Ugwu C, Aneke C, Chijioke-Akaniro O, Kushim J, Adekeye O, Kolawole G, Okoye C, Bimba J
Department of Clinical Sciences, Liverpool School of Tropical Medicine, UK.
Zankli Research Centre, Bingham University, Karu, Nigeria.
Public Health Action. 2025 Jun 4;15(2):1-20. doi: 10.5588/pha.24.0032. eCollection 2025 Jun.
The global TB burden shows significant gender disparity with men and women facing distinct challenges in accessing comprehensive care for TB. A full understanding of the gender dimensions of the TB epidemic is crucial for appropriate policy interventions and we therefore explored gender differences in the TB service cascade in Nigeria.
A retrospective gender-based analysis of the TB care cascade was conducted covering the four-year period between 2018-2021. We obtained sex-disaggregated service utilisation data for adults (aged ≥15 years) in 14 states through the monitoring and evaluation systems of the TB control programme. Using a care cascade framework, we present numbers accessing care at each step and gaps for men and women including TB/HIV collaborative services.
Overall, amongst men, 12.3 million visited health facilities, 6 million were screened for TB and 833,483 were identified as presumptive cases, of which 79% were tested for TB. For women, 12.3 million visited facilities, 6.9 million screened and 664,130 identified as presumptive cases, of which 76% were tested. Men exhibited a higher screening gap, whereas women had a higher testing gap, with variations in treatment outcomes across both genders.
The TB surveillance system screened more women and diagnosed more men with the disease, with significant missed opportunities and gaps along the continuum of care for both men and women. Targeted policy interventions are required to strengthen surveillance, data systems and to reduce gender inequity across the TB care cascade in Nigeria.
全球结核病负担存在显著的性别差异，男性和女性在获得全面的结核病治疗方面面临不同的挑战。全面了解结核病流行的性别层面对于采取适当的政策干预措施至关重要，因此我们探讨了尼日利亚结核病服务流程中的性别差异。
对2018年至2021年这四年期间的结核病治疗流程进行了基于性别的回顾性分析。我们通过结核病控制项目的监测和评估系统，获取了14个州15岁及以上成年人按性别分类的服务利用数据。使用治疗流程框架，我们列出了男性和女性在每个步骤获得治疗的人数以及差距，包括结核病/艾滋病协作服务方面的差距。
总体而言，男性中有1230万人前往医疗机构就诊，600万人接受了结核病筛查，833483人被确定为疑似病例，其中79%接受了结核病检测。女性中有1230万人前往医疗机构就诊，690万人接受了筛查，664130人被确定为疑似病例，其中76%接受了检测。男性的筛查差距更大，而女性的检测差距更大，两性的治疗结果也存在差异。
结核病监测系统筛查的女性更多，诊断出的男性患者更多，在男性和女性的整个治疗过程中都存在重大的机会错失和差距。需要有针对性的政策干预措施来加强监测、数据系统，并减少尼日利亚结核病治疗流程中的性别不平等现象。
