title: Investigating gender disparities in the profile and treatment outcomes of tuberculosis in Ebonyi state, Nigeria.
abstract: SUMMARY Globally, twice as many men as women are being diagnosed with tuberculosis (TB) annually. Little is known about gender differentials in TB in Africa. A retrospective cohort analysis of routine data was conducted on adult TB patients treated between 2011 and 2012 in two large healthcare facilities in Nigeria. Gender differences in their demographic characteristics and treatment outcomes were analysed accordingly. Of 1668 TB patients enrolled, the male:female ratio was 1.4:1. The mean ages of males and females were 40.2 ± 14.7 and 36.1 ± 14.6 years, respectively (t test 6.62, P < 0.001). Male gender was associated with a higher failure to smear convert after 2 months (21.8% vs. 17.5%, P = 0.06) and 5 months (4.3% vs. 1.5%, P = 0.02) of treatment for smear-positive TB patients. Moreover, men were more likely than women to fail treatment (2.2% vs. 0.7%, P = 0.01). No significant differences exist in the treatment success rates between women and men (78.2% vs. 74.5%, P = 0.08). Adjusted analyses showed significant association between being an urban male and a HIV-infected female with unsuccessful outcome adjusted by socio-demographic and clinical factors. We found that gender disparities exist in TB profile and treatment outcomes in Nigeria and gender-specific strategies are needed to optimize TB management.
authors.affiliation: Centre for Development and Reproductive Health,Enugu,Enugu State,Nigeria.
authors.forename: S N
authors.initials: SN
authors.lastname: Oshi
authors.affiliation: National Tuberculosis and Leprosy Control Programme,Ministry of Health,Abakaliki,Ebonyi State,Nigeria.
authors.forename: I
authors.initials: I
authors.lastname: Alobu
authors.affiliation: Department of Internal Medicine,Federal Teaching Hospital,Abakaliki,Ebonyi State,Nigeria.
authors.forename: K N
authors.initials: KN
authors.lastname: Ukwaja
authors.affiliation: Centre for Development and Reproductive Health,Enugu,Enugu State,Nigeria.
authors.forename: D C
authors.initials: DC
authors.lastname: Oshi
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D060085:Coinfection / Q000453:epidemiology; D004977:Ethambutol / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D054624:Health Status Disparities; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D011718:Pyrazinamide / Q000627:therapeutic use; D012189:Retrospective Studies; D012293:Rifampin / Q000627:therapeutic use; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D013307:Streptomycin / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D011718:Pyrazinamide; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin; D013307:Streptomycin
keywords: tuberculosis