Differential effects of sex on tuberculosis location and severity across the lifespan

Abstract

Disparities exist between sexes regarding tuberculosis (TB) incidence, as well as disease severity and outcome. Using a nationwide TB registry database, we explored the impact of sex and age on extrapulmonary TB (EPTB) among all enrolled patients by (1) calculating the female proportion for every age category according to TB-affected locations, (2) calculating the proportions of EPTB stratified by sex according to age, (3) conducting multivariable analysis to examine the impact of sex and age on EPTB likelihood, and (4) assessing the odds of EPTB for female compared to male as reference in every age category. Further, we explored the impact of sex and age on disease severity among pulmonary TB (PTB) patients. Of all the TB patients, 40.1% were female, with a male-to-female ratio of 1.49. The proportion of females was lowest in their fifties, resembling a U-shape. The male-to-female ratios in PTB and EPTB were 1.67 and 1.03, respectively. Compared to men, women were significantly associated with EPTB in their forties, fifties, and sixties. Female patients with PTB had significantly lower odds of having cavitation and positive smear test results in their fifties. Significant differences were found concerning TB location and severity between sexes, especially during reproductive age.

Obesity amplifies influenza virus-driven disease severity in male and female mice

“…Our model can also be utilized to uncover the existence of potential sex-specific differences in the adaptive immune responses to influenza virus via re-infection challenge experiments in obese hosts. Lastly, sex-dependent differences are reported for multiple infectious diseases 58 , including tuberculosis 59 and severe acute respiratory syndrome-coronavirus 2 60 , 61 . Thus, our novel model represents an ideal platform from which to examine the role of sex and metabolic disease in the pathogenesis of various infections.…”

Colliding Challenges: An Analysis of SARS-CoV-2 Infection in Patients with Pulmonary Tuberculosis versus SARS-CoV-2 Infection Alone

“…One common explanation suggests that the male bias observed in TB cases stems from systematic underreporting and underdiagnosis of the disease in women [50]. A comprehensive meta-analysis of 29 surveys across 14 countries revealed a consistent male bias in both notification and prevalence rates [51], hence, considering the consistent reports about sex bias around the world, it is strongly suggested that biological sex differences do exist [52].…”

Diferencias por sexo en enfermedad pulmonar causada por micobacterias diagnosticada en el INER en el período 2016-2018

“…Estos datos son concordantes con otros estudios, en los cuales se ha reportado una prevalencia mayor en hombres. 11,12 Las MNT más frecuentes incluyeron a micobacterias del complejo M. avium y M. bovis, que forman parte del complejo M. tuberculosis. Por esta razón, dividimos los grupos en aquellos infectados por miembros de los dos complejos y por otras MNT.…”