Tuberculosis and Gender in Nigeria, Sex Differences in Diagnosis and Treatment Outcome of TB and TB HIV Infected Patients
Abstract:
Background: Worldwide, gender differences are
reported in diagnosis and treatment outcome of TB and TB HIV patients.
Religious and socio-cultural factors are responsible but largely controversial.
This study assessed gender issues in diagnosis and treatment outcome of TB and
TB HIV patients.
Objective: To assess gender differences in
diagnosis and treatment outcome of TB and TB HIV infected patients.
Methodology: We did a cross sectional
retrospective analysis of 980 TB patients treated in 6 out of 21 randomly
selected local government areas of Anambra state Nigeria between 2008 and 2012.
Information on age, sex, HIV status, case notification, treatment outcome was
evaluated from TB treatment cards and TB registers. Treatment outcome was
recorded as cured, completed treatment, failed, defaulted, died.
Results: The male female ratio among the 980
TB patients was 57.4% vs 42.6%.. The study HIV prevalence is 27.7%; women
contributed 52.6% of this population. Women had better treatment success rate
than men (85.7% vs. 80.5%). TB treatment outcome in women compared to men were
Cured (50.4% vs 40.7%, p = 0.063), treatment completed (35.3% vs 39.8%, p= 0.330),
died (5.5% vs5.5%, p=0.8812), defaulter (6.55 vs10.5%, p = 0.042), failure
(1.6% vs 1.5%, p=0.749).
Conclusion: We conclude more TB cases in males
but females are more prone to TB HIV confection, have better treatment outcome and
lower default rate.
Gender-specific
strategies, including active case finding among women, increased tracking and
adherence for male, are warranted to optimize TB management.
Keywords:
Gender, Nigeria, Tuberculosis, HIV,
Co infection, NTBLCP.
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