areas. All pregnant mothers who visited the maternity clinics for routine ANC follow-up examinations were screened for PTB symptoms. Those who had at least 2 weeks of cough, in addition to other symptoms, were enrolled in the study. Sociodemographic and clinical data and sputum samples were collected by midwives and nurses. The sputum samples were shipped to the Tigray Regional Laboratory and stored at \u221280\u00b0C until TB culture was performed.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Between June 2014 and May 2015, 9600 pregnant mothers were screened for PTB symptoms. We collected 174 sputum samples from pregnant mothers who had \u22652 weeks of productive cough. The participant's median age was 27.5 years (interquartile range, 24\u201331 years). During enrollment, 604 (6.28%) participants were HIV seropositive. Among the HIV-positive mothers, 17 (38.1%) were informed about their HIV status when they visited the health institutions for ANC follow-up, whereas the remaining 27 (61.9%) were already on antiretroviral therapy. All sputum samples (\n n<\/jats:italic>\n = 174) were cultured using L\u00f6wenstein\u2013Jensen medium at the Tigray Regional Laboratory. One of the 174 sputum samples was positive (+1) in Ziehl\u2013Neelsen staining technique, and none of them was TB culture positive. During the study, at all study sites, no pregnant mother was even presumptively diagnosed and treated for TB during the routine ANC services.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Although the survey did not find any active PTB case among pregnant mothers, we identified 174 PTB-susceptive cases during the routine ANC services. Therefore, it was concluded that the integration of the WHO-recommended four-part symptom-based intensified case finding as one of the core components of ANC services can enhance the early detection of PTB, especially in high TB-burden countries.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/2212-5531.201889","type":"journal-article","created":{"date-parts":[[2017,5,18]],"date-time":"2017-05-18T11:07:10Z","timestamp":1495105630000},"page":"43-46","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["A Survey on Undiagnosed Active Pulmonary Tuberculosis among Pregnant Mothers in Mekelle and Surrounding Districts in Tigray, Ethiopia"],"prefix":"10.4103","volume":"6","author":[{"given":"Dawit","family":"Gebreegziabiher","sequence":"first","affiliation":[{"name":"Departmet of Medical Microbiology and Immunology, College of Health Sciences, Mekelle University, Mekelle, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelemework","family":"Adane","sequence":"additional","affiliation":[{"name":"Departmet of Medical Microbiology and Immunology, College of Health Sciences, Mekelle University, Mekelle, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markos","family":"Abebe","sequence":"additional","affiliation":[{"name":"Armauer Hansen Research Institute, TB\/HIV Laboratory, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250603","doi-asserted-by":"crossref","first-page":"e77","DOI":"10.1097\/QAI.0b013e31821ac9c1","article-title":"Active tuberculosis case-finding among pregnant women presenting to antenatal clinics in Soweto, South Africa","volume":"57","author":"Gounder","year":"2011","journal-title":"J Acquir Immune Defic Syndr"},{"key":"R2-20250603","doi-asserted-by":"crossref","first-page":"e62211","DOI":"10.1371\/journal.pone.0062211","article-title":"High prevalence of pulmonary tuberculosis but low sensitivity of symptom screening among HIV-infected pregnant women in South Africa","volume":"8","author":"Hoffmann","year":"2013","journal-title":"PLoS One"},{"key":"R3-20250603","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1086\/518975","article-title":"Human immunodeficiency virus, mycobacterium tuberculosis, and pregnancy: A deadly combination","volume":"45","author":"Mofenson","year":"2007","journal-title":"Clin Infect Dis"},{"key":"R4-20250603","first-page":"983","article-title":"The increasing burden of tuberculosis in pregnant women, newborns and infants under 6 months of age in Durban, KwaZulu-Natal","volume":"91","author":"Pillay","year":"2001","journal-title":"S Afr Med J"},{"key":"R5-20250603","doi-asserted-by":"crossref","first-page":"379271","DOI":"10.1155\/2012\/379271","article-title":"Tuberculosis in pregnancy: A review","volume":"2012","author":"Loto","year":"2012","journal-title":"J Pregnancy"},{"key":"R6-20250603","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1093\/jinfdis\/jiq064","article-title":"Maternal tuberculosis: A risk factor for mother-to-child transmission of human immunodeficiency virus","volume":"203","author":"Gupta","year":"2011","journal-title":"J Infect Dis"},{"key":"R7-20250603","first-page":"5","article-title":"Pulmonary tuberculosis among pregnant mothers in Tanzania","volume":"16","author":"Sheriff","year":"2010","journal-title":"Dar Es Salaam Med Stud J"},{"key":"R8-20250603","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1111\/j.1471-0528.2010.02504.x","article-title":"Increased risk of low birthweight and small for gestational age infants among women with tuberculosis","volume":"117","author":"Lin","year":"2010","journal-title":"BJOG"},{"key":"R9-20250603","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/QAI.0b013e3181900201","article-title":"Intensified case finding for tuberculosis in prevention of mother-to-child transmission programs: A simple and potentially vital addition for maternal and child health","volume":"50","author":"Deluca","year":"2009","journal-title":"J Acquir Immune Defic Syndr"},{"key":"R10-20250603","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/j.earlhumdev.2008.09.005","article-title":"Perinatal tuberculosis: New challenges in the diagnosis and treatment of tuberculosis in infants and the newborn","volume":"84","author":"Whittaker","year":"2008","journal-title":"Early Hum Dev"},{"key":"R11-20250603","doi-asserted-by":"crossref","first-page":"182","DOI":"10.4102\/sajhivmed.v13i4.113","article-title":"Forum: Tuberculosis prevention in HIV-infected pregnant women in South Africa","volume":"13","author":"Martin","year":"2012","journal-title":"S Afr J HIV Med"},{"key":"R12-20250603","doi-asserted-by":"crossref","first-page":"294","DOI":"10.5588\/pha.13.0073","article-title":"Screening for tuberculosis in pregnancy: Do we need more than a symptom screen? 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