Prenatal screening of potential infectious diseases in Manitoba

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Faizo, Arwa Ali A
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Perinatal infections are associated with significant morbidity and mortality for both pregnant women and their infants, including while in utero. Prenatal screening for potential infectious diseases can effectively prevent MTCT infections. It allows both timely and suitable medical interventions when required. In Manitoba, prenatal screening for Rubella, Hepatitis B Virus (HBV), Human Immunodeficiency Virus (HIV), Treponema pallidum, Chlamydia Trachomatis (CT) and Neisseria gonorrhoeae (GC) is recommended for all pregnant women and in each pregnancy. The research described in this thesis assesses the current adherence to the Manitoba prenatal screening guidelines. Data consisted of prenatal screening tests conducted at Cadham Provincial Lab (CPL) for the time period of 2006 to 2011. Approximately one fifth of pregnant women did not receive any form of recommended prenatal testings’. Adherence to prenatal screening guidelines varied by type of infection, age of women and area of residence. Overall, Rubella, HBV and syphilis prenatal screening were requested more frequently than HIV, CT and GC. From year to year, a significant improvement of HIV prenatal screening uptake was observed. Rubella, HBV and syphilis screening declined while GC and CT screening remained stable. Among screened women, HIV testing was requested significantly less frequently in the youngest <15 and oldest >45 age groups versus other age groups. Women >45 years old also received less GC and CT screening. A year- II to-year increase in HIV and GC screening was observed in pregnant women aged 15-25, 26-35, and 36-45 years old. Although HIV screening uptake increased over time among residents of Brandon and rural areas, the overall HIV screening test was still higher among residents of Winnipeg versus other areas. Similarly, residents of Brandon and rural areas were tested less frequently for CT infection. A significant improvement in GC screening among residents of Winnipeg and rural areas was observed. The results described in this thesis demonstrates inconsistent adherence to provincial guidelines – creates higher risk areas and population subsets for congenital infections.. The results also demonstrate the importance of promoting testing of this type among pregnant women. Improvement and enhancement of current practice is required to reach standard, satisfactory and appropriate adherence to screening guidelines. Ongoing periodic assessments are suggested to continually document and monitor uptake and adherence to recommended prenatal screening in Manitoba.
Prenatal, Infectious diseases, Manitoba