Original article
Difference in symptoms suggesting pulmonary tuberculosis among men and women

https://doi.org/10.1016/S0895-4356(01)00455-3Get rights and content

Abstract

Longer delays in diagnosis and lower case-detection of tuberculosis (TB) among women remain a problem in many countries. This study describes reported symptoms of new smear-positive pulmonary TB among men and women, and their association with TB diagnostic delays. All 1,027 new smear-positive pulmonary TB cases aged 15 years or over (757 men and 270 women) diagnosed by 23 district TB units of four provinces in Vietnam during 1996 were interviewed at the time of diagnosis. Among these, 540 patients diagnosed during January–June 1996 were followed up during treatment course. Pattern of symptoms was similar between the sexes. However, symptoms of cough (90.7% women, 94.7% men, P = .021), sputum expectoration (83.6% women, 89.9% men, P = .006), and hemoptysis (27.8% women, 34.9% men, P = .033) were less common among women than among men. Absence of cough and sputum expectoration was significantly associated with increased doctor's delays. Two months after treatment, cough and sputum expectoration recovered significantly more quickly among women compared to men.

Section snippets

Background

In our earlier study of a cohort of 757 male and 270 female smear-positive pulmonary tuberculosis (TB) cases, we reported that total delay from onset of symptoms to diagnosis of the disease was significantly longer among women than among men. This gender difference in delay was mainly due to longer doctor's delay in women (mean 5.4 weeks) compared to men (mean 3.8 weeks) [1]. A number of studies have reported long delays to TB diagnosis due to both patient's delay in seeking care and health

Method

This study was conducted in four provinces (Hanoi, Quang Ninh, Ho Chi Minh City, and Quang Nam-Da Nang) purposively selected from different regions of Vietnam (e.g., north and south, urban and rural areas). A sample of 23 districts was randomly selected from a total of 56 districts in these four provinces using stratified sampling technique with respect to geographic areas and number of TB patients detected in 1995. All 1,027 new smear-positive pulmonary TB cases aged 15–49 years diagnosed from

Background information

A total of 1,027 patients aged 15–49 years (757 men and 270 women) with new smear-positive pulmonary TB were interviewed. Within 15–49 years of age, the mean age of getting TB was found to be significantly lower for women compared to men, 32.7 years and 34.2 years, respectively. Educational level was significantly higher in men than in women. No significant difference was noted between men and women in area of residence and family size (Table 1).

Reported symptoms at diagnosis

General symptoms (e.g., fever, tiredness,

Discussion

From this study, symptoms suggesting pulmonary TB (e.g., cough, sputum expectoration, and hemoptysis) were significantly less frequently reported by women than by men with new smear-positive pulmonary TB. The absence of cough or sputum expectoration is significantly associated with increased doctor's delay. The difference between men and women in above reported symptoms can be explained by both biological and socio-cultural factors. Biologically, respiratory symptoms reflect lesions in lungs,

Acknowledgements

We highly appreciate the assistance in statistical analysis rendered by Bo Eriksson from the Nordic School of Public Health, Göteborg, Sweden. Support for the study presented in this article has been gratefully received in the form of grants from Sida/SAREC, Karolinska Institutet, and Vårdalstiftelsen, Sweden.

References (20)

There are more references available in the full text version of this article.

Cited by (49)

  • Complications of Pregnancy

    2017, Infectious Diseases, 2-Volume Set

  • Registration and management of community patients with tuberculosis in north-west China

    2015, Public Health
    Citation Excerpt :

    A possible explanation for this distribution may be that males participate in more social activities, and are therefore more likely to come into contact with cases with TB. In terms of the incidence of TB, biological differences between males and females affecting the sensitivity of smear examinations may play an important role.20 The majority of cases of TB in north-west China were young adults (38.6%) and elderly (31.1%), whereas elderly males (60%)21 and young adult males formed the majority in Japan and Saudi Arabia, respectively.22

  • The Added Value of Bronchoalveolar Lavage for Pulmonary Tuberculosis Diagnosis in High-Risk Hospitalized Patients with Negative Sputum Samples

    2024, Advances in Respiratory Medicine

  • HIV/Tuberculosis Coinfection in Pregnancy and the Postpartum Period

    2023, Journal of Clinical Medicine

  • Evidence for Implementation: Management of TB in HIV and Pregnancy

    2022, Current HIV/AIDS Reports

  • Prevalence and clinical characteristics of pulmonary TB among pregnant and post-partum women

    2022, International Journal of Tuberculosis and Lung Disease
View all citing articles on Scopus
View full text
Copyright © 2002 Elsevier Science Inc. All rights reserved.