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Diagnosis and Treatment Outcomes of Tuberculosis in Relation to Gender and HIV STATUS in South Benin

Tuberculosis (TB) has been a serious burden to mankind over many generations and remains a major global health concern. Some research has shown that HIV is the most important risk factor for TB and is also known to negatively impact treatment outcomes of co-infected TBHIV patients. However, in Benin, little is known about the influence of both gender and HIV-status on diagnostic patterns and treatment outcomes of tuberculosis patients. So the authors in this study aimed to assess whether differences in gender and HIV status affected diagnostic patterns and treatment outcomes of TB patients.

The authors conducted a retrospective cohort study of patients registered in 2013 and 2014 in the three largest TB Basic Management Units in south Benin. In total, 2694 TB patients were registered in 2013 and 2014, of whom 1700 (63.1%) were males and 994 (36.9%) were females. Case notification rates were higher in males compared with females (96 vs 53/100,000 inhabitants). The male to female ratio was 1:1 in HIV positive patients, but was 2:1 among HIV negative cases.

The results indicated that in HIV-positive patients, there were no differences in TB types between men and women. In HIV-negative patients, there were significantly higher proportions of females with clinically diagnosed pulmonary TB (p = 0.04) and extrapulmonary TB (p < 0.001). Retreatment TB was 4.65 times higher amongst males compared with females. For new bacteriologically confirmed pulmonary TB, no differences were observed in treatment outcomes between genders in the HIV positive group; but significantly more unfavorable outcomes were reported among HIV negative males, with higher rates of failure (p < 0.001) and loss-to-follow up (p = 0.02).

In conclusion, the study has shown that overall TB notification rates were higher in males than in females in south Benin, with more females co-infected with HIV. And unfavorable outcomes were more common in HIV-negative males. Further studies are needed to explain the country specific underlying reasons for these gender differences in TB case notifications in Benin and to assess if there are any variations across the different regions.

Article by Ablo Prudence Wachinou, et al, from Bénin, France and UK.

Full access: http://mrw.so/RPn5O  

Image by rtcmedia, from Flickr-cc.

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