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. 2020 Mar 20;55(3):1900851.
doi: 10.1183/13993003.00851-2019. Print 2020 Mar.

Screening and treatment of tuberculosis among pregnant women in Stockholm, Sweden, 2016-2017

Gabrielle Fröberg12, Lena Jansson3, Katherine Nyberg3, Birgitta Obasi4, Katarina Westling35, Ingela Berggren6, Judith Bruchfeld32
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Screening and treatment of tuberculosis among pregnant women in Stockholm, Sweden, 2016-2017

Gabrielle Fröberget al. Eur Respir J. .
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Abstract

Swedish National tuberculosis (TB) guidelines recommend screening of active and latent TB (LTBI) among pregnant women (PW) from high-endemic countries or with previous exposure to possibly improve early detection and treatment.We evaluated cascade of care of a newly introduced TB screening programme of pregnant women in Stockholm county in 2016-2017. The algorithm included clinical data and Quantiferon (QFT) at the Maternal Health Care clinics and referral for specialist care upon positive test or TB symptoms.About 29 000 HIV-negative pregnant women were registered yearly, of whom 11% originated from high-endemic countries. In 2016, 72% of these were screened with QFT, of which 22% were QFT positive and 85% were referred for specialist care. In 2017, corresponding figures were 64%, 19% and 96%, respectively. The LTBI treatment rate among all QFT-positive pregnant women increased from 24% to 37% over time. Treatment completion with mainly rifampicin post-partum was 94%. Of the 69 registered HIV-positive pregnant women, 78% originated from high-endemic countries. Of these, 72% where screened with QFT and 15% were positive, but none was treated for LTBI. 9 HIV-negative active pulmonary TB cases were detected (incidence: 215/100 000). None had been screened for TB prior to pregnancy and only one had sought care due to symptoms.Systematic TB screening of pregnant women in Stockholm was feasible with a high yield of unknown LTBI and mostly asymptomatic active TB. Optimised routines improved referrals to specialist care. Treatment completion of LTBI was very high. Our findings justify TB screening of this risk group for early detection and treatment.

Conflict of interest statement

Conflict of interest: G. Fröberg has nothing to disclose. Conflict of interest: L. Jansson has nothing to disclose. Conflict of interest: K. Nyberg has nothing to disclose. Conflict of interest: B. Obasi has nothing to disclose. Conflict of interest: K. Westling has nothing to disclose. Conflict of interest: I. Berggren has nothing to disclose. Conflict of interest: J. Bruchfeld has nothing to disclose.

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