Introduction
Tuberculosis (TB) is a bacterial infection that spreads through the air and is caused by Mycobacterium tuberculosis. When a person with lung TB coughs, speaks or sings, the bacteria that gets into the air and nearby people breathing in the bacteria can get infected. TB can be cured with an antibiotic regimen. However, if left untreated or delayed, diagnosis can severely impact the patient's health. Those with latent TB infection or weak immunity must take preventive measures to prevent TB disease. It is thus essential to manage pregnant mothers with latent TB disease or low immunity and prevent TB disease.
How to Prevent Latent Tuberculosis Infection From Progressing to Tuberculosis Disease?
The tuberculosis bacteria can live in the body without symptoms. This is called latent tuberculosis infection. When the body's immunity decreases, it can develop active tuberculosis disease. People with latent tuberculosis infection may or not develop the disease. Some people are more likely to get tuberculosis than others.
The individuals who are at a higher risk of developing tuberculosis disease include:
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People with human immunodeficiency virus (HIV) infection.
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Pregnant mothers with low immunity.
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People who were infected in the past two years.
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Newborns, infants, and young children.
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Individuals who have other underlying diseases that weaken their immune system.
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Elderly individuals.
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People who use and inject illegal drugs.
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Individuals who did not complete the TB treatment or were treated incorrectly.
If the person has latent tuberculosis infection and is at high risk, they should take medications to prevent developing tuberculosis. There are several options to treat latent TB infection, and the healthcare provider decides the best treatment option after considering the patient's condition. Taking TB medications as the doctor instructs is essential, as it can help prevent the disease. As the bacterial load is less in latent TB infection, treatment is easier than TB disease. A person with active tuberculosis has large amounts of bacteria in the body, and a combination of several drugs is essential to treat the disease.
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In Pregnant Women With HIV: Once active tuberculosis disease is excluded, the world health organization (WHO) recommends Isoniazid preventive therapy (IPT) for individuals living with HIV, including pregnant women, to prevent tuberculosis disease.
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Latent Tuberculosis Infection in Pregnant Women: The treatment of tuberculosis is delayed for two to three months post-partum to avoid unnecessary medication exposure during pregnancy. Treatment should not be delayed for women with a higher risk of progression to active disease, especially those in contact with an infectious person.
What Are the Most Important Steps to Prevent Tuberculosis in Pregnant Women?
As tuberculosis is an airborne disease, the tuberculosis bacteria may spread when the infected person sneezes or coughs. Thus pregnant women can follow a few simple precautions:
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Good Ventilation: A closed, crowded environment must be avoided by pregnant women as much as possible, as the tuberculosis bacteria can remain airborne for several hours when there is no sufficient ventilation.
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Natural Light: Pregnant women should be exposed to natural sunlight, as UV light can help kill tuberculosis bacteria.
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Good Hygiene: Covering the pregnant woman's nose in a crowded environment is essential. Also, people infected with tuberculosis must cover their mouths and nose while sneezing or coughing to reduce the spread of the bacteria.
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Precautions in Hospitals: In hospitals and other healthcare settings, masks, and ventilation systems can help protect pregnant women. It is essential to keep the potentially infectious individuals separate from other patients. It is also important to screen healthcare workers regularly for tuberculosis.
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Healthy Immune System: Pregnant women must ensure they have a healthy immune system. This is the best defense against tuberculosis. The majority of individuals with good immunity can completely kill the tuberculosis bacteria.
How Do Pregnant Women Prevent Exposure to TB Disease While Traveling?
Tuberculosis is more common in some countries than in the United States. Travelers, especially when pregnant, should avoid contact or prolonged exposure to tuberculosis patients. It is important that pregnant women, who are at high risk, should not spend a long time in closed and crowded environments such as clinics or hospitals, shelters or prisons, with known tuberculosis patients.
Multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) are also found in prevalent tuberculosis areas. HIV-infected and pregnant travelers with low immunity are at the greatest risk if exposed to drug-resistant strains. Though air travel carries a low risk of TB infection, it must be avoided in pregnancies unless necessary. Suppose pregnant mothers or travelers are working in hospitals, clinics, or other healthcare settings where there is a high possibility of encountering TB patients. In that case, consulting occupational health or infection control experts is essential. They should ensure that the administrative and environmental procedures to prevent TB are implemented. In addition, Medical professionals and doctors can use respiratory personal protective devices.
Women who anticipate possible prolonged exposure to TB patients while pregnant should have a skin test for tuberculosis or a blood test for precaution. Travelers must take a TB test if they travel to a region where TB is endemic and should repeat the test after returning.
What to Do if a Pregnant Mother Gets Tuberculosis Disease?
Tuberculosis can be treated with special antibiotics. It is safe to use these even during pregnancy. The standard duration of treatment is six months. It is essential to complete the whole course of medications to cure tuberculosis. If the pregnant mother does not complete the treatment course, tuberculosis may return in a resistant form (resistant to the usual drugs) and is more difficult to treat. In such a case, they may pass the disease to their family, friends, and the baby. If the mother is diagnosed earlier in the pregnancy, there is less chance that the baby will get infected. However, on delayed treatment, there is a chance of early labor and complications to the baby's health (small baby). Usually, there is very less chance of transmission of tuberculosis from the mother to the baby in the womb. However, if the infected woman avoids TB treatment during pregnancy, the newborn may get infected. So, treating pregnant women with tuberculosis as early as possible is essential.
Conclusion
Tuberculosis is a bacterial disease caused by bacteria that can spread through the air. Pregnant women must take necessary care to prevent diseases such as tuberculosis. Especially pregnant women with low immunity, HIV (human immunodeficiency virus), or latent women must take precautions to prevent active tuberculosis. Avoiding traveling to places endemic for tuberculosis, staying in well-ventilated, less crowded environments, wearing protective masks in crowded places, and ensuring good health and immunity, can help prevent the disease.