Gender disparities in retreatment patients of tuberculosis: A north Indian study

Abstract

Background:‘Retreatment’ for tuberculosis (TB) has long been a neglected area in global TB control India. However India disproportionately accounts for nearly half of retreatment TB cases notified globally. Sex differences vary in different age groups and in different parts of the world. The present study focuses on whether gender-based differences are present in notification rates, clinical presentation, and treatment outcomes of different subcategories of patients registered under category II of Revised National TB Control Programme (RNTCP) Chandigarh.Materials and Methods:A longitudinal study was designed and the patients registered under RNTCP category II from June 2010 to December 2011. Out of total 607 patients registered during this period under category II of RNTCP in Chandigarh, 545 consented to participate in the study. These were followed-up to September 2012 till the completion of treatment. All 545 recruited cases were stratified into males and females and the results analyzed. The Z test for proportion (for comparing differences in proportions) and Student's t-test (for comparing mean) were performed for statistical analysis.Results:From the cohort of 545 patients, 348 (63.9%) were males and 197 (36.1%) were female patients with overall male to female ratio 1.8:1. The proportion of male patients notified was significantly higher than females (Z = 5.93, P < 0.001). The proportion of extrapulmonary cases was higher in the females (28.4%) as compared with males (17%) (P < 0.001). Males outnumbered females in all the unfavorable outcomes death, default, and failure. The default in males was significant as compared to the females (Z = 5.21, P < 0.001).Conclusions:The findings of this study suggest a sex difference in the notification rate of retreatment cases of TB. Reasons for a better outcome and low notification rate for TB in females are more due to epidemiological factors than a differential access of the health care. Integrated research is required to outline the relative roles played by epidemiology.

Characteristics and Treatment Outcomes of Retreatment Tuberculosis Patients in Benin

“…The proportion of patients requiring a MDR-TB treatment regimen in the country in 2013 was not higher in comparison with previous years [ 16 , 17 ]. A predominance of males among retreatment TB cases was found in this study and this has also been reported elsewhere, although the reasons for this are not known [ 18 ]. “Atlantique-Littoral,” which houses Cotonou, the economic capital and the city with the highest density of population, always reports the highest number of TB cases in the country; and we are not surprised that this is also the case for retreatment TB cases.…”

Determinants of Categories of TB Retreatment with Special Reference to Sources of Primary Anti-TB Treatment

“…Majority of the study participants 52.8% were in the age group 36 to 55 years. The study conducted by Sarpal et al 7 in Chandigarh, shows similar findings as our present study with respect to gender and age. As per the census 2011 data, Pondicherry has an average literacy rate of 85.85%, higher than the national average of 74%.…”

Clinical, Laboratory and Radiological Profile of Re-Treatment Tuberculosis

“…Among total 22 cases of re-treatment registered during the study period, 18 (81.8%) were males and 4 (18.1%) were females. In this study male-to-female ratio of re-treatment TB is 4.5: 1, which shows a male predominance similar to other studies like Srinath Sharath et al 5 in Andhra Pradesh, which shows 67% male patients and Sandeep Naveen et al 6 at Chandigarh shows 63.9% males with male: female ratio of 1.8: 1, while Ugra Srinath et al 7 shows 80% male predominance.…”

“…Similar study by Srinath Sharath et al 5 in Andhra Pradesh shows 88% patients were in the age group of 15 -64 years. Sandeep Naveen et al 6 at Chandigarh conducted a study, which shows the mean ages of males and females were 38.79 ± 14.4 and 30.84 ± 15.85 years respectively, while Ugra Srinath et al 7 conducted a study which shows that the median age was 38 years.…”