4.6 Article

Gender-based differences in community-wide screening for pulmonary tuberculosis in Karachi, Pakistan: an observational study of 311 732 individuals undergoing screening

Journal

THORAX
Volume 77, Issue 3, Pages 298-299

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/thoraxjnl-2020-216409

Keywords

tuberculosis; clinical epidemiology

Funding

  1. Global Fund Against AIDS, Tuberculosis and Malaria via the Indus Health Network

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In a community-wide TB screening programme in Karachi, Pakistan, gender-based differences were observed, with female attendees less likely to undergo sputum collection and testing as well as initiate treatment, despite having a higher age-standardised prevalence of active TB. Integrating gender into the design and monitoring of TB screening programmes is crucial to ensure equal benefits for women and men.
We describe gender-based differences in a community-wide TB screening programme in Karachi, Pakistan, in which 311 732 individuals were screened in mobile camps using symptom questionnaires and van-mounted digital chest X-ray, between 1 January 2018 and 31 December 2019. Only 22.4% (69 869) of camp attendees were women. Female attendees were less likely to have sputum collected and tested (31.5% (95% CI 30.4% to 32.7%) vs 38.5% (95% CI 37.6% to 39.1%)) or to initiate TB treatment (75.9% (95% CI 68.1% to 82.6%) vs 82.8% (95% CI 78.9% to 86.2%)), when indicated. Among the participants, the age-standardised prevalence of active TB was higher among women (prevalence ratio 1.4, 95% CI 1.1 to 1.7). These findings underscore the importance of integrating gender into the design and monitoring of TB screening programmes to ensure that women and men benefit equally from this important intervention.

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