Sharma P P, Kumar Ashok, Singh Padam
LRS Institute of TB and Respiratory Diseases, (Near Qutab Minar), Sri Aurobindo Marg, New Delhi, India.
Indian J Community Med. 2010 Apr;35(2):230-7. doi: 10.4103/0970-0218.66869.
Worldwide, the case notification rate of tuberculosis has been reported to be higher for men than women. In India also, the prevalence of TB is higher among males as compared to females but it is important to study the trend of gender gap in the prevalence of tuberculosis over the years.
To examine the trend in gender gap in the prevalence of TB over the years.
The unit level data of NFHS-2 (1998-99) and NFHS-3 (2005-06) has been utilized. Gender gap in the prevalence of TB has been estimated for the two rounds of the surveys. The delta (Δ), the difference in gender gap in two surveys, has been estimated and decomposed by background characteristics such as place of residence(urban/rural), religion (Hindus/Muslims/others), caste(SC/ST/OBC/others) and standard of living(SLI) (low/medium/high) categories.
Overall, the prevalence of TB has remained almost same in the two surveys [432/lakh in NFHS-2 and 418/lakh in NFHJS-3; Z=1.19, P=0.275. The gender gap has increased to 217/lakh in NFHS-3 in comparison to 145 per lakh in NFHS-2. The increase in gender gap is significantly higher in rural areas [of 98 per lakh;167/ lakh in NFHS-2 vs 265/lakh in NFHS-3; P<0.05] as compared to corresponding increase in urban areas [of 30 per lakh; 88/ lakh in NFHS-2 vs118/ lakh in NFHS-3, P>0.05]. The increase in delta (D) (difference in gender gap in two surveys) is accounted for as 88% by the rural areas and 12% by the urban areas.
The increase in gender gap in the prevalence of TB is more in rural areas as compared to urban areas. The increase in rural areas is mainly contributed by Hindus, SC and ST and low and medium SLI categories and in urban areas, the contribution is mainly by Hindus, other castes and high SLI categories.
据报道,全球范围内,结核病的病例报告率男性高于女性。在印度,结核病的患病率也是男性高于女性,但研究多年来结核病患病率的性别差距趋势很重要。
研究多年来结核病患病率性别差距的趋势。
使用了全国家庭健康调查-2(1998 - 1999年)和全国家庭健康调查-3(2005 - 2006年)的单位层面数据。对两轮调查的结核病患病率性别差距进行了估计。通过居住地点(城市/农村)、宗教(印度教徒/穆斯林/其他)、种姓(在册种姓/在册部落/其他落后阶层/其他)和生活水平(低/中/高)等背景特征对两次调查中性别差距的差值(Δ)进行了估计和分解。
总体而言,两次调查中结核病的患病率几乎保持不变[全国家庭健康调查-2中为每10万人432例,全国家庭健康调查-3中为每10万人418例;Z = 1.19,P = 0.275]。与全国家庭健康调查-2中每10万人145例相比,全国家庭健康调查-3中的性别差距增加到了每10万人217例。与城市地区相应的增加[每10万人30例;全国家庭健康调查-2中为每10万人88例,全国家庭健康调查-3中为每10万人118例,P > 0.05]相比,农村地区性别差距的增加[每10万人98例;全国家庭健康调查-2中为每10万人167例,全国家庭健康调查-3中为每10万人265例;P < 0.05]明显更高。两次调查中性别差距差值(D)的增加,农村地区占88%,城市地区占12%。
与城市地区相比,农村地区结核病患病率的性别差距增加幅度更大。农村地区的增加主要由印度教徒、在册种姓和在册部落以及低和中等生活水平类别导致,而在城市地区,主要由印度教徒、其他种姓和高生活水平类别导致。