Sex Difference in Tuberculosis in Afghanistan: A National Cohort Study

Abstract

Background: In general, tuberculosis rate is higher among men than women globally. The reason for the sex difference in the rate is not clear. The purpose of this study is to examine sex difference in the incidence of smear- positive pulmonary Tuberculosis (TB) in Afghanistan and to discuss it from socio cultural perspectives. Methods: Patients with smear-positive pulmonary tuberculosis were identified by all health facilities capable to diagnose tuberculosis, throughout Afghanistan. Age-specific incidence rates of smear positive pulmonary tuberculosis for males and females census cohorts of 2005 were compared. Results: Of the 9,949 smear-positive TB cases identified during 2005, 3,131 (31.5%) were male and 6,818 (68.5%) were female. The annual incidence rates (per 100, 000 population) of TB were 60.0 for female population and 26.7 for male population. In all the age groups, except those aged more than 65 years, those rates were higher for females than for males. Conclusions: Based on the national registration data, for all the age groups equal to or under 65 years old in Afghanistan, the incidence rates of pulmonary TB are higher in females than in males. Possible factors contributing to this observation are discussed.