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 journalArticlepeer-review

3 Scopus citations


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 languageEnglish (US)
Pages (from-to)433-440
Number of pages8
JournalAmerican Journal of Tropical Medicine and Hygiene
Issue number2
StatePublished - Aug 2022

ASJC Scopus subject areas

  • Infectious Diseases
  • Virology
  • Parasitology


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