Rakhi Dandona , G Anil Kumar , S Siva Prasad Dora , Md Akbar , Kultar Singh , Sibin George , Moutushi Majumder , Navin Kumar , Rajendra P. Joshi , Mrigen Deka , Dimple Panchal , Venkatesh Roddawar , Amar Shah , Vikas Choudhary , Yogesh N. Patel , Bhavin Vadera , Kiran Rade , Lalit Dandona , Raghuram Rao
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引用次数: 0
Abstract
Background
We report on TB treatment coverage and outcomes by sex among a nationally representative sample of deaths in the background of the national framework for a gender-responsive approach to TB adopted by India.
Methods
Detailed interviews were undertaken for a nationally representative sample of deaths of all ages between 2019 and 2022 from the adult most knowledgeable about the deceased. Details about TB treatment were documented for females and males for whom history of TB diagnosis ever.
Findings
Detailed data were available for 26,957 (92.1% participation) deaths. The prevalence of TB diagnosis ever was 2.9% (95% CI 2.6–3.2) and 5.8% (95% CI 5.4–6.1) among females and males, respectively. TB treatment coverage was similar for females (81.4%; 95% CI 76.7–85.3) and males (82.4%; 95% CI 79.8–84.7). TB treatment coverage was significantly lower for males with TB diagnosis in years 2021 and 2022 as compared to those diagnosed in 2019 (−12.1%; 95% CI −22.7 to −1.5). A similar proportion of females (55%) and males (58.9%) were on TB treatment at the time of death, had completed TB treatment (39.3% females and 35% males, and had discontinued TB treatment (5.3% females and 5.2% males); significant variation in treatment status was seen by age and state for both, and by wealth index quartile for males. Majority took TB treatment from public sector (females 72.9% and males 76.0%).
Interpretation
The sex-disaggregated findings from this nationally representative sample of deaths are a value-add to effectively address TB in India as majority of such understanding towards gender-responsive strategies is available from those who are alive.
Funding
United States Agency for International Development (USAID).
背景：我们在印度采用促进性别平等的结核病国家框架的背景下，报告了全国代表性死亡样本中按性别分列的结核病治疗覆盖率和结果。方法对2019年至2022年期间所有年龄段死亡的全国代表性样本进行了详细的访谈，这些样本来自对死者最了解的成年人。记录了曾经有结核诊断史的女性和男性的结核治疗细节。研究结果：26,957例（92.1%）死亡病例的详细数据。女性和男性的结核病诊断率分别为2.9% （95% CI 2.6-3.2）和5.8% （95% CI 5.4-6.1）。女性结核病治疗覆盖率相似(81.4%；95% CI 76.7-85.3)和男性(82.4%；95% ci 79.8-84.7)。与2019年诊断出结核病的男性相比，2021年和2022年诊断出结核病的男性结核病治疗覆盖率显着降低(- 12.1%；95% CI为−22.7 ~−1.5)。女性（55%）和男性（58.9%）在死亡时正在接受结核病治疗，已完成结核病治疗（女性39.3%和男性35%），并已停止结核病治疗（女性5.3%和男性5.2%）的比例相似；治疗状态在年龄和州之间以及男性财富指数四分位数之间存在显著差异。大多数人在公共部门接受结核病治疗（女性72.9%，男性76.0%）。从这一具有全国代表性的死亡样本中得出的按性别分列的调查结果对印度有效解决结核病问题具有附加价值，因为这些对促进性别平等战略的理解大多数来自于活着的人。资助美国国际开发署（USAID）。
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