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. Systematic TB screening of pregnant women in Stockholm was feasible with high yield of unknown latent TB and mostly asymptomatic active TB. Optimised routines improved referrals to specialist care. Adherence to treatment of latent TB was very high. http://bit.ly/2NrhEwk

中文翻译：

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2016-2017年斯德哥尔摩孕妇结核病筛查和治疗

瑞典国家结核病 (TB) 指南建议对来自高流行国家或以前接触过的孕妇 (PW) 进行活动性和潜伏性结核病 (LTBI) 筛查，以可能改善早期发现和治疗。我们评估了 2016-2017 年斯德哥尔摩县新引入的孕妇结核病筛查计划的级联护理。该算法包括产妇保健诊所的临床数据和 Quantiferon (QFT)，并在检测呈阳性或出现结核病症状时转介专科护理。每年登记约 29 000 名 HIV 阴性孕妇，其中 11% 来自高流行国家。2016 年，其中 72% 的患者接受了 QFT 筛查，其中 22% 为 QFT 阳性，85% 被转诊至专科护理。2017年，相应数字分别为64%、19%和96%。随着时间的推移，所有 QFT 阳性孕妇的 LTBI 治疗率从 24% 增加到 37%。产后主要使用利福平的治疗完成率为 94%。在登记的 69 名艾滋病毒阳性孕妇中，78% 来自高流行国家。其中，72% 的 QFT 和 15% 的筛查呈阳性，但没有人接受 LTBI 治疗。检测到 9 例 HIV 阴性活动性肺结核病例（发生率：215/100 000）。没有人在怀孕前接受过结核病筛查，只有一个人因症状而寻求治疗。在斯德哥尔摩对孕妇进行系统性结核病筛查是可行的，未知 LTBI 和大多数无症状活动性结核病的高产率。优化的例程改善了转诊到专科护理。LTBI 的治疗完成率非常高。我们的研究结果证明了对这一风险组进行结核病筛查以进行早期发现和治疗是合理的。在斯德哥尔摩对孕妇进行系统性结核病筛查是可行的，未知潜伏性结核病和大多数无症状活动性结核病的高产率。优化的例程改善了转诊到专科护理。对潜伏性结核病治疗的依从性非常高。http://bit.ly/2NrhEwk