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Home / The International Journal of Tuberculosis and Lung Disease, Volume 19, Number 10

Gender differences in treatment outcomes among 15–49 year olds with smear-positive pulmonary tuberculosis in Kenya

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OBJECTIVE: To determine gender differences in treatment outcomes among 15–49 year olds with smear-positive pulmonary tuberculosis (PTB) and factors associated with poor outcomes in Kenya.

DESIGN: Retrospective descriptive cohort.

RESULTS: Of 16 056 subjects analysed, 38% were female and 62% male. Females had a higher risk of poor treatment outcome than males (12% vs. 10%, P < 0.001; adjusted OR 1.29, 95%CI 1.16–1.44, P < 0.001). In the first multivariate model, restricting the analysis to human immunodeficiency virus (HIV) positive patients and adjusting for risk factors and clustering, females had a non-significantly lower risk of poor outcome (OR 0.99, 95%CI 0.86–1.13, P = 0.844). In the model restricted to HIV-negative patients, a non-significantly lower risk was found (OR 0.89, 95%CI 0.73–1.09, P = 0.267). In the second model, restricting analysis to patients on antiretroviral therapy (ART) and adjusting for risk factors and clustering, females had a non-significantly lower risk of poor PTB treatment outcomes (OR 0.98, 95%CI 0.84–1.14, P = 0.792). In the model restricted to HIV-positive patients not on ART, a non-significantly higher risk was found (OR 1.15, 95%CI 0.79–1.67, P = 0.461).

CONCLUSION: Females of reproductive age are likely to have poorer treatment outcomes than males. Among females, not commencing ART during anti-tuberculosis treatment seemed to be associated with poor outcomes.

Keywords: HIV; reproductive age; women

Document Type: Research Article

Affiliations: 1: Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya 2: Ministry of Health, Department of Disease Prevention and Control, Nairobi, Kenya; Moi University Department of Epidemiology, Nairobi Campus, Nairobi, Kenya 3: World Health Organization, Nairobi, Kenya 4: Division of Leprosy Tuberculosis and Lung Disease, Ministry of Health, Nairobi, Kenya 5: Ruby Medical Centre, Kiambu West, Kenya 6: Department of Human Anatomy, University of Nairobi, Nairobi, Kenya, Kenya 7: Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium 8: Department of Health Management, Moi University, Eldoret, Kenya 9: Alpert School of Medicine at Brown University, Providence, Rhode Island, USA

Publication date: 01 October 2015

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

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