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

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. Fema...

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Published in:	The international journal of tuberculosis and lung disease Vol. 19; no. 10; pp. 1176 - 1181
Main Authors:	Kosgei, R. J., Sitienei, J. K., Kipruto, H., Kimenye, K., Gathara, D., Odawa, F. X., Gichangi, P., Callens, S., Temmerman, M., Sitienei, J. C., Kihara, A-B., Carter, E-J.
Format:	Journal Article
Language:	English
Published:	France International Union Against Tuberculosis and Lung Disease 01-10-2015
Subjects:	Adolescent Adult Anti-HIV Agents - therapeutic use Antitubercular Agents - therapeutic use Female HIV HIV Infections - drug therapy HIV Infections - epidemiology Humans Kenya Male Middle Aged Multivariate Analysis Mycobacterium Reproductive Age Retrospective Studies Risk Factors Sex Factors Sputum - microbiology Treatment Outcome Tuberculosis, Pulmonary - diagnosis Tuberculosis, Pulmonary - drug therapy Tuberculosis, Pulmonary - microbiology Women Young Adult Kenya
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Summary:	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.
Bibliography:	(R) Medicine - General 1027-3719(20151001)19:10L.1176;1- ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1027-3719 1815-7920
DOI:	10.5588/ijtld.15.0070