CGH Faculty, Dr. Jyoti Mathad, presents at the CDC Tuberculosis Trials Consortium (TBTC) on the management of TB during pregnancy

On May 16th, Center for Global Health faculty, Dr. Jyoti Mathad presented at the Centers for Disease Control and Prevention’s Tuberculosis Trials Consortium (TBTC) to provide an overview of tuberculosis in pregnancy with a specific focus on including pregnant people in tuberculosis (TB) trials.

Dr. Mathad, an Assistant Professor of Medicine and Obstetrics & Gynecology at WCM, focuses her research on the immune and metabolic changes of pregnancy and their impact on the development of infectious diseases such as TB. She has conducted NIH-funded research on this topic in India, South Africa, and Haiti.

Recently, Dr. Mathad has been a part of multiple collective efforts to improve the management of TB in pregnancy. Though more than 200,000 pregnant people become sick with TB each year, there are no existing evidence-based guidelines to provide optimal care for this population. Pregnant people are more likely to become infected with TB and progress to deadly TB disease, but are less likely to receive high-quality care, particularly due to fear, discrimination, and substandard clinical practices among clinicians. As a part of a multi-institutional collaboration, Dr. Mathad helped to publish best practices for the care of pregnant people living with TB within nine areas including:

1. Screening and diagnosis
2. Reproductive health services and family planning
3. Treatment of drug-susceptible TB
4. Treatment of rifampicin-resistant/multidrug-resistant TB
5. Compassionate infection control practices
6. Feeding considerations
7. Counseling and support
8. Treatment of TB infection and TB preventive therapy
9. Additional research considerations

Dr. Mathad and her collaborators emphasize the importance of providing TB and reproductive care in a welcoming and understanding manner to ensure that patients’ needs are optimally met so they feel confident to complete their treatment.

Additional work with which she has been involved highlights the importance of TB prevention during pregnancy. In addition to the suffering caused by the disease itself, TB contributes to poor pregnancy outcomes including miscarriage, pre-eclampsia/eclampsia, low birth weight, premature birth, and mortality. These findings substantiate the inclusion of pregnant people in TB prevention trials to identify the safest regimen to treat both drug-sensitive and drug-resistant TB during pregnancy.

Article by Megan Willkens