Health care workers' gender bias in testing could contribute to missed tuberculosis among women in South Africa.
Smith, A;
Burger, R;
Claassens, M;
Ayles, H;
Godfrey-Faussett, P;
Beyers, N;
(2016)
Health care workers' gender bias in testing could contribute to missed tuberculosis among women in South Africa.
The international journal of tuberculosis and lung disease, 20 (3).
pp. 350-356.
ISSN 1027-3719
DOI: https://doi.org/10.5588/ijtld.15.0312
Permanent Identifier
Use this Digital Object Identifier when citing or linking to this resource.
SETTING: Eight communities with high tuberculosis (TB) prevalence, Western Cape, South Africa. OBJECTIVE: To identify sex differences in TB health-seeking behaviour and diagnosis in primary health care facilities and how this influences TB diagnosis. DESIGN: We used data from a prevalence survey among 30,017 adults conducted in 2010 as part of the Zambia, South Africa Tuberculosis and AIDS Reduction (ZAMSTAR) trial. RESULTS: A total of 1670 (5.4%) adults indicated they had a cough of ⩾2 weeks, 950 (56.9%) of whom were women. Women were less likely to report a cough of ⩾2 weeks (5.1% vs. 6.4%, P < 0.001), but were more likely to seek care for their cough (32.6% vs. 26.9%, P = 0.012). Of all adults who sought care, 403 (80.0%) sought care for their cough at a primary health care (PHC) facility (79.0% women vs. 81.4% men, P = 0.511). Women were less likely to be asked for a sputum sample at the PHC facility (63.3% vs. 77.2%, P = 0.003) and less likely to have a positive sputum result (12.6% vs. 20.7%, P = 0.023). CONCLUSION: The attainment of sex equity in the provision of TB health services requires adherence to testing protocols. Everyone, irrespective of sex, who seeks care for a cough of ⩾2 weeks should be tested.