Sex-specific performance of routine TB diagnostic tests
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Date
2005Author
Kivihya-Ndugga, LE
van Cleeff, MR
Ng'ang'a, LW
Meme, H
Odhiambo, JA
Klatser, PR
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
SETTING:
City Council Chest Clinic, Nairobi, Kenya.
OBJECTIVE:
To determine to what extent the performance of smear microscopy is responsible for sex differences in notification rates.
METHODOLOGY:
Three sputum samples from TB suspects were subjected to smear microscopy with Ziehl-Neelsen (ZN) and auramine (FM) staining. Lowenstein-Jensen culture was used as the gold standard.
RESULTS:
Of 998 suspects, 600 (60%) were men and 398 (40%) women. The odds of detecting culture-positive patients with ZN was lower for women (OR 0.67). By examining the first spot specimen, ZN detected 35% of culture-positive males and 26% of culture-positive females. These proportions increased to respectively 63% and 53% when examining three specimens, and to 79% and 74% when using FM. The sex difference reduced and became non-significant (P = 0.19) when adjusted for HIV; however, the numbers involved for HIV stratification were low.
CONCLUSION:
The performance of a diagnostic tool contributes to sex differences in notification rates and influences male/female ratios. Women were less likely to be diagnosed (P = 0.08), and when ZN was used they were less likely to be labelled as smear-positive TB (P < 0.01). The application of more sensitive diagnostic tools such as FM is to the advantage of women.
Citation
Int J Tuberc Lung Dis. 2005 Mar;9(3):294-300.Publisher
University of Nairobi
Collections
- Faculty of Health Sciences (FHS) [10387]