Tuberculosis in women: A reflection of gender inequity

Srivastava, Kirti; Kant, Surya; Narain, Apoorva; Bajpai, Jaya

doi:10.1183/13993003.congress-2018.pa531

Cited by 6 publications

(5 citation statements)

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“…In the adult population, men are at a substantially higher risk of contracting and dying from tuberculosis than women, whereas women face distinct challenges to access tuberculosis services and care, including stigma. 28,29 Our study findings with respect to skin colour and race were similar to other studies that showed that those identifying with Black or Brown skin colour had higher odds of loss to followup and death from tuberculosis in Brazil than those with White skin colour. 22 These findings probably relate to structural racism that persists for people identifying with Black or Brown skin colour, with respect to education, employment, occupation, and income level, which are distal determinants of tuberculosis.…”

Section: Discussionsupporting

confidence: 88%

Social and health factors associated with unfavourable treatment outcome in adolescents and young adults with tuberculosis in Brazil: a national retrospective cohort study

Chenciner

Annerstedt

Pescarini

et al. 2021

The Lancet Global Health

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Background Tuberculosis elimination strategies in Brazil might neglect adolescents and young adults aged 10-24 years, hampering tuberculosis control. However, little is known about factors associated with tuberculosis treatment outcomes in this underserved group. In this study, we aimed to investigate social and health factors associated with unfavourable treatment outcomes in young people with tuberculosis in Brazil.Methods A national retrospective cohort study was done using data from Sistema de Informação de Agravos de Notificação (SINAN), the national tuberculosis registry in Brazil. People aged 10-24 years (young people) with tuberculosis registered in SINAN between Jan 1, 2015, and Dec 31, 2018, were included. Unfavourable outcomes were defined as loss to follow-up, treatment failure, and death. Favourable outcome was defined as treatment success. Multiple logistic regression models estimated the association between social and health factors and tuberculosis treatment outcomes. Findings 67 360 young people with tuberculosis were notified to SINAN, and we included 41 870 young people in our study. 7024 (17%) of the 41 870 included individuals had unfavourable treatment outcomes. Young people who received government cash transfers were less likely to have an unfavourable outcome (adjusted odds ratio 0•83, 95% CI 0•70-0•99). Homelessness (3•03, 2•07-4•42), HIV (2•89, 2•45-3•40), and illicit drug use (2•22, 1•93-2•55) were the main factors associated with unfavourable treatment outcome. Interpretation In this national cohort of young people with tuberculosis in Brazil, tuberculosis treatment success rates were lower than WHO End TB Strategy targets, with almost a fifth of participants experiencing unfavourable treatment outcomes. Homelessness, HIV, and illicit drug use were the main factors associated with unfavourable outcome. In Brazil, strategies are required to support this underserved group to ensure favourable tuberculosis treatment outcomes.

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Section: Discussionsupporting

confidence: 88%

Social and health factors associated with unfavourable treatment outcome in adolescents and young adults with tuberculosis in Brazil: a national retrospective cohort study

Chenciner

Annerstedt

Pescarini

et al. 2021

The Lancet Global Health

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“…Although far more males than females have TB globally [28,29], TB-infected females than males often have more precarious social and economic positions [29,30]. In this study, females seemed to have a higher risk of developing cancer than males after TB, although esophageal cancer and non-Hodgkin's lymphoma were exceptions, suggesting that TB may contribute to the sex-specific development of malignant cancer.…”

Section: Discussionmentioning

confidence: 58%

Cancer risk in tuberculosis patients in a high endemic area

et al. 2021

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Background Tuberculosis (TB) may facilitate carcinogenesis. We performed a case-control study of the association between TB and cancer in Xinjiang, a high TB endemic area of China. Methods From January 2016 to December 2018, a total of 45,455 patients hospitalized in Xinjiang Cancer Hospital were consecutively enrolled and divided into a malignant tumor group (n = 32,539) and a benign tumor group (n = 12,916). Patients with active and previous TB before the diagnosis of cancer were retrospectively identified in the two groups. Results A significantly higher proportion of TB was found in the malignant tumor group (n = 1776, 5.46%) than in the control (benign tumor) group (n = 175, 1.35%) (p < 0.0001). The highest and lowest proportions of TB in the malignant group were in patients with non-Hodgkin’s lymphoma (16.74%) and thyroid cancer (0.77%), respectively. In multivariate analysis adjusting for age, sex, and ethnicity, TB remained an independent risk factor for all cancers (odds ratio (OR) 1.68; 95% confidence interval (CI) 1.43–1.97). Furthermore, TB was associated with a significantly higher risk of non-Hodgkin’s lymphoma, cervical cancer, esophageal cancer, “other” cancers, ovarian cancer, and breast cancer. Moreover, females with TB were more likely to develop cancer than males (p < 0.0001), except for esophageal cancer and lymphoma. Conclusion TB patients have an elevated cancer risk. A screening strategy for TB should be taken into consideration before treatment in patients with some cancer types that are associated with a high proportion of TB.

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“…Nearly 12 million TB-related HIV deaths were averted in the period 2000-2020 because of TB/HIV-related interventions (full integration) [15,16,17,18]. Integration of TB-HIV care, strong management and leadership at the health district and facility level have been shown to be predictors of good TB and HIV treatment outcomes as studies have demonstrated elsewhere [19,20,21,22,23]. These findings aligns with those of Kanyerere et al, [24] in Kenyanian clinics, while in Durban, South Africa Health Systems Trust observe similar findings [26].…”

Section: Discussionmentioning

confidence: 99%

Voices from the Patients: A Qualitative Study of Integration of HIV, Tuberculosis, and Primary Healthcare Services in O.R Tambo District, South Africa

Dlatu¹,

Apalata²,

Oladimeji³

2022

Preprint

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Tuberculosis (TB) and human immunodeficiency virus (HIV) epidemics in South Africa have been closely related and persistent, posing a significant burden for healthcare provision. We explored the patients perspectives on challenges and barriers of scaling up TB and HIV integrated services. A descriptive cross-sectional study applying a qualitive research approach was used. Through focus group discusssions (FGDs), we interviewed 29 patients accessing TB and HIV services at the study sites which were selected at primary health care (PHC) clinics in the O.R Tambo district in Eastern Cape, South Africa. Anonymised data was analysed using both content and thematic analysis technique. Challenges and barriers identified included a lack of health education about TB and HIV; an inadequate counselling for antiretroviral drugs (ARVs) and HIV; a lack of awareness of the National TB control program; and poor quality of services provided by the health care facilities. These findings suggest that the O.R. Tambo district needs to strengthen its TB-HIV integration immediately. Keywords: TB-HIV integration; Challenges and barriers; Patients; O.R Tambo District; Eastern Cape; South Africa

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Tuberculosis in women: A reflection of gender inequity

Cited by 6 publications

References 0 publications

Social and health factors associated with unfavourable treatment outcome in adolescents and young adults with tuberculosis in Brazil: a national retrospective cohort study

Social and health factors associated with unfavourable treatment outcome in adolescents and young adults with tuberculosis in Brazil: a national retrospective cohort study

Cancer risk in tuberculosis patients in a high endemic area

Voices from the Patients: A Qualitative Study of Integration of HIV, Tuberculosis, and Primary Healthcare Services in O.R Tambo District, South Africa

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