According to WHO, tuberculosis (TB) is the leading infectious disease causing death among women, with nearly 1 billion women infected. Every year, there are 2.5 million new cases of TB, resulting in approximately 1 million deaths, the majority of whom are women of childbearing age and those raising children.
Why are women of childbearing age and those raising children more susceptible to TB compared to other age groups and men?
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| Treatment for patients at the Central Hospital for Lung Disease and Tuberculosis (Photo: TTO) |
– Hormonal changes: Estrogen, progesterone, and the presence of placental hormones prepare the reproductive organs, pelvic area, skin, and muscles for pregnancy and childbirth, increasing metabolism and fluid absorption, which also affects lung tissue. Scarring becomes softer, allowing TB bacteria to thrive more easily.
– The need to nourish an additional life can lead to inadequate nutrition due to nausea, scarcity, and poverty.
– The mother’s natural immune response decreases to accommodate a foreign body, half of which is from another person.
– The physical demands during pregnancy, childbirth, and child-rearing, combined with additional responsibilities for family life, further complicate the situation.
These factors contribute to the greater likelihood of TB developing in women during pregnancy, postpartum, and while raising children. Furthermore, they are at risk for severe forms of TB, such as disseminated TB and pulmonary TB, which can cause significant damage. When they fall ill, their children are also at risk of contracting the disease, even in utero, leading to congenital TB, making treatment very challenging.
Some important guidelines to follow:
– When taking chest X-rays or imaging other parts of the body to detect TB damage, it is crucial to cover the abdomen with lead cloth to prevent congenital abnormalities, birth defects, or even stillbirths in pregnant women during the first trimester. X-rays are highly penetrating and can be harmful to developing cells, so caution is essential.
– When treating mothers, anti-TB medications can be toxic to both the mother and child, especially streptomycin, which may cause hearing loss; thus, it should be replaced with ethambutol.
– There is no absolute indication for abortion, but thorough counseling is needed for both mother and child.
Isolation from the child is crucial when the mother has pulmonary TB with bacteria present in her sputum. If conditions do not allow for isolation, at the very least, the mother should wear a mask whenever she is close to, caring for, or breastfeeding her child until the TB bacteria test negative.
– The child of a mother with TB must be closely monitored to detect congenital TB early, and they should receive the BCG vaccine promptly to prevent primary TB infection.
– It is important to avoid excessive fear of examinations aimed at detecting TB, as this can affect the fetus when the disease is diagnosed too late in the mother.
The above points highlight the impact of TB on women. However, women play an incredibly important role in TB prevention efforts. “Half of humanity” is seen as a crucial network in the fight against TB, as they are active participants in identifying TB cases and eliminating sources of infection. They are key to ensuring the success of the Directly Observed Treatment, Short-course (DOTS) strategy.
As wives, mothers, and heads of households, they can counsel and encourage relatives with suspicious symptoms to seek medical attention; they can also motivate patients to adhere to treatment guidelines and manage all developments effectively. Therefore, the National Tuberculosis Prevention Program has collaborated with the Vietnam Women’s Union to ensure a successful TB control campaign.
