Sexual inequality in tuberculosis.
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ABSTRACT:
SUBMITTER: Neyrolles O
PROVIDER: S-EPMC2788129 | biostudies-literature | 2009 Dec
REPOSITORIES: biostudies-literature
Publications
Sexual inequality in tuberculosis.
Neyrolles Olivier O Quintana-Murci Lluis L
PLoS medicine 20091222 12
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Project description:OBJECTIVE:Animal studies showed that male subjects had lower activity of immune response to infections than female subjects, which may increase the risk of the development of tuberculosis in male population. This study intended to investigate the risk of incident tuberculosis in male and female adults in Taiwan. DESIGN:This is a retrospective cohort study. SETTING:The present analyses used data of Taiwan National Health Interview Survey 2001, 2005 and 2009, National Register of Deaths Dataset, and National Health Insurance Research Database from 2000 to 2013. PARTICIPANTS:A total of 43 424 subjects with a mean age of 43.04 years were analysed. PRIMARY OUTCOME MEASURES:Incidence of tuberculosis. RESULTS:During 381 561 person-years of follow-up period, incident tuberculosis was recognised in 268 individuals. The incidence rates of tuberculosis were 97.56 and 43.24 per 100 000 person-years among male and female participants, respectively. Kaplan-Meier curves comparing male and female subjects showed statistical significance (log-rank test, P value<0.01). After adjusting for subjects' demographics and comorbidities, men showed increased risks of incident tuberculosis (adjusted HR, 1.68; 95% CI 1.21 to 2.34; P value<0.01) compared with women. On subgroup analysis, after stratifying by age, smoking and alcohol use, men had a higher risk of incident tuberculosis than women in all patient subgroups, except those who were current smokers. CONCLUSIONS:This study suggests that men had a higher risk of incident tuberculosis than women. Future tuberculosis control programmes should particularly target the male population.
| S-EPMC5829922 | biostudies-literature
Project description:Global stakeholders including the World Health Organization rely on predictive models for developing strategies and setting targets for tuberculosis care and control programs. Failure to account for variation in individual risk leads to substantial biases that impair data interpretation and policy decisions. Anticipated impediments to estimating heterogeneity for each parameter are discouraging despite considerable technical progress in recent years. Here we identify acquisition of infection as the single process where heterogeneity most fundamentally impacts model outputs, due to selection imposed by dynamic forces of infection. We introduce concrete metrics of risk inequality, demonstrate their utility in mathematical models, and pack the information into a risk inequality coefficient (RIC) which can be calculated and reported by national tuberculosis programs for use in policy development and modeling.
| S-EPMC6554307 | biostudies-literature
Project description:IntroductionFew societal-level factors are established as risk or protective factors for sexual violence. Traditional gender norms and gender inequality are linked to sexual violence, but much of this research was conducted internationally or is becoming outdated and may not reflect current norms in the U.S. This study expands on previously published research by examining gender inequality's association with state-level sexual violence.MethodsUsing state-level prevalence estimates published in the National Intimate Partner and Sexual Violence Survey 2010-2012 State Report and the Gender Inequality Index, Pearson correlations were examined to investigate the relationship between state-level gender inequality and lifetime victimization for various types of sexual violence among U.S. female and male adults. The analysis was conducted in 2019.ResultsFindings indicate that states with a high degree of gender inequality also report higher prevalence estimates among women for rape using physical force. Gender inequality was also negatively correlated with noncontact unwanted sexual experiences among women and men. In addition, an exploratory analysis of the relationship between individual indicators of gender inequality and violence outcomes suggest that the adolescent birth rate, female government representation, and labor force participation demonstrate an association with certain state-level violence outcomes, although the patterns were inconsistent.ConclusionsAlthough this study relied on cross-sectional data, collectively, these findings suggest that gender inequality may represent an important societal-level factor associated with sexual violence among women and men. However, this relationship appears complex and requires further research. These findings have potential to inform population-level violence prevention approaches.
