Tuberculosis may be underestimated in Rwandan women
METHODS: We analysed the 2006 series of TB cases among persons aged ≥15 years in Huye District and Kigali. Severe TB was defined as disease leading to death, or extra-pulmonary or disseminated TB.
RESULTS: Of 1673 cases identified, 40% involved women, who were younger than men (65% vs. 54% aged <35 years). Overall severity was similar in both sexes. Considering age <35 years, women were at higher risk of severe TB than men, although the difference was not statistically significant. Smear-negative pulmonary TB (SNPTB), and human immunodeficiency virus (HIV) infection were more frequent in women than in men (59% vs. 42%, P < 0.001). For women with smear-positive pulmonary TB (SPPTB), the risk of death was twice that among men (adjusted hazard ratio 1.8; 95%CI 1.0–3.2).
CONCLUSIONS: Among female TB patients, the higher risk of death with SPPTB, the higher frequency of SNPTB and the higher prevalence of HIV infection suggest that the passive system of case detection may underestimate the burden of TB in Rwandan women.
Keywords: Rwanda; severity; sex; tuberculosis
Document Type: Regular Paper
Affiliations: 1: Tuberculosis Unit, Centre for Treatment and Research on AIDS, Malaria, Tuberculosis and Other Epidemics (TRAC Plus), Kigali, Rwanda 2: Laval University, Faculty of Medicine, Department of Social and Preventive Medicine, Québec, Québec, Canada; and Institut National de Santé Publique du Québec, Québec, Québec, Canada 3: McGill University, Faculty of Medicine, Respiratory Division and Respiratory Epidemiology and Clinical Research Unit, Montreal, Québec, Canada
Publication date: 01 June 2011
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