K Dale1, E Tay2, J M Trauer3, P Trevan1, J Denholm4. 1. Victorian Tuberculosis Program, Melbourne, Victoria, Australia. 2. Department of Health and Human Services, Melbourne, Victoria, Australia. 3. Victorian Tuberculosis Program, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. 4. Victorian Tuberculosis Program, Melbourne, Department of Microbiology and Immunology, University of Melbourne, Melbourne, Victoria, Australia.
Abstract
BACKGROUND: Gender has a significant impact on tuberculosis (TB) diagnosis and outcomes in many settings worldwide. We explored gender differences in Victoria, Australia, a low-incidence setting. METHODS: Retrospective cohort study: 2002-2015. Gender was included as an independent variable in multivariate statistical analyses assessing TB management. RESULTS: There were 2655 (54.5%) males and 2212 (45.5%) females notified (male:female ratio = 1.2:1). Among cases with pulmonary involvement, males underwent a chest X-ray or CT scan (CXR) sooner (hazard ratio [HR] 1.2, 95%CI 1.04-1.31, P = 0.010), began treatment sooner after presentation (HR 1.2, 95%CI 1.08-1.34, P = 0.001) and were more likely to have a sputum smear sample performed (OR 1.3, 95%CI 1.01-1.55, P = 0.037). Male cases with extra-pulmonary TB sought health care sooner after symptom onset (HR 1.3, 95%CI 1.03-1.58, P = 0.024) and were more likely to have an abnormal CXR (OR 1.9, 95%CI 1.54-2.32, P < 0.001). Males were more likely to die before or during treatment (OR 1.5, 95%CI 1.06-2.11, P = 0.024). CONCLUSIONS: Women experienced small delays in management compared with men, with no obvious detriment to assessment results or treatment outcomes. Differences were consistent with the hypothesis that males manifest more severe disease at presentation, which could be related to a range of biological and social factors.
BACKGROUND: Gender has a significant impact on tuberculosis (TB) diagnosis and outcomes in many settings worldwide. We explored gender differences in Victoria, Australia, a low-incidence setting. METHODS: Retrospective cohort study: 2002-2015. Gender was included as an independent variable in multivariate statistical analyses assessing TB management. RESULTS: There were 2655 (54.5%) males and 2212 (45.5%) females notified (male:female ratio = 1.2:1). Among cases with pulmonary involvement, males underwent a chest X-ray or CT scan (CXR) sooner (hazard ratio [HR] 1.2, 95%CI 1.04-1.31, P = 0.010), began treatment sooner after presentation (HR 1.2, 95%CI 1.08-1.34, P = 0.001) and were more likely to have a sputum smear sample performed (OR 1.3, 95%CI 1.01-1.55, P = 0.037). Male cases with extra-pulmonary TB sought health care sooner after symptom onset (HR 1.3, 95%CI 1.03-1.58, P = 0.024) and were more likely to have an abnormal CXR (OR 1.9, 95%CI 1.54-2.32, P < 0.001). Males were more likely to die before or during treatment (OR 1.5, 95%CI 1.06-2.11, P = 0.024). CONCLUSIONS:Women experienced small delays in management compared with men, with no obvious detriment to assessment results or treatment outcomes. Differences were consistent with the hypothesis that males manifest more severe disease at presentation, which could be related to a range of biological and social factors.
Authors: James O'Connell; Niamh Reidy; Cora McNally; Eoghan de Barra; Debbi Stanistreet; Samuel McConkey Journal: Open Forum Infect Dis Date: 2022-04-02 Impact factor: 4.423
Authors: Kee Chee Cheong; Sumarni Mohd Ghazali; Ahmed Syahmi Syafiq Md Zamri; Yoon Ling Cheong; Nuur Hafizah Md Iderus; Tharmarajah Nagalingam; Qistina Ruslan; Mohd Azahadi Omar; Ahmad Faudzi Yusoff Journal: Int J Environ Res Public Health Date: 2022-05-21 Impact factor: 4.614