Tuberculosis and Gender in Nigeria, Sex Differences in Diagnosis and Treatment Outcome of TB and TB HIV Infected Patients

Abstract

Background: Worldwide, gender differences are reported in diagnosis and treatment outcome of TB and TB HIV patients. Religious and socio-cultural factors are responsible but largely controversial. This study assessed gender issues in diagnosis and treatment outcome of TB and TB HIV patients. Objective: To assess gender differences in diagnosis and treatment outcome of TB and TB HIV infected patients. Methodology: We did a cross sectional retrospective analysis of 980 TB patients treated in 6 out of 21 randomly selected local government areas of Anambra state Nigeria between 2008 and 2012. Information on age, sex, HIV status, case notification, treatment outcome was evaluated from TB treatment cards and TB registers. Treatment outcome was recorded as cured, completed treatment, failed, defaulted, died. Results: The male female ratio among the 980 TB patients was 57.4% vs 42.6%.. The study HIV prevalence is 27.7%; women contributed 52.6% of this population. Women had better treatment success rate than men (85.7% vs. 80.5%). TB treatment outcome in women compared to men were Cured (50.4% vs 40.7%, p = 0.063), treatment completed (35.3% vs 39.8%, p= 0.330), died (5.5% vs5.5%, p=0.8812), defaulter (6.55 vs10.5%, p = 0.042), failure (1.6% vs 1.5%, p=0.749). Conclusion: We conclude more TB cases in males but females are more prone to TB HIV confection, have better treatment outcome and lower default rate. Gender-specific strategies, including active case finding among women, increased tracking and adherence for male, are warranted to optimize TB management.