Sex differences and HIV status of tuberculosis in adults at a rural hospital in southern Ethiopia: an 18-year retrospective cross-sectional study.

Background: The aim of the study was to compare the epidemiology, clinical characteristics and treatment outcome of tuberculosis (TB), including HIV status, in women and men in southern rural Ethiopia.

Methods: We conducted a register-based retrospective cohort study covering the period from September 1998 to August 2015.

Result: We included records of 2252 registered TB patients: 1080 (48%) women and 1172 (52%) men. Median age was similar for women and men: 27.5 years and 25.0 years, respectively. Median weight in women was 43.0 kg (interquartile range IQR: 38.0, 49.0), significantly lower than in men (50.0 kg, IQR 44.0, 55.0; p = 0.01). Extrapulmonary TB was significantly more common in women than in men (34.1% versus 28.7%; p=0.006). Treatment outcomes were similar in both sexes: in 70.3% of women and 68.9% of men, TB mortality was slightly lower in women than men (4.7% vs. 6.5%; p=0.08). In patients with TB, female sex was independently associated with low weight (adjusted aOR: 0.91; 95% CI 0.90, 0.92), less mortality (aOR: 0.54; 95% CI 0.36, 0.81), and lymph node TB (aOR: 1.57; 95% CI 1.13, 2.19).

Conclusion: Lymph node TB was more common in women. Treatment outcomes were similar in both sexes, but women had a lower mortality rate.