Prevention and Treatment Guide for Tuberculosis in Pregnant Women and Children
등록일 2017년 11월 07일 화요일
수정일 2017년 11월 07일 화요일

Photo By Kateryna Konvia Shutterstock  

Tuberculosis is a very deadly infection caused by the bacteria Mycobacterium tuberculosis.It is a very difficult disease to diagnose, treat, and contain.Prevention is the key to avoid TB infection in your household and to stop the spread from person to person.

Preventive Measures at Your Home

Family members can be vaccinated with Bacillus Calmette-Guerin vaccine and it is particularly effective in children.BCG vaccine protects children from disseminated forms of TB or TB that has spread from the lungs to the other parts of the body.The vaccine, however, only provides a partial protection from pulmonary TB in adults.It is because the vaccine was designed to protect children rather than to interrupt transmission in adults.

If someone in your household has infectious TB, you can take these precautionary steps to reduce exposure to other household members:

- Make sure that your house is well ventilated to let the air circulate properly.

- Cough etiquette and respiratory hygiene should be practiced at all times.

- For the TB patient, spend more time outdoors, sleep in a separate but well-ventilated room, and spend little time in places where people gather and crowds, such as malls and public transportation.

Unlike before, people diagnosed with TB are allowed to stay in their homes provided the infection is not XDR TB.XDR TB or extensively drug-resistant tuberculosis which is a rare type of TB that resists known medication against the infection, such as isoniazid and rifampin.People with this rare TB type must be isolated and monitored because of the complications that may arise.XDR TB patients are treated in healthcare facilities and isolated from others to reduces the rate of transmission.

Tuberculosis in Pregnant Women

Tuberculosis in pregnant women threatens both the mother and the baby.Untreated TB in pregnant women increases the risk of adverse outcomes for babies, such as low birth weight.The tuberculin skin test is the safest screening test for pregnant women and it can be done throughout the duration of pregnancy.Treatment of TB in pregnant women depends on the severity of the infection.

- For the initial TB infection, the preferred treatment regimen is composed of isoniazid or INH, rifampin or RIF, and ethambutol or EMB for two months.It is followed by INH and RIF for seven months.The entire treatment lasts for a total of nine months.Streptomycin should never be used because of its harmful effects on the fetus.It is not recommended to use pyrazinamide because its effects on the fetus remain unknown at this time

- For the latent TB infection, the treatment involves the combination of INH and pyridoxine or vitamin B6 supplement.The vitamin B6 prevents nerve damage caused by INH medication.For pregnant women or women planning to become pregnant within three weeks, 3HP INH and rifapentine are both invalid treatment options.

- In case HIV is present in the pregnant patient, the doctor may recommend the same treatment applied to non-pregnant HIV-positive women.The changes in the combined treatment will be given consideration as long as the patient discusses important details to the clinician.TB treatment regimen for HIV-positive pregnant women should include a rifamycin, an effective drug against mycobacteria like tuberculosis and leprosy.

Certain TB medications have contraindications with pregnant women, such as amikacin, capreomycin, fluoroquinolones, kanamycin, and streptomycin, because these drugs can harm the baby.If the patient has drug-resistant TB, visit the doctor immediately and discuss treatment options, particularly the adverse effects on the child.

According to the Center for Disease Control and Prevention, the first line of antituberculosis drugs is not toxic to the breast milk of breastfeeding mothers.At the same time, breast milk does not have a therapeutic effect to treat TB infection.

 

Tuberculosis in Children

Pediatric tuberculosis is the term of TB infection in children ages 15 and younger.TB infection in infants, babies, and young children can potentially lead to life-threatening TB stages, such as disseminated TB and TB meningitis.Moreover, children who get infected with TB bacteria get sick quicker than adults.

1.Disseminated tuberculosis occurs when the immune system fails to contain the infection in the lungs.In this stage, TB infection goes beyond the lungs, affecting other organs and the lymphatic system.Disseminated TB may start within weeks after the primary infection.

2.TB meningitis occurs when the tissues surrounding the brain and spinal cord become infected by the TB bacteria.It is a very rare complication of TB infection and usually happens if the patient has a weakened immune system.

Diagnosis of TB in children can be challenging because obtaining sputum samples from babies and younger kids is difficult.So clinicians usually make a diagnosis based the clinical symptoms of TB, positive result from the tuberculin skin test, chest x-ray result, and history of contact with a TB carrier.

As a parent, you can monitor your child for the signs and symptoms of TB infection.The common symptoms include a cough, weakness, less playfulness, weight loss, fever, and night sweats.If your child is suffering from these symptoms and you suspect they made contact with a TB carrier, do not hesitate to consult a doctor.

Treatment of TB infection in children involves standard medication for six to nine months.However, latent TB infection or complications from the disease will require special consideration by the physician because household members where the child lives may get infected by TB.As of date, the most effective protection against TB infection for children is the BCG vaccine.

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