Gender Distribution of Smear Positive Tuberculosis Cases at a Tertiary Care Chest Diseases Centre in Karachi
Keywords:
Tuberculosis, Smear positivity, GenderAbstract
Objective: To determine the gender differences in smear positive subjects off Tuberculosis presenting to a tertiary care chest disease hospital from urban population of Sindh province.
Methods: Laboratory records of Provincial Reference Laboratory at Ojha Institute of Chest Diseases were retrospectively examined for the year 2013. Z-test for proportions was performed using Social Science Statistics© Calculator, while Odds ratio and Relative risk were calculated using online calculator available at Vassar Statistics©.
Results: A total of 3006 suspects were screened over the period of twelve months in 2013 including 1766 males (58.75%) and 1240 females (41.25%). Of these, 452 males (25.59%) and 381 females (30.72%) were tested positives. There was a statistically significant (p-value = 0.01174) difference in the proportion of test positives among males and females. Male suspects outnumbered females by 1.42:1, however amongst the confirmed TB cases, this ratio reduced to 1.18:1. Odds ratio (OR) for smear positivity amongst males was 0.77, (95% CI 0.66-0.91) with a significantly lower odds (p-value <0.01) among males compared with females.
Conclusions: The proportion of smear positivity in females exceeded that of males despite the fact that fewer females were screened for tuberculosis as compared to males. This may be suggestive of that we are only looking at the tip of the iceberg and a large number of undetected cases is present in females. This observation highlights the significance of prompt identification of active cases among the female population in Karachi.
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References
Organization WH. Global tuberculosis report 2013. World Health Organization; 2013.
Neyrolles O, Quintana-Murci L. Sexual inequality in tuberculosis. PLoS medicine. 2009;6(12):e1000199.
Lienhardt C, Glaziou P, Uplekar M, La K. Global tuberculosis control: Lessons learnt and future prospects. Nature Reviews Microbiology. 2005;10(6):407-16.
Lienhardt C, Fielding K, Sillah JS, Bah B, Gustafson P, Warndorff D, et al. Investigation of the risk factors for tuberculosis: a case control study in three countries in West Africa. Int J Epidemiol. 2005;34(4):914-23.
Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of
Disease Study 2010. The lancet. 2013;380(9859):2224- 60.
Boeree MJ, Harries AD, Godschalk P, Demast Q, Upindi B, Mwale A, et al. Gender differences in relation to sputum submission and smear-positive pulmonary tuberculosis in Malawi [Notes from the Field]. Int J Tuberc Lung Dis. 2000;4(9):882-4.
Austin JF, Dick JM, Zwarenstein M. Gender disparity amongst TB suspects and new TB patients according to data recorded at the South African Institute of Medical Research laboratory for the Western Cape Region of South Africa. Int J Tuberc Lung Dis. 2004;8(4):435-9.
Long NH, Johansson E, Lonnroth K, Eriksson B, Winkvist A, Diwan VK. Longer delays in tuberculosis diagnosis among women in Vietnam. Int J Tuberc Lung Dis. 1999;3(5):388-93.
Nhamoyebonde S, Leslie A. Biological Differences Between the Sexes and Susceptibility to Tuberculosis. J Infect Dis. 2014;209(suppl 3):S100-S6.
Borgdorff MW, Nagelkerke NJD, Dye C, Nunn P. Gender and tuberculosis: a comparison of prevalence surveys with notification data to explore sex differences in case detection. Int J Tuberc Lung Dis. 2000;4(2):123-32.
Stangroom J. Social Sciences Statistics. 2014 [updated 2014; cited 2014 31st July 2014]; Available from: http://www.socscistatistics.com.
Lowry R. Vassar Statistics. 2014 [updated 2014; cited 2014 31st July 2014]; Available from: http://vassarstats.net
Thorson A, Diwan VK. Gender inequalities in tuberculosis: Aspects of infection, notification rates, and compliance. Curr Opin Pulm Med. 2001;7(3):165-9.
Holmes CB, Hausler H, Nunn P. A review of sex differences in the epidemiology of tuberculosis. Int J Tuberc Lung Dis. 1998;2(2):96-104.
Codlin AJ, Khowaja S, Chen Z, Rahbar MH, Qadeer E, Ara I, et al. Gender differences in tuberculosis notification in Pakistan. The American journal of tropical medicine and hygiene. 2011;85(3):514-7.
Dogar OF, Shah SK, Chughtai AA, Qadeer E. Gender disparity in tuberculosis cases in eastern and western provinces of Pakistan. BMC infectious diseases. 2012;12(1):244.
Qureshi SA, Morkve O, Mustafa T. Patient and health system delays: health-care seeking behaviour among
pulmonary tuberculosis patients in Pakistan. JPMA J Pak Med Assoc. 2008;58(6):318.
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