| Summary: | Last year, two striking studies focused attention on sex differences in tuberculosis (TB) epidemiology. Katherine Horton and team’s metaanalysis of 56 prevalence surveys undertaken in low- and middle-income countries found that adult men had 2.21 (95% CI, 1.92–2.54) times more bacteriologically confirmed TB than adult women. The equivalent ratio for smear-positive TB (reported in 40 surveys), was 2.51 (95%CI 2.07–3.04). A male preponderance of prevalent TB was observed in all World Health Organization geographical regions that contributed sufficient data to draw meaningful conclusions. In the second study, Pete Dodd and colleagues utilised data on adult TB prevalence, the incidence of Mycobacterium tuberculosis infection in children, and data on social contact patterns from communities in Zambia and the Western Cape of South Africa, to produce modelled estimates of the incidence of M. tuberculosis infection, by age and sex. Whilst men and women had similar numbers of social contacts, contact patterns were strongly age and sex assortative. A key finding was that 66% (95%CI 64–67, Zambia) and 57% (95%CI 56–58, Western Cape) of incident M. tuberculosis infections were attributable to contact with adult men. The authors commented that this ‘was largely because tuberculosis prevalence was higher in male interviewees’.
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