Sex Differences in Active Pulmonary Tuberculosis Outcomes in Mali, West Africa

Djeneba Dabitao; Amadou Somboro; Ibrahim Sanogo; Bassirou Diarra; Chad J. Achenbach; Jane L. Holl; Bocar Baya; Moumine Sanogo; Mamadou Wague; Nadie Coulibaly; Mahamadou Kone; Hawa Baye Drame; Mohamed Tolofoudie; Bourahima Kone; Ayouba Diarra; Mamadou D. Coulibaly; Kathryn Saliba-Shaw; Yacouba Toloba; Mahamadou Diakite; Seydou Doumbia; Sabra L. Klein; William R. Bishai; Souleymane Diallo; Robert L. Murphy

doi:10.4269/ajtmh.21-1141

Sex Differences in Active Pulmonary Tuberculosis Outcomes in Mali, West Africa

Djeneba Dabitao^*, Amadou Somboro, Ibrahim Sanogo, Bassirou Diarra, Chad J. Achenbach, Jane L. Holl, Bocar Baya, Moumine Sanogo, Mamadou Wague, Nadie Coulibaly, Mahamadou Kone, Hawa Baye Drame, Mohamed Tolofoudie, Bourahima Kone, Ayouba Diarra, Mamadou D. Coulibaly, Kathryn Saliba-Shaw, Yacouba Toloba, Mahamadou Diakite, Seydou DoumbiaSabra L. Klein, William R. Bishai, Souleymane Diallo, Robert L. Murphy

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Men and women often respond differently to infectious diseases and their treatments. Tuberculosis (TB) is a life-threatening communicable disease that affects more men than women globally. Whether male sex is an independent risk factor for unfavorable TB outcomes, however, has not been rigorously investigated in an African context, where individuals are likely exposed to different microbial and environmental factors. We analyzed data collected from a cohort study in Mali by focusing on newly diagnosed active pulmonary TB individuals who were treatment naive. We gathered baseline demographic, clinical, and microbiologic characteristics before treatment initiation and also at three time points during treatment. More males than females were affected with TB, as evidenced by a male-to-female ratio of 2.4:1. In addition, at baseline, males had a significantly higher bacterial count and shorter time to culture positivity as compared with females. Male sex was associated with lower smear negativity rate after 2 months of treatment also known as the intensive phase of treatment, but not at later time points. There was no relationship between patients’ sex and mortality from any cause during treatment. This study suggests that sex-based differences in TB outcomes exist, with sex-specific effects on disease outcomes being more pronounced before treatment initiation and during the intensive phase of treatment rather than at later phases of treatment.

Original language	English (US)
Pages (from-to)	433-440
Number of pages	8
Journal	American Journal of Tropical Medicine and Hygiene
Volume	107
Issue number	2
DOIs	https://doi.org/10.4269/ajtmh.21-1141
State	Published - Aug 2022

Funding

Financial support: Research described in this publication was supported by the Fogarty International Center and the Office of the Director of the National Institutes of Health through the Office of Research on Women’s Health, under Career Development Award K43TW011426 (principal investigator: Dabitao D). The research was also supported by the Institute for Global Health at the Feinberg School of Medicine of the Northwestern University, under the Catalyzer Award (principal investigators: Dabitao D and Murphy RL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health and Northwestern University. We are grateful to the staff (laboratory, clinic, and management teams) of the University Clinical Research Center at the University of Sciences, Techniques, and Technologies of Bamako in Mali. We also thank members of the Institute for Global Health at the Feinberg School of Medicine, Northwestern University in Chicago, IL. Research described in this publication was supported by the Fogarty International Center and the Office of the Director of the National Institutes of Health through the Office of Research on Women’s Health, under Career Development Award K43TW011426 (principal investigator: Dabitao D). The research was also supported by the Institute for Global Health at the Feinberg School of Medicine of the Northwestern University, under the Catalyzer Award (principal investigators: Dabitao D and Murphy RL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health and Northwestern University.

