title: Tuberculosis and patient gender in Bangladesh: sex differences in diagnosis and treatment outcome.
abstract: METHODS
  The public health sector of Bangladesh.
  
  
  OBJECTIVE
  To assess gender differences in access to tuberculosis diagnosis and in tuberculosis treatment outcome in Bangladesh.
  
  
  METHODS
  Information on the age and sex of a sample of patients in 1997 was collected from out-patient registers and tuberculosis laboratory and treatment registers in 59 thanas in three divisions in Bangladesh.
  
  
  RESULTS
  The female/male ratio was 0.79 among 42,877 out-patients with respiratory complaints, 0.51 among 5,665 tuberculosis suspects undergoing sputum smear microscopy, 0.36 among 869 tuberculosis suspects with positive sputum smears, and 0.35 among 5,632 patients registered for tuberculosis treatment. Treatment was successful (cured or treatment completed) in 86% of female and 84% of male patients.
  
  
  CONCLUSIONS
  Women in Bangladesh appear to have less access to public out-patient clinics than men, and if they present with respiratory symptoms they are less likely to undergo sputum smear examination. If examined, women are less likely than men to be smear-positive. No gender bias was observed in tuberculosis treatment outcome. It is recommended to focus further research on exploration of sex differences in the incidence of respiratory conditions, identification of constraints among women in accessing out-patient clinics and verification of the quality of sputum submitted by women for examination.
authors.affiliation: National TB Control Programme, Directorate General of Health Services, Dhaka, Bangladesh.
authors.forename: V
authors.initials: V
authors.lastname: Begum
authors.forename: P
authors.initials: P
authors.lastname: de Colombani
authors.forename: S
authors.initials: S
authors.lastname: Das Gupta
authors.forename: A H
authors.initials: AH
authors.lastname: Salim
authors.forename: H
authors.initials: H
authors.lastname: Hussain
authors.forename: M
authors.initials: M
authors.lastname: Pietroni
authors.forename: S
authors.initials: S
authors.lastname: Rahman
authors.forename: D
authors.initials: D
authors.lastname: Pahan
authors.forename: M W
authors.initials: MW
authors.lastname: Borgdorff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001459:Bangladesh; D002648:Child; D003695:Delivery of Health Care; D023801:Directly Observed Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D013183:Sputum / Q000382:microbiology; D014376:Tuberculosis / Q000175:diagnosis* / Q000628:therapy*