Gender and tuberculosis: A comparison of prevalence surveys with notification data to explore sex differences in case detection

Martien W. Borgdorff, N. J.D. Nagelkerke, C. Dye, P. Nunn

Research output: Contribution to journalArticlepeer-review

186 Citations (Scopus)

Abstract

OBJECTIVE: To explore whether lower tuberculosis notification rates among women are due to a reduced access to health care, particularly diagnostic services, for women. METHODS: Age- and sex-specific tuberculosis prevalence rates of smear-positive tuberculosis were obtained from tuberculosis prevalence surveys reported to the WHO or published in the literature. Age- and sex-specific notification rates from the same countries in 1996 were used. RESULTS: Prevalence data and notifications from 29 surveys in 14 countries were used. Notification rates varied strongly among countries, but the female/male ratio was below 1 and decreased with increasing age in almost all. The female/male (F/M) prevalence ratios were less than 0.5 in surveys in the South-East Asia and Western Pacific Region, and approximately 1 in the African Region. CONCLUSION: In most countries the F/M sex ratio in prevalent cases was similar or lower than that in notified cases, suggesting that F/M differences in notification rates may be largely due to epidemiological differences and not to differential access to health care. However, available data are limited as the prevalence surveys in Africa were carried out many years ago, and in Asia notification rates may be distorted by a large private sector with deficiencies in notification.

Original languageEnglish
Pages (from-to)123-132
Number of pages10
JournalInternational Journal of Tuberculosis and Lung Disease
Volume4
Issue number2
Publication statusPublished - Feb 1 2000

Keywords

  • Case detection
  • Gender
  • Notification
  • Prevalence surveys
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

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