TY - JOUR
T1 - Sex Differences in Active Pulmonary Tuberculosis Outcomes in Mali, West Africa
AU - Dabitao, Djeneba
AU - Somboro, Amadou
AU - Sanogo, Ibrahim
AU - Diarra, Bassirou
AU - Achenbach, Chad J.
AU - Holl, Jane L.
AU - Baya, Bocar
AU - Sanogo, Moumine
AU - Wague, Mamadou
AU - Coulibaly, Nadie
AU - Kone, Mahamadou
AU - Drame, Hawa Baye
AU - Tolofoudie, Mohamed
AU - Kone, Bourahima
AU - Diarra, Ayouba
AU - Coulibaly, Mamadou D.
AU - Saliba-Shaw, Kathryn
AU - Toloba, Yacouba
AU - Diakite, Mahamadou
AU - Doumbia, Seydou
AU - Klein, Sabra L.
AU - Bishai, William R.
AU - Diallo, Souleymane
AU - Murphy, Robert L.
N1 - Publisher Copyright:
Copyright © 2022 The American Society of Tropical Medicine and Hygiene.
PY - 2022/8
Y1 - 2022/8
N2 - Men and women often respond differently to infectious diseases and their treatments. Tuberculosis (TB) is a life-threatening communicable disease that affects more men than women globally. Whether male sex is an independent risk factor for unfavorable TB outcomes, however, has not been rigorously investigated in an African context, where individuals are likely exposed to different microbial and environmental factors. We analyzed data collected from a cohort study in Mali by focusing on newly diagnosed active pulmonary TB individuals who were treatment naive. We gathered baseline demographic, clinical, and microbiologic characteristics before treatment initiation and also at three time points during treatment. More males than females were affected with TB, as evidenced by a male-to-female ratio of 2.4:1. In addition, at baseline, males had a significantly higher bacterial count and shorter time to culture positivity as compared with females. Male sex was associated with lower smear negativity rate after 2 months of treatment also known as the intensive phase of treatment, but not at later time points. There was no relationship between patients’ sex and mortality from any cause during treatment. This study suggests that sex-based differences in TB outcomes exist, with sex-specific effects on disease outcomes being more pronounced before treatment initiation and during the intensive phase of treatment rather than at later phases of treatment.
AB - Men and women often respond differently to infectious diseases and their treatments. Tuberculosis (TB) is a life-threatening communicable disease that affects more men than women globally. Whether male sex is an independent risk factor for unfavorable TB outcomes, however, has not been rigorously investigated in an African context, where individuals are likely exposed to different microbial and environmental factors. We analyzed data collected from a cohort study in Mali by focusing on newly diagnosed active pulmonary TB individuals who were treatment naive. We gathered baseline demographic, clinical, and microbiologic characteristics before treatment initiation and also at three time points during treatment. More males than females were affected with TB, as evidenced by a male-to-female ratio of 2.4:1. In addition, at baseline, males had a significantly higher bacterial count and shorter time to culture positivity as compared with females. Male sex was associated with lower smear negativity rate after 2 months of treatment also known as the intensive phase of treatment, but not at later time points. There was no relationship between patients’ sex and mortality from any cause during treatment. This study suggests that sex-based differences in TB outcomes exist, with sex-specific effects on disease outcomes being more pronounced before treatment initiation and during the intensive phase of treatment rather than at later phases of treatment.
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U2 - 10.4269/ajtmh.21-1141
DO - 10.4269/ajtmh.21-1141
M3 - Article
C2 - 35895582
AN - SCOPUS:85148505315
SN - 0002-9637
VL - 107
SP - 433
EP - 440
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
IS - 2
ER -