R J Kosgei1, J K Sitienei2, H Kipruto3, K Kimenye4, D Gathara5, F X Odawa1, P Gichangi6, S Callens7, M Temmerman7, J C Sitienei8, A-B Kihara1, E-J Carter9. 1. Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya. 2. Ministry of Health, Department of Disease Prevention and Control, Nairobi, Kenya; Moi University Department of Epidemiology, Nairobi Campus, Nairobi, Kenya. 3. World Health Organization, Nairobi, Kenya. 4. Division of Leprosy Tuberculosis and Lung Disease, Ministry of Health, Nairobi, Kenya. 5. Ruby Medical Centre, Kiambu West, Kenya. 6. Department of Human Anatomy, University of Nairobi, Nairobi, Kenya, Kenya. 7. Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. 8. Department of Health Management, Moi University, Eldoret, Kenya. 9. Alpert School of Medicine at Brown University, Providence, Rhode Island, USA.
Abstract
OBJECTIVE: To determine gender differences in treatment outcomes among 15-49 year olds with smear-positive pulmonary tuberculosis (PTB) and factors associated with poor outcomes in Kenya. DESIGN: Retrospective descriptive cohort. RESULTS: Of 16 056 subjects analysed, 38% were female and 62% male. Females had a higher risk of poor treatment outcome than males (12% vs. 10%, P < 0.001; adjusted OR 1.29, 95%CI 1.16-1.44, P < 0.001). In the first multivariate model, restricting the analysis to human immunodeficiency virus (HIV) positive patients and adjusting for risk factors and clustering, females had a non-significantly lower risk of poor outcome (OR 0.99, 95%CI 0.86-1.13, P = 0.844). In the model restricted to HIV-negative patients, a non-significantly lower risk was found (OR 0.89, 95%CI 0.73-1.09, P = 0.267). In the second model, restricting analysis to patients on antiretroviral therapy (ART) and adjusting for risk factors and clustering, females had a non-significantly lower risk of poor PTB treatment outcomes (OR 0.98, 95%CI 0.84-1.14, P = 0.792). In the model restricted to HIV-positive patients not on ART, a non-significantly higher risk was found (OR 1.15, 95%CI 0.79-1.67, P = 0.461). CONCLUSION: Females of reproductive age are likely to have poorer treatment outcomes than males. Among females, not commencing ART during anti-tuberculosis treatment seemed to be associated with poor outcomes.
OBJECTIVE: To determine gender differences in treatment outcomes among 15-49 year olds with smear-positive pulmonary tuberculosis (PTB) and factors associated with poor outcomes in Kenya. DESIGN: Retrospective descriptive cohort. RESULTS: Of 16 056 subjects analysed, 38% were female and 62% male. Females had a higher risk of poor treatment outcome than males (12% vs. 10%, P < 0.001; adjusted OR 1.29, 95%CI 1.16-1.44, P < 0.001). In the first multivariate model, restricting the analysis to human immunodeficiency virus (HIV) positive patients and adjusting for risk factors and clustering, females had a non-significantly lower risk of poor outcome (OR 0.99, 95%CI 0.86-1.13, P = 0.844). In the model restricted to HIV-negative patients, a non-significantly lower risk was found (OR 0.89, 95%CI 0.73-1.09, P = 0.267). In the second model, restricting analysis to patients on antiretroviral therapy (ART) and adjusting for risk factors and clustering, females had a non-significantly lower risk of poor PTB treatment outcomes (OR 0.98, 95%CI 0.84-1.14, P = 0.792). In the model restricted to HIV-positive patients not on ART, a non-significantly higher risk was found (OR 1.15, 95%CI 0.79-1.67, P = 0.461). CONCLUSION: Females of reproductive age are likely to have poorer treatment outcomes than males. Among females, not commencing ART during anti-tuberculosis treatment seemed to be associated with poor outcomes.
Authors: M E Murphy; G H Wills; S Murthy; C Louw; A L C Bateson; R D Hunt; T D McHugh; A J Nunn; S K Meredith; C M Mendel; M Spigelman; A M Crook; S H Gillespie Journal: BMC Med Date: 2018-10-17 Impact factor: 8.775
Authors: Rose J Kosgei; Steven Callens; Peter Gichangi; Marleen Temmerman; Anne-Beatrice Kihara; Gathara David; Eunice Nyaboe Omesa; Enos Masini; E Jane Carter Journal: PLoS One Date: 2020-12-14 Impact factor: 3.240