| S-EPMC7810166 | biostudies-literature
Project description:BackgroundFemale sexual dysfunction affects 41% of reproductive-age women worldwide, making it a highly prevalent medical issue. Predictors of female sexual dysfunction are multifaceted and vary from country to country. A synthesis of potential risk factors and protective factors may aid healthcare practitioners in identifying populations at risk, in addition to revealing modifiable factors to prevent sexual dysfunction among reproductive-age women.MethodsObservational studies which assessed the prevalence and predictors of female sexual dysfunction in reproductive-age women were systematically sought in relevant databases (2000-2014). Significant predictors were extracted from each included publication. A qualitative analysis of predictors was performed with a focus on types of sexual regimes and level of human development.ResultsOne hundred thirty-five studies from 41 countries were included in the systematic review. The types of predictors varied according to the location of the study, the type of sexual regime and the level of gender inequality in that country/region. Consistently significant risk factors of female sexual dysfunction were: poor physical health, poor mental health, stress, abortion, genitourinary problems, female genital mutilation, relationship dissatisfaction, sexual abuse, and being religious. Consistently significant protective factors included: older age at marriage, exercising, daily affection, intimate communication, having a positive body image, and sex education. Some factors however had an unclear effect: age, education, employment, parity, being in a relationship, frequency of sexual intercourse, race, alcohol consumption, smoking and masturbation.ConclusionsThe sexual and reproductive lives of women are highly impacted by female sexual dysfunction, and a number of biological, psychological and social factors play a role in the prevalence of sexual dysfunction. Healthcare professionals who work with women should be aware of the many risk factors for reproductive-age women. Future prevention strategies should aim to address modifiable factors, e.g. physical activity and access to sex education; international efforts in empowering women should continue.
| S-EPMC6013982 | biostudies-literature
Project description:Tuberculosis (TB) mortality rates in the USA fell rapidly from 1910 to 1933. However, during this period, racial disparities in TB mortality in the nation's expanding cities grew. Because of long delays between infection and disease, TB mortality is a poor indicator of short-term changes in transmission. We estimated the annual risk of TB infection (ARTI) in 11 large US cities to understand whether rising inequality in mortality reflected rising inequality in ARTI using city-level TB mortality data compiled by the US Department of Commerce from 1910 to 1933. We estimated ARTI for African-Americans and whites using pediatric extrapulmonary TB mortality data for African-Americans and whites in our panel of cities. We also estimated age-adjusted pulmonary TB mortality rates for these cities. We find that the ratio of ARTI for African-Americans vs. whites increased from 2·1 (95% CI = 1·7, 2·4) in 1910 to 4·2 (95% CI = 3·4, 5·2) in 1933. This change mirrored the increasing inequality in age-adjusted pulmonary TB mortality during this period. These findings may reflect the combined effects of migration, inequality in access to care, increasing population density, and racial residential segregation in northern cities during this period.
| S-EPMC9203285 | biostudies-literature
Project description:BackgroundHuman migration facilitate the spread of tuberculosis (TB). Migrants face an increased risk of TB infection. In this study, we aim to explore the spatial inequity of sputum smear-positive pulmonary TB (SS + PTB) in China; and the spatial heterogeneity between SS + PTB and internal migration.MethodsNotified SS + PTB cases in 31 provinces in mainland China were obtained from the national web-based PTB surveillance system database. Internal migrant data were extracted from the report on China's migrant population development. Spatial autocorrelations were explored using the global Moran's statistic and local indicators of spatial association. The spatial variation in temporal trends was performed using Kulldorff's scan statistic. Fixed effect and spatial autoregressive models were used to explore the spatial inequity between SS + PTB and internal migration.ResultsA total of 2 380 233 SS + PTB cases were reported in China between 2011 and 2017, of which, 1 716 382 (72.11%) were male and 663 851 (27.89%) were female. Over 70% of internal migrants were from rural households and had lower income and less education. The spatial variation in temporal trend results showed that there was an 9.9% average annual decrease in the notification rate of SS + PTB from 2011 to 2017; and spatial clustering of SS + PTB cases was mainly located in western and southern China. The spatial autocorrelation results revealed spatial clustering of internal migration each year (2011-2017), and the clusters were stable within most provinces. Internal emigration, urban-to-rural migration and GDP per capita were significantly associated with SS + PTB, further, internal emigration could explain more variation in SS + PTB in the eastern region in mainland. However, internal immigration and rural-to-urban migration were not significantly associated with SS + PTB across China.ConclusionsOur study found the spatial inequity between SS + PTB and internal migration. Internal emigration, urban-to-rural migration and GDP per capita were statistically associated with SS + PTB; the negative association was identified between internal emigration, urban-to-rural migration and SS + PTB. Further, we found those migrants with lower income and less education, and most of them were from rural households. These findings can help stakeholders to implement effective PTB control strategies for areas at high risk of PTB and those with high rates of internal migration.
