A Smith1, R Burger2, M Claassens3, H Ayles4, P Godfrey-Faussett5, N Beyers3. 1. Department of Economics, Stellenbosch University, Private Bag X1, Matieland 7602, Stellenbosch, South Africa. anjasmith@sun.ac.za. 2. Department of Economics, Stellenbosch University, Stellenbosch, South Africa. 3. Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa. 4. Zambia AIDS Related Tuberculosis Project, Lusaka, Zambia; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK. 5. Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK.
Abstract
SETTING: Eight communities with high tuberculosis (TB) prevalence, Western Cape, South Africa. OBJECTIVE: To identify sex differences in TB health-seeking behaviour and diagnosis in primary health care facilities and how this influences TB diagnosis. DESIGN: We used data from a prevalence survey among 30,017 adults conducted in 2010 as part of the Zambia, South Africa Tuberculosis and AIDS Reduction (ZAMSTAR) trial. RESULTS: A total of 1670 (5.4%) adults indicated they had a cough of ⩾2 weeks, 950 (56.9%) of whom were women. Women were less likely to report a cough of ⩾2 weeks (5.1% vs. 6.4%, P < 0.001), but were more likely to seek care for their cough (32.6% vs. 26.9%, P = 0.012). Of all adults who sought care, 403 (80.0%) sought care for their cough at a primary health care (PHC) facility (79.0% women vs. 81.4% men, P = 0.511). Women were less likely to be asked for a sputum sample at the PHC facility (63.3% vs. 77.2%, P = 0.003) and less likely to have a positive sputum result (12.6% vs. 20.7%, P = 0.023). CONCLUSION: The attainment of sex equity in the provision of TB health services requires adherence to testing protocols. Everyone, irrespective of sex, who seeks care for a cough of ⩾2 weeks should be tested.
SETTING: Eight communities with high tuberculosis (TB) prevalence, Western Cape, South Africa. OBJECTIVE: To identify sex differences in TB health-seeking behaviour and diagnosis in primary health care facilities and how this influences TB diagnosis. DESIGN: We used data from a prevalence survey among 30,017 adults conducted in 2010 as part of the Zambia, South Africa Tuberculosis and AIDS Reduction (ZAMSTAR) trial. RESULTS: A total of 1670 (5.4%) adults indicated they had a cough of ⩾2 weeks, 950 (56.9%) of whom were women. Women were less likely to report a cough of ⩾2 weeks (5.1% vs. 6.4%, P < 0.001), but were more likely to seek care for their cough (32.6% vs. 26.9%, P = 0.012). Of all adults who sought care, 403 (80.0%) sought care for their cough at a primary health care (PHC) facility (79.0% women vs. 81.4% men, P = 0.511). Women were less likely to be asked for a sputum sample at the PHC facility (63.3% vs. 77.2%, P = 0.003) and less likely to have a positive sputum result (12.6% vs. 20.7%, P = 0.023). CONCLUSION: The attainment of sex equity in the provision of TB health services requires adherence to testing protocols. Everyone, irrespective of sex, who seeks care for a cough of ⩾2 weeks should be tested.
Authors: Leonardo Martinez; Lin Xu; Cheng Chen; Juliet N Sekandi; Yongzhong Zhu; Changsheng Zhang; Christopher C Whalen; Limei Zhu Journal: Am J Trop Med Hyg Date: 2017-02-13 Impact factor: 2.345
Authors: M Armstrong-Hough; J Ggita; P Turimumahoro; A J Meyer; E Ochom; D Dowdy; A Cattamanchi; A Katamba; J L Davis Journal: Int J Tuberc Lung Dis Date: 2018-10-01 Impact factor: 2.373
Authors: Nozipho Orykah Musakwa; Jacob Bor; Cornelius Nattey; Elisabet Lönnermark; Peter Nyasulu; Lawrence Long; Denise Evans Journal: PLoS One Date: 2021-01-22 Impact factor: 3.240
Authors: Carmen S Christian; Ulf-G Gerdtham; Dumisani Hompashe; Anja Smith; Ronelle Burger Journal: Int J Environ Res Public Health Date: 2018-04-12 Impact factor: 3.390