Gender differences in tuberculosis diagnosis, treatment and outcomes in Victoria, Australia, 2002–2015

Dale, Katie; Tay, Ee Laine; Trauer, James M.; Trevan, Peter; Denholm, Justin T.

doi:10.5588/ijtld.17.0338

Cited by 21 publications

(13 citation statements)

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“…Overall, our results are consistent with the few national studies in individual high-income countries, with higher incidence rates reported among boys/men ( 5 , 7 ). A study conducted in Hong Kong found that tuberculosis rates were higher in men than in women across all age groups ( 5 ).…”

Section: Discussionsupporting

confidence: 92%

“…After age 25, the incidence in men was two to three times higher than that in women ( 6 ). Among TB patients in Victoria from 2002 to 2015, in all age groups, the male-to-female ratio was 1.2 ( 7 ). In 2016, in Germany, the age-specific incidence was highest in the age group of 20–24 years (18.3 cases per 100,000 population; 25.9 in men and 9.7 in women) ( 8 ).…”

Section: Discussionmentioning

confidence: 99%

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Gender differences in tuberculosis incidence rates—A pooled analysis of data from seven high-income countries by age group and time period

Peer

Schwartz²,

Green³

2023

Front. Public Health

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IntroductionGender differences in the incidence rates for tuberculosis are occasionally reported. However, the magnitude and consistency of the differences by age group, among different populations, and over extended periods of time are not clear.Materials and methodsWe obtained national data from seven countries from open-access internet sites or personal communications with official representatives. We computed the male-to-female incidence rate ratios (IRRs) by country and year for every age group and pooled these ratios using meta-analytic methods. Meta-regression analysis was performed to estimate the contribution of age, country, and calendar years to the variation in the IRRs.ResultsIn the age groups of < 1, 1–4, 5–9, and 10–14, the pooled male-to-female IRRs (with 95% CI) were as follows: 1.21 (1.05, 1.40), 0.99 (0.95, 1.04), 1.01 (0.96, 1.06), and 0.83 (0.77, 0.89), respectively. In the age groups 15–44, 45–64, and 65+ years, incidence rates were significantly higher in men, with IRRs of 1.25 (1.16, 1.35), 1.79 (1.56, 2.06), and 1.81 (1.66, 1.96), respectively. Meta-regression analysis revealed that age significantly contributed to the variation in the IRRs.ConclusionsThere were gender differences in the incidence rates for tuberculosis, with higher rates in boys aged less than one, no significant differences in boys of ages 1–9, and higher rates in boys/men older than 15. The only excess in female gender was in the age group 10–14 years. The age-related gender differences in tuberculosis incidence rates observed over several countries indicate the importance of including sex as a biological variable when assessing the risk factors for tuberculosis.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Gender differences in tuberculosis incidence rates—A pooled analysis of data from seven high-income countries by age group and time period

Peer

Schwartz²,

Green³

2023

Front. Public Health

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“…As expected, we note a smaller proportion of reactivation in patients receiving treatment for at least 7 months. With respect to risk factors for reactivation and reinfection, we showed that males had a higher risk of reactivation after completing treatment, which is also observed in other studies [ 9 , 11 , 24 , 25 ]. The WHO has reported a male to female ratio of 1.7:1 among global TB notifications in 2015 [ 26 ].…”

Section: Discussionsupporting

confidence: 88%

Recurrent tuberculosis in the Netherlands – a 24-year follow-up study, 1993 to 2016