ASJC Scopus subject areas

Parasitology
Infectious Diseases
Virology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Dabitao, D., Somboro, A., Sanogo, I., Diarra, B., Achenbach, C. J., Holl, J. L., Baya, B., Sanogo, M., Wague, M., Coulibaly, N., Kone, M., Drame, H. B., Tolofoudie, M., Kone, B., Diarra, A., Coulibaly, M. D., Saliba-Shaw, K., Toloba, Y., Diakite, M., ... Murphy, R. L. (2022). Sex Differences in Active Pulmonary Tuberculosis Outcomes in Mali, West Africa. American Journal of Tropical Medicine and Hygiene, 107(2), 433-440. https://doi.org/10.4269/ajtmh.21-1141

@article{f2736ed0f76b46c388ace89b786f34fe,

title = "Sex Differences in Active Pulmonary Tuberculosis Outcomes in Mali, West Africa",

abstract = "Men and women often respond differently to infectious diseases and their treatments. Tuberculosis (TB) is a life-threatening communicable disease that affects more men than women globally. Whether male sex is an independent risk factor for unfavorable TB outcomes, however, has not been rigorously investigated in an African context, where individuals are likely exposed to different microbial and environmental factors. We analyzed data collected from a cohort study in Mali by focusing on newly diagnosed active pulmonary TB individuals who were treatment naive. We gathered baseline demographic, clinical, and microbiologic characteristics before treatment initiation and also at three time points during treatment. More males than females were affected with TB, as evidenced by a male-to-female ratio of 2.4:1. In addition, at baseline, males had a significantly higher bacterial count and shorter time to culture positivity as compared with females. Male sex was associated with lower smear negativity rate after 2 months of treatment also known as the intensive phase of treatment, but not at later time points. There was no relationship between patients{\textquoteright} sex and mortality from any cause during treatment. This study suggests that sex-based differences in TB outcomes exist, with sex-specific effects on disease outcomes being more pronounced before treatment initiation and during the intensive phase of treatment rather than at later phases of treatment.",

author = "Djeneba Dabitao and Amadou Somboro and Ibrahim Sanogo and Bassirou Diarra and Achenbach, {Chad J.} and Holl, {Jane L.} and Bocar Baya and Moumine Sanogo and Mamadou Wague and Nadie Coulibaly and Mahamadou Kone and Drame, {Hawa Baye} and Mohamed Tolofoudie and Bourahima Kone and Ayouba Diarra and Coulibaly, {Mamadou D.} and Kathryn Saliba-Shaw and Yacouba Toloba and Mahamadou Diakite and Seydou Doumbia and Klein, {Sabra L.} and Bishai, {William R.} and Souleymane Diallo and Murphy, {Robert L.}",

note = "Funding Information: Financial support: Research described in this publication was supported by the Fogarty International Center and the Office of the Director of the National Institutes of Health through the Office of Research on Women{\textquoteright}s Health, under Career Development Award K43TW011426 (principal investigator: Dabitao D). The research was also supported by the Institute for Global Health at the Feinberg School of Medicine of the Northwestern University, under the Catalyzer Award (principal investigators: Dabitao D and Murphy RL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health and Northwestern University. Funding Information: We are grateful to the staff (laboratory, clinic, and management teams) of the University Clinical Research Center at the University of Sciences, Techniques, and Technologies of Bamako in Mali. We also thank members of the Institute for Global Health at the Feinberg School of Medicine, Northwestern University in Chicago, IL. Research described in this publication was supported by the Fogarty International Center and the Office of the Director of the National Institutes of Health through the Office of Research on Women{\textquoteright}s Health, under Career Development Award K43TW011426 (principal investigator: Dabitao D). The research was also supported by the Institute for Global Health at the Feinberg School of Medicine of the Northwestern University, under the Catalyzer Award (principal investigators: Dabitao D and Murphy RL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health and Northwestern University. Publisher Copyright: Copyright {\textcopyright} 2022 The American Society of Tropical Medicine and Hygiene.",

year = "2022",

month = aug,

doi = "10.4269/ajtmh.21-1141",

language = "English (US)",

volume = "107",

pages = "433--440",

journal = "American Journal of Tropical Medicine and Hygiene",

issn = "0002-9637",

publisher = "American Society of Tropical Medicine and Hygiene",

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Dabitao, D, Somboro, A, Sanogo, I, Diarra, B, Achenbach, CJ, Holl, JL, Baya, B, Sanogo, M, Wague, M, Coulibaly, N, Kone, M, Drame, HB, Tolofoudie, M, Kone, B, Diarra, A, Coulibaly, MD, Saliba-Shaw, K, Toloba, Y, Diakite, M, Doumbia, S, Klein, SL, Bishai, WR, Diallo, S & Murphy, RL 2022, 'Sex Differences in Active Pulmonary Tuberculosis Outcomes in Mali, West Africa', American Journal of Tropical Medicine and Hygiene, vol. 107, no. 2, pp. 433-440. https://doi.org/10.4269/ajtmh.21-1141

TY - JOUR

T1 - Sex Differences in Active Pulmonary Tuberculosis Outcomes in Mali, West Africa

AU - Dabitao, Djeneba

AU - Somboro, Amadou

AU - Sanogo, Ibrahim

AU - Diarra, Bassirou

AU - Achenbach, Chad J.