| S-EPMC7678065 | biostudies-literature
Project description:When they do not meet norms related to sexuality and reproduction, Bangladeshi women often face abandonment and are thus deprived of an active sexual life, a marital relationship, and motherhood. Little is known about how a stigmatised disease such as tuberculosis (TB) may constrain the reproductive health and sexual lives of women. This article, derived from a larger study on the impact of TB on women's sexual and reproductive health and rights in Narsingdi district and Dhaka, Bangladesh, aims to fill this gap. Based on interviews with nine married women who have or had TB, four husbands, and two mothers-in-law, this article highlights that the ways in which TB impedes on the sexual and reproductive lives of women depends on the stigma within their family and community, their relationships with their husbands, motherhood, their living arrangements, their economic contribution to the family and/or their disclosure of their TB diagnosis. Women with children and supportive husbands retain a stronger position among their in-laws and are less likely to be isolated or rejected. The patients' narratives revealed that the instructions of health workers influenced their decisions about intercourse or abstinence. Future studies should examine the instructions patients receive from health workers regarding their living and sleeping arrangements, sexual intercourse, and pregnancy, as well as policy documents on TB treatment and prevention.
| S-EPMC6053219 | biostudies-literature
Project description:This study explores the consequences and origins of between-ethnicity economic inequality across countries. First, combining satellite images of nighttime luminosity with the historical homelands of ethnolinguistic groups we construct measures of ethnic inequality for a large sample of countries. We also compile proxies of overall spatial inequality and regional inequality across administrative units. Second, we uncover a strong negative association between ethnic inequality and contemporary comparative development; the correlation is also present when we condition on regional inequality, which is itself related to under-development. Third, we investigate the roots of ethnic inequality and establish that differences in geographic endowments across ethnic homelands explain a sizable fraction of the observed variation in economic disparities across groups. Fourth, we show that ethnic-specific inequality in geographic endowments is also linked to under-development.
| S-EPMC4907503 | biostudies-literature
Project description:There is evidence that in more economically unequal societies, social relations are more strained. We argue that this may reflect the tendency for wealth to become a more fitting lens for seeing the world, so that in economically more unequal circumstances, people more readily divide the world into "the haves" and "have nots." Our argument is supported by archival and experimental evidence. Two archival analyses reveal that at times of greater inequality, books in the United Kingdom and the United States and news media in English-speaking countries were more likely to mention the rich and poor. Three experiments, two preregistered, provided evidence for the causal role of economic inequality in people's use of wealth categories when describing life in a fictional society; effects were weaker when examining real economic contexts. Thus, one way in which inequality changes the world may be by changing how we see it.
| S-EPMC9245161 | biostudies-literature
Project description:Research has shown that giving disadvantaged families financial incentives to invest in their children could decrease socioeconomic inequality by enhancing human capital formation. Yet, within the household how are such gains achieved? We use a field experiment to investigate how parents allocate time when they receive financial incentives. We find that incentives increase investment in the target child. But, parents achieve these gains by substituting away from time spent with the child's sibling(s). An unintended consequence is that intrahousehold inequality increases and aggregate gains from the program are overstated when focusing only on target children.
| S-EPMC8452229 | biostudies-literature