Gender and HIV-associated pulmonary tuberculosis: presentation and outcome at one year after beginning antituberculosis treatment in UgandaReport as inadecuate




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BMC Pulmonary Medicine

, 2:4

First Online: 11 September 2002Received: 05 March 2002Accepted: 11 September 2002

Abstract

BackgroundTuberculosis is responsible for more female deaths around the earth than any other infectious disease. Reports have suggested that responses to tuberculosis may differ between men and women. We investigated gender related differences in the presentation and one year outcomes of HIV-infected adults with initial episodes of pulmonary tuberculosis in Uganda.

MethodsWe enrolled and followed up a cohort of 105 male and 109 female HIV-infected adults on treatment for initial episodes of culture-confirmed pulmonary tuberculosis between March 1993 and March 1995. A favorable outcome was defined as being cured and alive at one year while an unfavorable outcome was not being cured or dead. Subjects were followed-up by serial medical examinations, complete blood counts, serum β2 microglobulin, CD4+ cell counts, sputum examinations, and chest x-rays.

ResultsMale patients were older, had higher body mass indices, and lower serum β2 microglobulin levels than female patients at presentation. At one year, there was no difference between male and female patients in the likelihood of experiencing a favorable outcome RR 1.02, 95% CI 0.89–1.17. This effect persisted after controlling for symptoms, serum β2 microglobulin, CD4+ cell count, and severity of disease on chest x-ray OR 1.07, 95% CI 0.54–2.13 with a repeated measures model.

ConclusionsWhile differences existed between males and females with HIV-associated pulmonary tuberculosis at presentation, the outcomes at one year after the initiation of tuberculosis treatment were similar in Uganda. Women in areas with a high HIV and tuberculosis prevalence should be encouraged to present for screening at the first sign of tuberculosis symptoms.

KeywordsTuberculosis Gender HIV infection List of abbreviationsAIDSAcquired Immune Deficiency Syndrome

BMIBody Mass Index

HIVHuman immuno-deficiency virus

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Author: Peter Nsubuga - John L Johnson - Alphonse Okwera - Roy D Mugerwa - Jerrold J Ellner - Christopher C Whalen

Source: https://link.springer.com/







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