Tuberculosis and gender: exploring the patterns in a case control study in Malawi


Crampin, AC; Glynn, JR; Floyd, S; Malema, SS; Mwinuka, VK; Ngwira, BM; Mwaungulu, FD; Warndorff, DK; Fine, PE; (2004) Tuberculosis and gender: exploring the patterns in a case control study in Malawi. The international journal of tuberculosis and lung disease, 8 (2). pp. 194-203. ISSN 1027-3719

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Abstract

BACKGROUND: In many populations there is an excess of tuberculosis in young women and older men. We explored possible explanations for these patterns, concentrating on human immunodeficiency virus (HIV) status, pregnancy, smoking, cooking smoke exposure, contact with tuberculosis cases within the household or outside, and gender differences in health service usage and diagnostic delay.<br/> DESIGN: Case control study in Karonga District, Malawi.<br/> METHODS: Cases were new tuberculosis patients with bacteriological or histological evidence of tuberculosis. Controls were selected in the community using field-based random sampling.<br/> RESULTS: The study included 598 tuberculosis cases and 992 controls, with an excess of tuberculosis in young females and older males. This was more marked in HIV-positive individuals. HIV infection was a similarly strong risk factor for tuberculosis in both men and women. Tuberculosis was associated with having a family or household contact with tuberculosis for both men and women. For women, but not men, contacts outside the close family and household were also a risk factor for tuberculosis. Tuberculosis was not associated with current or recent pregnancy, or with smoking or smoke exposure. There were no differences between men and women in health service usage or delay.<br/> CONCLUSIONS: In this population, HIV infection and contacts with known tuberculosis patients are important determinants of the gender distribution of cases.<br/>

Item Type: Article
Keywords: tuberculosis, HIV, risk factors, gender, Africa, Human-immunodeficiency-virus, rural south-africa, hiv-, infection, risk factor, pulmonary tuberculosis, northern, malawi, leprosy, smoking, epidemiology, pregnancy
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: MEIRU
TB Centre
Population Studies Group
PubMed ID: 15139448
Web of Science ID: 221164600006
URI: http://researchonline.lshtm.ac.uk/id/eprint/14688

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