AU - Holl, Jane L.

AU - Baya, Bocar

AU - Sanogo, Moumine

AU - Wague, Mamadou

AU - Coulibaly, Nadie

AU - Kone, Mahamadou

AU - Drame, Hawa Baye

AU - Tolofoudie, Mohamed

AU - Kone, Bourahima

AU - Diarra, Ayouba

AU - Coulibaly, Mamadou D.

AU - Saliba-Shaw, Kathryn

AU - Toloba, Yacouba

AU - Diakite, Mahamadou

AU - Doumbia, Seydou

AU - Klein, Sabra L.

AU - Bishai, William R.

AU - Diallo, Souleymane

AU - Murphy, Robert L.

N1 - Funding Information: Financial support: Research described in this publication was supported by the Fogarty International Center and the Office of the Director of the National Institutes of Health through the Office of Research on Women’s Health, under Career Development Award K43TW011426 (principal investigator: Dabitao D). The research was also supported by the Institute for Global Health at the Feinberg School of Medicine of the Northwestern University, under the Catalyzer Award (principal investigators: Dabitao D and Murphy RL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health and Northwestern University. Funding Information: We are grateful to the staff (laboratory, clinic, and management teams) of the University Clinical Research Center at the University of Sciences, Techniques, and Technologies of Bamako in Mali. We also thank members of the Institute for Global Health at the Feinberg School of Medicine, Northwestern University in Chicago, IL. Research described in this publication was supported by the Fogarty International Center and the Office of the Director of the National Institutes of Health through the Office of Research on Women’s Health, under Career Development Award K43TW011426 (principal investigator: Dabitao D). The research was also supported by the Institute for Global Health at the Feinberg School of Medicine of the Northwestern University, under the Catalyzer Award (principal investigators: Dabitao D and Murphy RL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health and Northwestern University. Publisher Copyright: Copyright © 2022 The American Society of Tropical Medicine and Hygiene.

PY - 2022/8

Y1 - 2022/8

N2 - Men and women often respond differently to infectious diseases and their treatments. Tuberculosis (TB) is a life-threatening communicable disease that affects more men than women globally. Whether male sex is an independent risk factor for unfavorable TB outcomes, however, has not been rigorously investigated in an African context, where individuals are likely exposed to different microbial and environmental factors. We analyzed data collected from a cohort study in Mali by focusing on newly diagnosed active pulmonary TB individuals who were treatment naive. We gathered baseline demographic, clinical, and microbiologic characteristics before treatment initiation and also at three time points during treatment. More males than females were affected with TB, as evidenced by a male-to-female ratio of 2.4:1. In addition, at baseline, males had a significantly higher bacterial count and shorter time to culture positivity as compared with females. Male sex was associated with lower smear negativity rate after 2 months of treatment also known as the intensive phase of treatment, but not at later time points. There was no relationship between patients’ sex and mortality from any cause during treatment. This study suggests that sex-based differences in TB outcomes exist, with sex-specific effects on disease outcomes being more pronounced before treatment initiation and during the intensive phase of treatment rather than at later phases of treatment.

AB - Men and women often respond differently to infectious diseases and their treatments. Tuberculosis (TB) is a life-threatening communicable disease that affects more men than women globally. Whether male sex is an independent risk factor for unfavorable TB outcomes, however, has not been rigorously investigated in an African context, where individuals are likely exposed to different microbial and environmental factors. We analyzed data collected from a cohort study in Mali by focusing on newly diagnosed active pulmonary TB individuals who were treatment naive. We gathered baseline demographic, clinical, and microbiologic characteristics before treatment initiation and also at three time points during treatment. More males than females were affected with TB, as evidenced by a male-to-female ratio of 2.4:1. In addition, at baseline, males had a significantly higher bacterial count and shorter time to culture positivity as compared with females. Male sex was associated with lower smear negativity rate after 2 months of treatment also known as the intensive phase of treatment, but not at later time points. There was no relationship between patients’ sex and mortality from any cause during treatment. This study suggests that sex-based differences in TB outcomes exist, with sex-specific effects on disease outcomes being more pronounced before treatment initiation and during the intensive phase of treatment rather than at later phases of treatment.

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Sex Differences in Active Pulmonary Tuberculosis Outcomes in Mali, West Africa

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