ArticleThe Lancet regional health. Europe2025
Sex differences in risk factors for unsuccessful tuberculosis treatment outcomes in Eastern Europe from 2020 to 2022: a multi-country retrospective cohort study.
Article in The Lancet regional health. Europe, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Drug-resistance profiles, population structure, genomic clustering, and temporal trends in drug resistance amongThe Lancet regional health. Europe · 2026Article
- Sex differences in tuberculosis incidence: a pooled analysis of 11 prospective cohort studies.EClinicalMedicine · 2026Article
- Factors Associated With Tuberculosis Treatment Failure Among Hill Tribe and Stateless People in Chiang Rai Province, Thailand: A Case-Control Study.Tropical medicine & international health : TM & IH · 2026Article
- Investigating Gendered Implicit Bias Among Healthcare Workers in South Africa: Development and Piloting of an Implicit Association Test in a High Tuberculosis and HIV Setting.Research square · 2026Article
- Sex disparities in tuberculosis outcomes: evidence from a multicenter Italian cohort (Italian South TB Network (ISTB-Net).Infection · 2026Article
- Sex as a Biological Variable in Tuberculosis Pathogenesis.Immunological reviews · 2026Review
- Spatiotemporal patterns of tuberculosis in urban slums and urban-rural transition zones: evidence from Tétouan, Morocco, 2019-2023.PLOS global public health · 2026Article
- Type 2 diabetes is associated with pulmonary cavitation in men with HIV-TB coinfection.Frontiers in endocrinology · 2026Article
- Cox Proportional Hazards Model Analysis of Survival Among Tuberculosis Patients Under Treatment in Mbuji-Mayi, Democratic Republic of the Congo.Journal of multidisciplinary healthcare · 2026Article
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Abstract
Background: Addressing the disproportionate representation between sexes is essential for achieving universal health coverage. Studies on the association between sex and unsuccessful tuberculosis treatment outcomes have shown conflicting results. This study examines this association and analyses sex-stratified risk factors associated with unsuccessful outcomes. Methods: This retrospective, observational cohort study analysed prospectively collected data from six Eastern European countries from 2020 to 2022. Treatment outcomes were defined using World Health Organization criteria. Uni- and multivariable logistic regression models were used to assess the association between sex and unsuccessful outcomes ('treatment failure', 'lost to follow-up', 'died', or any of these). After propensity score matching females and males, the multivariable analysis was repeated. Risk factors were analysed separately for each sex and compared using interaction terms. Findings: Among females, 19·5% (n = 290/1490) (95% confidence interval [CI]: 18, 22) achieved an unsuccessful treatment outcome, compared with 30% (n = 1363/4553) (95% CI: 29, 31) among males. In the multivariable analyses, female sex was associated with 32% lower odds of any unsuccessful outcome (adjusted odds ratio [aOR] 0·68, 95% CI: 0·58, 0·80), 36% lower odds of dying (aOR 0·64, 95% CI: 0·51, 0·80), and 37% lower odds of treatment failure (aOR 0·63, 95% CI: 0·47, 0·85). The association between sex and being 'lost to follow-up' was not significant. In the propensity score-matched cohort, sex was not associated with unsuccessful outcomes. Risk factors for unsuccessful outcomes were similar for females and males, except that in females aged >65 years, the odds of death were 2·2 times higher (95% CI: 1·1, 4·4). Interpretation: Male sex was associated with unsuccessful outcomes, including death and treatment failure, but adjusting for socio-demographic and clinical factors, and matching males to females, attenuated the association, suggesting that sex disparities in tuberculosis outcomes may be driven more by behavioural than biological factors. Longitudinal studies are needed to confirm these findings. Funding: The publication fee was funded by the Civilian Research and Development Foundation (CRDF) under grant #G-202407-72538.
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