Eight communities with high tuberculosis (TB) prevalence, Western Cape, South Africa. Our objective was to identify sex differences in TB health-seeking behaviour and diagnosis in primary health care facilities and how this influences TB diagnosis. We used data from a prevalence survey among 30,017 adults conducted in 2010 as part of the Zambia, South Africa Tuberculosis and AIDS Reduction (ZAMSTAR) trial. A total of 1670 (5.4%) adults indicated they had a cough of ⩾2 weeks, 950 (56.9%) of who were women. Women were less likely to report a cough of ⩾2 weeks (5.1% vs. 6.4%, P < 0.001), but were more likely to seek care for their cough (32.6% vs. 26.9%, P = 0.012). Of all adults who sought care, 403 (80.0%) sought care for their cough at a primary health care (PHC) facility (79.0% women vs. 81.4% men, P = 0.511). Women were less likely to be asked for a sputum sample at the PHC facility (63.3% vs. 77.2%, P = 0.003) and less likely to have a positive sputum result (12.6% vs. 20.7%, P = 0.023). The attainment of sex equity in the provision of TB health services requires adherence to testing protocols. Everyone, irrespective of sex, who seeks care for a cough of ⩾2 weeks should be tested.
Smith, A., Burger, R., Claassens, M., Ayles, H., Godfrey-Faussett, P. and Beyers, N., 2016. Health care workers’ gender bias in testing could contribute to missed tuberculosis among women in South Africa. The international journal of tuberculosis and lung disease, 20(3), pp.350-356.