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Free Content Tuberculosis and patient gender in Bangladesh: sex differences in diagnosis and treatment outcome

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SETTING: The public health sector of Bangladesh.

OBJECTIVE: To assess gender differences in access to tuberculosis diagnosis and in tuberculosis treatment outcome in Bangladesh.

METHODS: Information on the age and sex of a sample of patients in 1997 was collected from out-patient registers and tuberculosis laboratory and treatment registers in 59 thanas in three divisions in Bangladesh.

RESULTS: The female/male ratio was 0.79 among 42877 out-patients with respiratory complaints, 0.51 among 5665 tuberculosis suspects undergoing sputum smear microscopy, 0.36 among 869 tuberculosis suspects with positive sputum smears, and 0.35 among 5632 patients registered for tuberculosis treatment. Treatment was successful (cured or treatment completed) in 86% of female and 84% of male patients.

CONCLUSION: Women in Bangladesh appear to have less access to public out-patient clinics than men, and if they present with respiratory symptoms they are less likely to undergo sputum smear examination. If examined, women are less likely than men to be smear-positive. No gender bias was observed in tuberculosis treatment outcome. It is recommended to focus further research on exploration of sex differences in the incidence of respiratory conditions, identification of constraints among women in accessing out-patient clinics and verification of the quality of sputum submitted by women for examination.
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Keywords: Bangladesh; DOTS; diagnosis; gender; treatment; tuberculosis

Document Type: Regular Paper

Affiliations: 1: National TB Control Programme, Directorate General of Health Services, Dhaka, Bangladesh 2: World Health Organization, Dhaka, Bangladesh 3: Health Education Economic Development (HEED), Moulvibazar, Shylhet, Bangladesh 4: Damien Foundation, Dhaka, Bangladesh 5: Bangladesh Rural Advancement Committee (BRAC), Dhaka, Bangladesh 6: LAMB Hospital, Parbatipur, Dinajpur, Bangladesh 7: Rangpur Dinajpur Rural Service (RDRS), Lalmonirhat, Bangladesh 8: Danish Bangladesh Leprosy Mission (DBLM), Nilphamari, Bangladesh 9: Royal Netherlands Tuberculosis Association (KNCV), The Hague, The Netherlands

Publication date: July 1, 2001

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on lung health world-wide.

    To share scientific research of immediate concern as rapidly as possible, The Union is fast-tracking the publication of certain articles from the IJTLD and publishing them on The Union website, prior to their publication in the Journal. Read fast-track articles.

    Certain IJTLD articles are also selected for translation into French, Spanish, Chinese or Russian. These are available on the Union website.

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