Gender differences in treatment outcomes of tuberculosis patients in Taiwan: A prospective observational study

J. Y. Feng, S. F. Huang, W. Y. Ting, Y. C. Chen, Y. Y. Lin, R. M. Huang, C. H. Lin, J. J. Hwang, J. J. Lee, M. C. Yu, K. W. Yu, Y. C. Lee, W. J. Su

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Gender disparities in tuberculosis (TB) cases are reported worldwide, and socio-cultural factors have been proposed as possible causes. To date, gender differences in treatment outcomes of TB patients remain controversial. In this prospective observational study, newly diagnosed, culture-proven TB patients from six hospitals in Taiwan were enrolled for analysis. Gender differences in demographic characteristics and treatment outcomes, including sputum conversion and on-treatment mortality, were analysed accordingly. From January 2007 through to December 2009, a total of 1059 patients were enrolled, including 819 (77.3%) males and 240 (22.7%) females. The ratio of male gender was around 50∼60% in TB patients below 35years and >80% for those older than 65years. When compared with the female patients, the male patients were older, more likely to have the habit of smoking, chronic obstructive pulmonary disorder, malignancy and liver cirrhosis, and more likely to present with haemoptysis, body weight loss and pleural effusion. Regarding treatment outcomes, male gender is associated with a lower 2-month sputum culture conversion rate (78.8% vs. 89.3%, p0.002) and higher on-treatment mortality (21.1% vs. 12.1%, p0.002). Kaplan-Meier survival analysis demonstrated significantly higher mortality in the men (p0.005). In multivariate analysis, male gender was an independent risk factor for 2-month sputum culture un-conversion (OR, 1.96; 95% CI, 1.12-3.41). Our findings suggest that male gender is associated with older age, more co-morbidities and worse treatment outcomes. Gender-specific strategies, including active case finding in elderly women and smoking cessation in male patients, are warranted to optimize TB management.

Original languageEnglish
JournalClinical Microbiology and Infection
Volume18
Issue number9
DOIs
Publication statusPublished - Sep 2012

Fingerprint

Taiwan
Observational Studies
Tuberculosis
Prospective Studies
Sputum
Mortality
Hemoptysis
Kaplan-Meier Estimate
Smoking Cessation
Pleural Effusion
Survival Analysis
Liver Cirrhosis
Habits
Weight Loss
Multivariate Analysis
Smoking
Body Weight
Demography
Morbidity
Lung

Keywords

  • Gender
  • Mortality
  • Outcomes
  • Sputum conversion
  • Tuberculosis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Gender differences in treatment outcomes of tuberculosis patients in Taiwan : A prospective observational study. / Feng, J. Y.; Huang, S. F.; Ting, W. Y.; Chen, Y. C.; Lin, Y. Y.; Huang, R. M.; Lin, C. H.; Hwang, J. J.; Lee, J. J.; Yu, M. C.; Yu, K. W.; Lee, Y. C.; Su, W. J.

In: Clinical Microbiology and Infection, Vol. 18, No. 9, 09.2012.

Research output: Contribution to journalArticle

Feng, JY, Huang, SF, Ting, WY, Chen, YC, Lin, YY, Huang, RM, Lin, CH, Hwang, JJ, Lee, JJ, Yu, MC, Yu, KW, Lee, YC & Su, WJ 2012, 'Gender differences in treatment outcomes of tuberculosis patients in Taiwan: A prospective observational study', Clinical Microbiology and Infection, vol. 18, no. 9. https://doi.org/10.1111/j.1469-0691.2012.03931.x
Feng, J. Y. ; Huang, S. F. ; Ting, W. Y. ; Chen, Y. C. ; Lin, Y. Y. ; Huang, R. M. ; Lin, C. H. ; Hwang, J. J. ; Lee, J. J. ; Yu, M. C. ; Yu, K. W. ; Lee, Y. C. ; Su, W. J. / Gender differences in treatment outcomes of tuberculosis patients in Taiwan : A prospective observational study. In: Clinical Microbiology and Infection. 2012 ; Vol. 18, No. 9.
@article{77338b81b5044978b115da7900436aa0,
title = "Gender differences in treatment outcomes of tuberculosis patients in Taiwan: A prospective observational study",
abstract = "Gender disparities in tuberculosis (TB) cases are reported worldwide, and socio-cultural factors have been proposed as possible causes. To date, gender differences in treatment outcomes of TB patients remain controversial. In this prospective observational study, newly diagnosed, culture-proven TB patients from six hospitals in Taiwan were enrolled for analysis. Gender differences in demographic characteristics and treatment outcomes, including sputum conversion and on-treatment mortality, were analysed accordingly. From January 2007 through to December 2009, a total of 1059 patients were enrolled, including 819 (77.3{\%}) males and 240 (22.7{\%}) females. The ratio of male gender was around 50∼60{\%} in TB patients below 35years and >80{\%} for those older than 65years. When compared with the female patients, the male patients were older, more likely to have the habit of smoking, chronic obstructive pulmonary disorder, malignancy and liver cirrhosis, and more likely to present with haemoptysis, body weight loss and pleural effusion. Regarding treatment outcomes, male gender is associated with a lower 2-month sputum culture conversion rate (78.8{\%} vs. 89.3{\%}, p0.002) and higher on-treatment mortality (21.1{\%} vs. 12.1{\%}, p0.002). Kaplan-Meier survival analysis demonstrated significantly higher mortality in the men (p0.005). In multivariate analysis, male gender was an independent risk factor for 2-month sputum culture un-conversion (OR, 1.96; 95{\%} CI, 1.12-3.41). Our findings suggest that male gender is associated with older age, more co-morbidities and worse treatment outcomes. Gender-specific strategies, including active case finding in elderly women and smoking cessation in male patients, are warranted to optimize TB management.",
keywords = "Gender, Mortality, Outcomes, Sputum conversion, Tuberculosis",
author = "Feng, {J. Y.} and Huang, {S. F.} and Ting, {W. Y.} and Chen, {Y. C.} and Lin, {Y. Y.} and Huang, {R. M.} and Lin, {C. H.} and Hwang, {J. J.} and Lee, {J. J.} and Yu, {M. C.} and Yu, {K. W.} and Lee, {Y. C.} and Su, {W. J.}",
year = "2012",
month = "9",
doi = "10.1111/j.1469-0691.2012.03931.x",
language = "English",
volume = "18",
journal = "Clinical Microbiology and Infection",
issn = "1198-743X",
publisher = "Elsevier Limited",
number = "9",

