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Barriers and delays in tuberculosis diagnosis and treatment services: does gender matter?


ABSTRACT: Background. Tuberculosis (TB) remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation. Methods. Following a systematic review process, we: searched 12 electronic databases; included quantitative studies assessing gender differences in accessing TB diagnostic and treatment services; abstracted data; and assessed study validity. We defined barriers and delays at the individual and provider/system levels using a conceptual framework of the TB care continuum and examined gender-related differences. Results. Among 13,448 articles, 137 were included: many assessed individual-level barriers (52%) and delays (42%), 76% surveyed persons presenting for care with diagnosed or suspected TB, 24% surveyed community members, and two-thirds were from African and Asian regions. Many studies reported no gender differences. Among studies reporting disparities, women faced greater barriers (financial: 64% versus 36%; physical: 100% versus 0%; stigma: 85% versus 15%; health literacy: 67% versus 33%; and provider-/system-level: 100% versus 0%) and longer delays (presentation to diagnosis: 45% versus 0%) than men. Conclusions. Many studies found no quantitative gender-related differences in barriers and delays limiting access to TB services. When differences were identified, women experienced greater barriers and longer delays than men.

SUBMITTER: Yang WT 

PROVIDER: S-EPMC4020203 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Barriers and delays in tuberculosis diagnosis and treatment services: does gender matter?

Yang Wei-Teng WT   Gounder Celine R CR   Akande Tokunbo T   De Neve Jan-Walter JW   McIntire Katherine N KN   Chandrasekhar Aditya A   de Lima Pereira Alan A   Gummadi Naveen N   Samanta Santanu S   Gupta Amita A  

Tuberculosis research and treatment 20140428


Background. Tuberculosis (TB) remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation. Methods. Following a systematic review process, we: searched 12 electronic databases; included quantitative studies assessing gender differences in accessing TB diagnostic and treatment services; abstracted data; and assessed study validity. We defined b  ...[more]

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