The spread of Tuberculosis (TB) is a concerning issue in many countries around the world. According to media reports, men are more likely to contract TB and experience fatal outcomes compared to women. In South Africa, the disparity is particularly alarming, with 70 percent more men dying from TB than women. This discrepancy raises serious concerns about the number of men being diagnosed with the disease. The impact of TB extends beyond just the health of men; it also affects their daily lives, work, and their families. In many cases, women in the household are burdened with caregiving responsibilities and may need to work to support their families, especially if their husbands become unable to work due to TB.
South Africa is a significant contributor to the global burden of TB, ranking among the top six countries responsible for 60 percent of worldwide TB cases. Research conducted in the region aimed to uncover the factors contributing to the high rates of TB among men in South Africa. One of the key findings was that men are 70 percent more likely to develop TB and succumb to the disease compared to women. In 2019, the TB incidence rate was 801 cases per 100,000 adult men, while for women, it was 478 cases per 100,000.
Current TB interventions primarily focus on biomedical approaches, including preventive TB medication, diagnosis, and treatment with anti-TB drugs. However, the research suggests that there is a need to improve men’s access to healthcare facilities and encourage them to seek medical care, especially considering that HIV is a significant risk factor for TB and plays a central role in the epidemic. The TB model has been integrated with the existing Thembisa HIV model, which demonstrates that between 1990 and 2019, South African men consistently had higher rates of TB development and mortality compared to women. The estimates indicate that there were 1.6 times more new TB cases and 1.7 times more deaths among men than women in 2019.
Interestingly, the research also highlights that HIV is more prevalent in women than in men, which is contrary to the expectation that higher HIV incidence should lead to higher TB rates in women. Other contributing factors to the elevated TB epidemic among certain risk groups of men include excessive alcohol consumption, smoking, diabetes, and undernutrition.
In 2019, approximately 51 percent of new TB cases in men were attributed to heavy alcohol consumption, 30 percent to smoking, and 16 percent to undernutrition. In contrast, the contribution of these factors to TB in women was relatively low. Addressing the gender disparities in TB incidence and outcomes in South Africa and other affected regions will require a comprehensive approach that goes beyond biomedical interventions. Strategies should include improving healthcare access for men, targeting HIV prevention and management, and addressing risk factors such as alcohol use, smoking, and nutritional deficiencies. Reducing the burden of TB among men is not only a health imperative but also crucial for the well-being and economic stability of affected households and communities.
Image Source: https://en.wikipedia.org/wiki/HIV/AIDS_in_South_African_townships