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首页> 外文期刊>BMC Infectious Diseases >Are current case-finding methods under-diagnosing tuberculosis among women in Myanmar? An analysis of operational data from Yangon and the nationwide prevalence survey
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Are current case-finding methods under-diagnosing tuberculosis among women in Myanmar? An analysis of operational data from Yangon and the nationwide prevalence survey

机译：当前的病例发现方法是否不足以诊断缅甸妇女的结核病？仰光的业务数据分析和全国患病率调查

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Background Although there is a large increase in investment for tuberculosis control in Myanmar, there are few operational analyses to inform policies. Only 34?% of nationally reported cases are from women. In this study, we investigate sex differences in tuberculosis diagnoses in Myanmar in order to identify potential health systems barriers that may be driving lower tuberculosis case finding among women. Methods From October 2014 to March 2015, we systematically collected data on all new adult smear positive tuberculosis cases in ten township health centres across Yangon, the largest city in Myanmar, to produce an electronic tuberculosis database. We conducted a descriptive cross-sectional analysis of sex differences in tuberculosis diagnoses at the township health centres. We also analysed national prevalence survey data to calculate additional case finding in men and women by using sputum culture when smear microscopy was negative, and estimated the sex-specific impact of using a more sensitive diagnostic tool at township health centres. Results Overall, only 514 (30?%) out of 1371 new smear positive tuberculosis patients diagnosed at the township health centres were female. The proportion of female patients varied by township (from 21?% to 37?%, p =?0.0172), month of diagnosis (37?% in February 2015 and 23?% in March 2015 p =?0.0004) and age group (26?% in 25–64 years and 49?% in 18–25 years, p Conclusions Our study, which is the first to systematically compile and analyse routine operational data from tuberculosis diagnostic centres in Myanmar, found that substantially fewer women than men were diagnosed in all study townships. The sex ratio of newly diagnosed cases varied by age group, month of diagnosis and township of diagnosis. Low sensitivity of tuberculosis diagnosis may lead to a potential under-diagnosis of tuberculosis among women.
机译：背景信息尽管缅甸控制结核病的投资大量增加，但很少有可用于政策分析的操作分析。在全国报告的病例中，只有34％来自女性。在这项研究中，我们调查了缅甸结核病诊断中的性别差异，以发现可能导致女性患上较低结核病病例的潜在卫生系统障碍。方法2014年10月至2015年3月，我们系统地收集了缅甸最大城市仰光的10个乡镇卫生中心的所有新成人涂阳结核病病例数据，以建立一个电子结核病数据库。我们在乡镇卫生院对结核病诊断中的性别差异进行了描述性的横断面分析。我们还分析了全国患病率调查数据，以在涂片显微镜检查阴性时通过痰培养来计算男女的其他病例发现，并估计在乡镇卫生中心使用更敏感的诊断工具对性别的影响。结果总体上，在乡镇卫生院诊断出的1371名新涂阳结核患者中，只有514名（30％）是女性。女性患者的比例因镇（从21％到37％，p =？0.0172），诊断月份（2015年2月的37％和2015年3月的23％，p = 0.0004）和年龄组而异（结论我们的研究是第一个系统地汇编和分析缅甸结核病诊断中心的常规运行数据的研究，在25-64年中占26％，在18-25年中占49％，p研究发现，女性比男性少得多在所有研究乡镇中均被诊断为结核病，新诊断病例的性别比因年龄组，诊断月份和诊断乡镇而异;结核病诊断的敏感性低，可能导致女性对结核病的潜在诊断不足。

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