Abstract
To assess sex disparities in tuberculosis in Vietnam, we conducted a nested, case-control study based on a 2017 tuberculosis prevalence survey. We defined the case group as all survey participants with laboratory-confirmed tuberculosis and the control group as a randomly selected group of participants with no tuberculosis. We used structural equation modeling to describe pathways from sex to tuberculosis according to an a priori conceptual framework. Our analysis included 1,319 participants, of whom 250 were case-patients. We found that sex was directly associated with tuberculosis prevalence (adjusted odds ratio for men compared with women 3.0 [95% CI 1.7-5.0]) and indirectly associated through other domains. The strong sex difference in tuberculosis prevalence is explained by a complex interplay of factors relating to behavioral and environmental risks, access to healthcare, and clinical manifestations. However, after controlling for all those factors, a direct sex effect remains that might be caused by biological factors.
Original language | English |
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Pages (from-to) | 967-976 |
Number of pages | 10 |
Journal | Emerging infectious diseases |
Volume | 29 |
Issue number | 5 |
DOIs | |
Publication status | Published - May 2023 |
Keywords
- Vietnam
- bacteria
- epidemiology
- nested case-control study
- sex-based disparities
- tuberculosis and other mycobacteria