Ben Jmaa Maissa, Ben Ayed Houda, Koubaa Makram, Hammami Fatma, Damak Jamel, Ben Jemaa Mounir
Tunis Med. 2020 Mar;98(3):232-240.
Worldwide, many more males than females were diagnosed with tuberculosis (TB) and died from it globally. In light of this, examining the gender differences among patients with TB is crucial to institute effective prevention, coverage and treatment.
To analyze gender differences in the epidemiological, clinical and evolutionary specificities of TB in Southern Tunisia.
We conducted a retrospective study including all new cases of TB of any age, diagnosed between January 1995 and December 2016. Data were collected from the regional register of TB at the Center of Tuberculosis Control of Sfax, Southern Tunisia.
We recorded 2771 new cases of TB. The sex ratio was 1.2. We noted 1160 new cases with pulmonary TB (PTB) (41.9%). Males were more likely to have PTB than females (Odds Ratio (OR)=2.5;p<0.001), while extra-pulmonary TB (EPTB) was more common in females (OR=0.4;p<0.001). Lymph node (OR=2.6;p<0.001), cutaneous (OR=2.3;p<0.001) and abdominal TB (OR=2;p<0.001) were significantly more frequent in females. Pleural TB was significantly more common in males (OR=1.2; p<0.001). Case fatality rate was significantly higher in males (OR=1.7;p=0.02). Females experienced recovery more frequently (OR=1.3;p=0.04). Treatment duration was significantly higher in females (8.88±3.6months vs.8.41±3.2months; p<0.001). Between 1995 and 2016, the age standardized notification rate (ASNR) of TB (Rho=0.68; p<0.001) and EPTB (Rho=0.59 p=0.003) had significantly increased in females, while it had not significantly changed in males.
Our study highlighted higher burden and morbidity in males in TB cases in Southern Tunisia. National TB programs should actively focus on these facts with more routine diagnostic and screening targeting males.
在全球范围内，被诊断出患有结核病（TB）并死于该病的男性比女性多得多。鉴于此，研究结核病患者的性别差异对于制定有效的预防、覆盖范围和治疗措施至关重要。
分析突尼斯南部结核病在流行病学、临床和演变特异性方面的性别差异。
我们进行了一项回顾性研究，纳入了1995年1月至2016年12月期间诊断出的所有各年龄段的新结核病病例。数据从突尼斯南部斯法克斯结核病控制中心的地区结核病登记册中收集。
我们记录了2771例新结核病病例。性别比为1.2。我们注意到1160例肺结核（PTB）新病例（41.9%）。男性患PTB的可能性高于女性（优势比（OR）=2.5；p<0.001），而肺外结核（EPTB）在女性中更为常见（OR=0.4；p<0.001）。女性的淋巴结结核（OR=2.6；p<0.001）、皮肤结核（OR=2.3；p<0.001）和腹部结核（OR=2；p<0.001）明显更为常见。男性的结核性胸膜炎明显更为常见（OR=1.2；p<0.001）。男性的病死率明显更高（OR=1.7；p=0.02）。女性康复更为频繁（OR=1.3；p=0.04）。女性的治疗持续时间明显更长（8.88±3.6个月对8.41±3.2个月；p<0.001）。1995年至2016年期间，女性结核病的年龄标准化报告率（ASNR）（Rho=0.68；p<0.001）和EPTB的年龄标准化报告率（Rho=0.59；p=0.003）显著增加，而男性则没有显著变化。
我们的研究突出了突尼斯南部结核病病例中男性的更高负担和发病率。国家结核病项目应积极关注这些情况，对男性进行更多的常规诊断和筛查。