et al. 2022

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Background Not all treated tuberculosis (TB) patients achieve long-term recovery and reactivation rates reflect effectiveness of TB treatment. Aim We aimed to estimate rates and risk factors of TB reactivation and reinfection in patients treated in the Netherlands, after completed or interrupted treatment. Methods Retrospective cohort study of TB patients with available DNA fingerprint data, registered in the Netherlands Tuberculosis register (NTR) between 1993 and 2016. Reactivation was defined as an identical, and reinfection as a non-identical Mycobacterium tuberculosis strain in sequential episodes. Results Reactivation rate was 55/100,000 person-years (py) for patients who completed, and 318/100,000 py for patients who interrupted treatment. The risk of reactivation was highest in the first 5 years after treatment in both groups. The incidence rate of reactivation was 228/100,000 py in the first 2 years and 57/100,000 py 2–5 years after completed treatment. The overall rate of reinfection was 16/100,000 py. Among those who completed treatment, patients with male sex, mono or poly rifampicin-resistant TB and a previous TB episode had significantly higher risk of reactivation. Extrapulmonary TB was associated with a lower risk. Among patients who interrupted treatment, directly observed treatment (DOT) and being an undocumented migrant or people experiencing homelessness were associated with a higher risk of reactivation. Conclusions Both patients who completed or interrupted TB treatment should be considered as risk groups for reactivation for at least 2–5 years after treatment. They patients should be monitored and guidelines should be in place to enhance early detection of recurrent TB.

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“…Therefore, a benchmark for EPTB patient-related delay could not be reliably defined for comparison with the outcomes reported in this evaluation. Among patients with EPTB, the health care–related delays reported in the included studies were 32, 39, and 42 days [ 20 , 26 ], all less than the health care–related delay among patients with EPTB in this evaluation of 66 days.…”

Section: Resultsmentioning

confidence: 96%

“…The median patient-related delay in this evaluation of 60 days among those with PTB suggests that patient-related delays were prolonged. The health care–related delay among patients with PTB was reported in the included studies as 11, 14, 15, 22, 26, 27, and 36 days [ 18 , 20–22 , 24 , 25 ]. The median, minimum, and maximum health care–related delays among patients with PTB are 22 days, 11 days, and 36 days, respectively.…”

Section: Resultsmentioning

confidence: 99%

Delayed Tuberculosis Treatment and Cost of Care in a Low-Incidence Country

O’Connell

Reidy

McNally

et al. 2022

Open Forum Infectious Diseases

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Purpose Tuberculosis (TB) elimination requires high-quality, timely care. In countries with a low incidence of TB, such as Ireland, delayed diagnosis is common. This evaluation aimed to determine factors that predict patient-related and health care provider-related delays in TB management and to establish how TB care cost is affected by care delays. Methods Health care records of patients with signs and symptoms of TB evaluated by a tertiary service in Ireland between July 1 st 2018 and December 31 st 2019 were reviewed to measure and determine predictors of patient-related delays, health care-provider related delay and the cost of TB care. Outcomes were compared against benchmarks derived from the literature. Results Thirty-seven patients were diagnosed with TB and 51% (19/37) had pulmonary TB (PTB). The median patient-related delay was 60 days among those with PTB, greater than the benchmark derived from the literature (38 days). The median health care provider-related delay among patients with PTB was 16 days and, although similar to the benchmark (median 22 days, minimum 11 days, maximum 36 days) could be improved. The health care-provider related delay among patients with EPTB was 66 days, greater than the benchmark (42 days). The cost of care was €8298, and while similar to that reported in the literature (median €9,319, minimum €6,486, maximum €14,750) could be improved. Patient-related delay among those with PTB predicted care costs. Conclusion Patient-related and health care-related delays in TB diagnosis in Ireland must be reduced. Initiatives to do so should be resourced.

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Gender differences in tuberculosis diagnosis, treatment and outcomes in Victoria, Australia, 2002–2015

Cited by 21 publications

References 0 publications

Gender differences in tuberculosis incidence rates—A pooled analysis of data from seven high-income countries by age group and time period

Gender differences in tuberculosis incidence rates—A pooled analysis of data from seven high-income countries by age group and time period

Recurrent tuberculosis in the Netherlands – a 24-year follow-up study, 1993 to 2016

Delayed Tuberculosis Treatment and Cost of Care in a Low-Incidence Country

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