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. 2024 Jul 9:31:100448.
doi: 10.1016/j.lansea.2024.100448. eCollection 2024 Dec.

Sex-disaggregated patterns in tuberculosis treatment coverage and outcomes among a nationally representative sample of deaths in India: 2019-2022

Rakhi Dandona  1 , G Anil Kumar  1 , S Siva Prasad Dora  1 , Md Akbar  1 , Kultar Singh  2 , Sibin George  1 , Moutushi Majumder  1 , Navin Kumar  2 , Rajendra P Joshi  3 , Mrigen Deka  3 , Dimple Panchal  3 , Venkatesh Roddawar  4 , Amar Shah  5 , Vikas Choudhary  2 , Yogesh N Patel  4 , Bhavin Vadera  5 , Kiran Rade  6   7 , Lalit Dandona  1 , Raghuram Rao  3
Affiliations

Sex-disaggregated patterns in tuberculosis treatment coverage and outcomes among a nationally representative sample of deaths in India: 2019-2022

Rakhi Dandona et al. Lancet Reg Health Southeast Asia. .

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).

Keywords: Gender; India; Survival; TB; Treatment coverage; Tuberculosis.

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Conflict of interest statement

VR and YNP are employees of TIFA India, and AS and BV are employees of USAID/India. Other authors declare no completing interests.

Figures

Fig. 1
Fig. 1
Distribution of Tuberculosis (TB) treatment status among deaths who were ever diagnosed with TB, by the year of TB diagnosis.
Fig. 2
Fig. 2
Distribution of Tuberculosis (TB) treatment status among deaths who were reported to have started TB treatment, by the year of death.
Fig. 3
Fig. 3
Distribution of private sector Tuberculosis (TB) treatment provider among deaths who had taken treatment for TB, by place of residence and wealth index quartile.
See this image and copyright information in PMC

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