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What to Do About Tuberculosis in Pregnancy

Mwanipela, Malawi—“When I was pregnant, I was coughing a lot. I was also experiencing dizziness and shortness of breath. It was so hard to breathe,” said Eliza Kayange, keeping an eye on her twin sons playing beside her.

“I was very concerned,” the mother added. “I thought I was going to die from this disease, and I was concerned that my babies would die too.”

Kayange wasn’t talking about something untreatable or even incurable. She was talking about tuberculosis (TB), a preventable disease that still kills an estimated 1.5 million people every year.

Kayange went to her village’s health center, where her health surveillance assistant had the training to recognize, test and diagnose TB. She was given medication, instructed to follow a healthy diet to support her recovery and told to breastfeed exclusively for six months. She was also taught proper coughing etiquette to prevent spreading the illness to family and friends.

A persistent cough during pregnancy led Elizabeth Kayange to the health facility where she was tested and treated for TB. Early intervention kept her children safe for the preventable disease. Photo by Naomi Kalemba

Today, Kayange and her boys are healthy.

Many women are not as fortunate. In 2014, TB killed an estimated 480,000 women—placing the disease among the top five causes of death for women of childbearing age. Many pregnant women are undiagnosed or misdiagnosed because TB symptoms are similar to typical complaints during pregnancy. As part of its work in supporting the global goal of eliminating TB, Jhpiego aims to reach these women with TB care that’s integrated with maternal health or HIV prevention and treatment services.

In Malawi, Jhpiego is working in partnership with the Ministry of Health to ensure that women who attend routine antenatal care at their health facility are screened for TB and, if necessary, receive quality treatment for TB in pregnancy through the five-year Support for Service Delivery-Integration Services Project funded by the U.S. Agency for International Development.

Why TB in Pregnancy Is Especially Dangerous

When a mother has TB, it’s dangerous not only for her but also for her baby. Women infected with TB are twice as likely to have a premature or underweight baby, and the baby can be born with congenital TB.

Multidrug-resistant TB is resistant to the two most potent drugs used to treat TB disease and further exacerbates the risk that pregnant women can face. There is a conspicuous lack of treatment guidelines for women with multidrug-resistant TB, leading to few options for the expectant mother: delaying treatment until after the pregnancy; terminating the pregnancy and beginning immediate treatment; or continuing the treatment without knowing all of its effects. None of these are optimal options for women or their babies.

Prompt, accurate diagnosis and timely treatment of TB—like what Kayange received—can save women and their children.

On World TB Day, we celebrate successes like Kayange’s and push ahead for the millions more who need that same care. Take three minutes and watch the video above, which tells you everything you need to know about TB today.

Jhpiego believes that when women are healthy, families and communities are strong. We won’t rest until all women and their families—no matter where they live—can access the health care they need to pursue happy and productive lives.

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