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OBJECTIVE:To determine gender differences in treatment outcomes among 15-49 year olds with smear-positive pulmonary tuberculosis (PTB) and factors associated with poor outcomes in Kenya. DESIGN:Retrospective descriptive cohort. RESULTS:Of 16 056 subjects analysed, 38% were female and 62% male. Females had a higher risk of poor treatment outcome than males (12% vs. 10%, P < 0.001; adjusted OR 1.29, 95%CI 1.16-1.44, P < 0.001). In the first multivariate model, restricting the analysis to human immunodeficiency virus (HIV) positive patients and adjusting for risk factors and clustering, females had a non-significantly lower risk of poor outcome (OR 0.99, 95%CI 0.86-1.13, P = 0.844). In the model restricted to HIV-negative patients, a non-significantly lower risk was found (OR 0.89, 95%CI 0.73-1.09, P = 0.267). In the second model, restricting analysis to patients on antiretroviral therapy (ART) and adjusting for risk factors and clustering, females had a non-significantly lower risk of poor PTB treatment outcomes (OR 0.98, 95%CI 0.84-1.14, P = 0.792). In the model restricted to HIV-positive patients not on ART, a non-significantly higher risk was found (OR 1.15, 95%CI 0.79-1.67, P = 0.461). CONCLUSION:Females of reproductive age are likely to have poorer treatment outcomes than males. Among females, not commencing ART during anti-tuberculosis treatment seemed to be associated with poor outcomes.

Original publication





The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease

Publication Date





1176 - 1181


Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya.


Sputum, Humans, Tuberculosis, Pulmonary, HIV Infections, Antitubercular Agents, Anti-HIV Agents, Treatment Outcome, Multivariate Analysis, Risk Factors, Retrospective Studies, Sex Factors, Adolescent, Adult, Middle Aged, Kenya, Female, Male, Young Adult