A dissertation submitted to the Faculty of Health Sciences, university of the
witwatersrand, in fulfilment ofthe requirements for the degree of
Master of Medicine (paediatrics)
Johannesburg, 20 I 6 / Background: Though features of infants with congenital tubercuiosis (TB) are known
including being low-birth-weight (LBw), features of in-utero TB-exposed infants including
non-infected are not well reported. Infants bom to TB-infected women are at risk of
contracting TB post-delivery, therefore chemoprophylaxis is recommended, and this includes
use of isoniazid and rifampicin combination, but littie is known about its effectiveness.
Objective: To determine features of in-utero TB-exposed infants and proportion with TB
after chemoprophylaxis with isoniazid and rifampicin.
Methods: Retrospective review of records of TB-infected women and their infants, from
ZA07-20rc. Clinical features of mothers and infants at time of delivery; and follow-up of
infants after completion of isoniazid and rifampicin are described.
Results: Eighty-eight infants bom to 86 women with a diagnosis of TB were studied. TB
diagnosis was made peripartum in24.4Yoof women, 23.3%had exka-pulmonary TB. Among
those diagnosed antepa$um 46.2o/owere on treatment for >2 months. Human
immunodeficiency virus (HIV) was positive in 97.7Yo;wi& CD4 count <200 cells/mm3 in
74'6yo' Eight mothers (9.3%) died before discharge. There were 56 {63.6%)LBW and 45
(51'2W preterun infants. Culture for acid-fast-bacilli was positive in 4 (4.5%)infants. At 3-
months follow-up, 17 (20.2%)defaulted, and among 67 who returned, 7 OAoA)did not return
for Mantoux test reading, 1160 (1.7%)had positive Manroux.
Conclusion: Majority of TB-exposed infants are born to mothers with TB/ HIV co-infection.
A high proportion of TB-exposed infants are born preterm and LBW. The high attrition rate
made it difficult to assess effectiveness of chemoprophylaxis with isoniazid and rifampicin / MT2016
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/21169 |
| Date | January 2016 |
| Creators | Mathivha, Khakhu Tshilidzi |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf, application/pdf |
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