}

TY - JOUR

T1 - Gender differences in treatment outcomes of tuberculosis patients in Taiwan

T2 - A prospective observational study

AU - Feng, J. Y.

AU - Huang, S. F.

AU - Ting, W. Y.

AU - Chen, Y. C.

AU - Lin, Y. Y.

AU - Huang, R. M.

AU - Lin, C. H.

AU - Hwang, J. J.

AU - Lee, J. J.

AU - Yu, M. C.

AU - Yu, K. W.

AU - Lee, Y. C.

AU - Su, W. J.

PY - 2012/9

Y1 - 2012/9

N2 - Gender disparities in tuberculosis (TB) cases are reported worldwide, and socio-cultural factors have been proposed as possible causes. To date, gender differences in treatment outcomes of TB patients remain controversial. In this prospective observational study, newly diagnosed, culture-proven TB patients from six hospitals in Taiwan were enrolled for analysis. Gender differences in demographic characteristics and treatment outcomes, including sputum conversion and on-treatment mortality, were analysed accordingly. From January 2007 through to December 2009, a total of 1059 patients were enrolled, including 819 (77.3%) males and 240 (22.7%) females. The ratio of male gender was around 50∼60% in TB patients below 35years and >80% for those older than 65years. When compared with the female patients, the male patients were older, more likely to have the habit of smoking, chronic obstructive pulmonary disorder, malignancy and liver cirrhosis, and more likely to present with haemoptysis, body weight loss and pleural effusion. Regarding treatment outcomes, male gender is associated with a lower 2-month sputum culture conversion rate (78.8% vs. 89.3%, p0.002) and higher on-treatment mortality (21.1% vs. 12.1%, p0.002). Kaplan-Meier survival analysis demonstrated significantly higher mortality in the men (p0.005). In multivariate analysis, male gender was an independent risk factor for 2-month sputum culture un-conversion (OR, 1.96; 95% CI, 1.12-3.41). Our findings suggest that male gender is associated with older age, more co-morbidities and worse treatment outcomes. Gender-specific strategies, including active case finding in elderly women and smoking cessation in male patients, are warranted to optimize TB management.

AB - Gender disparities in tuberculosis (TB) cases are reported worldwide, and socio-cultural factors have been proposed as possible causes. To date, gender differences in treatment outcomes of TB patients remain controversial. In this prospective observational study, newly diagnosed, culture-proven TB patients from six hospitals in Taiwan were enrolled for analysis. Gender differences in demographic characteristics and treatment outcomes, including sputum conversion and on-treatment mortality, were analysed accordingly. From January 2007 through to December 2009, a total of 1059 patients were enrolled, including 819 (77.3%) males and 240 (22.7%) females. The ratio of male gender was around 50∼60% in TB patients below 35years and >80% for those older than 65years. When compared with the female patients, the male patients were older, more likely to have the habit of smoking, chronic obstructive pulmonary disorder, malignancy and liver cirrhosis, and more likely to present with haemoptysis, body weight loss and pleural effusion. Regarding treatment outcomes, male gender is associated with a lower 2-month sputum culture conversion rate (78.8% vs. 89.3%, p0.002) and higher on-treatment mortality (21.1% vs. 12.1%, p0.002). Kaplan-Meier survival analysis demonstrated significantly higher mortality in the men (p0.005). In multivariate analysis, male gender was an independent risk factor for 2-month sputum culture un-conversion (OR, 1.96; 95% CI, 1.12-3.41). Our findings suggest that male gender is associated with older age, more co-morbidities and worse treatment outcomes. Gender-specific strategies, including active case finding in elderly women and smoking cessation in male patients, are warranted to optimize TB management.

KW - Gender

KW - Mortality

KW - Outcomes

KW - Sputum conversion

KW - Tuberculosis

UR - http://www.scopus.com/inward/record.url?scp=84865300822&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84865300822&partnerID=8YFLogxK

U2 - 10.1111/j.1469-0691.2012.03931.x

DO - 10.1111/j.1469-0691.2012.03931.x

M3 - Article

C2 - 22734962

AN - SCOPUS:84865300822

VL - 18

JO - Clinical Microbiology and Infection

JF - Clinical Microbiology and Infection

SN - 1198-743X

IS - 9

ER -