Sex Difference in Tuberculosis in Afghanistan: A National Cohort Study

Wrishmeen Sabawoon

doi:10.4172/2161-1068.1000115

Abstract

Background: In general, tuberculosis rate is higher among men than women globally. The reason for the sex difference in the rate is not clear. The purpose of this study is to examine sex difference in the incidence of smearpositive pulmonary Tuberculosis (TB) in Afghanistan and to discuss it from socio cultural perspectives. Methods: Patients with smear-positive pulmonary tuberculosis were identified by all health facilities capable to diagnose tuberculosis, throughout Afghanistan. Age-specific incidence rates of smear positive pulmonary tuberculosis for males and females census cohorts of 2005 were compared. Results: Of the 9,949 smear-positive TB cases identified during 2005, 3,131 (31.5%) were male and 6,818 (68.5%) were female. The annual incidence rates (per 100, 000 population) of TB were 60.0 for female population and 26.7 for male population. In all the age groups, except those aged more than 65 years, those rates were higher for females than for males. Conclusions: Based on the national registration data, for all the age groups equal to or under 65 years old in Afghanistan, the incidence rates of pulmonary TB are higher in females than in males. Possible factors contributing to this observation are discussed.

Highlights

Tuberculosis (TB) is a major cause of illness and death worldwide, especially in Asia and Africa
We studied the records of all patients with smear-positive TB who registered for TB treatment within the national surveillance system of Afghanistan and whose cases were reported to the World Health Organization (WHO)
The diagnosis of smear-positive TB required that Acid-Fast Bacilli (AFB) be visible on microscopic examination of two or more sputum samples, or that there be one sputum sample positive for AFB in addition to clinical and radiologic features compatible with TB

Summary

Introduction

Tuberculosis (TB) is a major cause of illness and death worldwide, especially in Asia and Africa. The apparent rates of TB among male and female children and adolescents were similar, but the rate among females aged 15-34 years was very high in the middle of the twentieth century. The apparent rates for both sexes during the last few decades were similar to those in industrialized countries in the middle of the twentieth century. In Nicaragua, Kenya, Tanzania, and China, for example, similar rates of smear-positive pulmonary TB were reported in males and females up to the age of 14 years, above which males had higher rates [4]. The higher rates among young-to-early-middle-aged women that were observed in the middle of the twentieth century in industrialized countries with high incidence rates of TB have not yet been reported from developing countries [5,6]. The purpose of this study is to examine sex difference in the incidence of smearpositive pulmonary Tuberculosis (TB) in Afghanistan and to discuss it from socio cultural perspectives

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Conclusion