Sex differences in tuberculosis in Hong Kong

SETTING: The Hong Kong Tuberculosis and Chest Service, Department of Health, Hong Kong. OBJECTIVE: To examine sex differences in the rate and clinical manifestations of tuberculosis in Hong Kong. DESIGN: Notification rates of tuberculosis during the past five decades were obtained from the Hong Kong Tuberculosis and Chest Service, Department of Health, Hong Kong. In addition, all patients registered with the Chest Service for treatment of tuberculosis in 1996 were studied. RESULTS: The rate of tuberculosis during the past five decades was consistently higher in men than in women, irrespective of age group. The sex difference in rates was highest among those aged over 60 years. In 1996, a higher proportion of women had extra-pulmonary tuberculosis than men; the main site of involvement was the lymph nodes. More women completed treatment at 12 months and fewer women missed treatment appointments. A higher proportion of men had relapse pulmonary disease that was more extensive, a history of previous default from treatment and co-morbid illnesses. CONCLUSION: There are sex differences in the rates and clinical manifestations of tuberculosis in Hong Kong. Study of sex differences is essential for targeting prevention programmes at groups at higher risk.