Relationship between patient sex and anatomical sites of extrapulmonary tuberculosis in Mali

Bocar Baya; Ibrahim Sanogo; Mahamadou Kone; Dianguina Soumare; Kadidia Ouattara; Amadou Somboro; Mamadou Wague; Nadie Coulibaly; Isaac Koloma; Mariam Coulibaly; Mohamed Nantoume; Mamadou Perou; Kadidia Kone; Djeneba Coulibaly; Hawa Boukary Diarra; Bourahima Kone; Ayouba Diarra; Mamadou D Coulibaly; Moumine Sanogo; Bassirou Diarra; Mahamadou Diakite; Chad J Achenbach; Seydou Doumbia; William R Bishai; Sabra L Klein; Jane L Holl; Souleymane Diallo; Robert L Murphy; Yacouba Toloba; Djeneba Dabitao

doi:10.1016/j.jctube.2023.100389

Relationship between patient sex and anatomical sites of extrapulmonary tuberculosis in Mali

J Clin Tuberc Other Mycobact Dis. 2023 Aug 9:33:100389. doi: 10.1016/j.jctube.2023.100389. eCollection 2023 Dec.

Authors

Bocar Baya^{1

2}, Ibrahim Sanogo¹, Mahamadou Kone¹, Dianguina Soumare², Kadidia Ouattara², Amadou Somboro¹, Mamadou Wague¹, Nadie Coulibaly¹, Isaac Koloma¹, Mariam Coulibaly¹, Mohamed Nantoume¹, Mamadou Perou¹, Kadidia Kone¹, Djeneba Coulibaly¹, Hawa Boukary Diarra¹, Bourahima Kone¹, Ayouba Diarra¹, Mamadou D Coulibaly¹, Moumine Sanogo¹, Bassirou Diarra¹, Mahamadou Diakite¹, Chad J Achenbach³, Seydou Doumbia¹, William R Bishai⁴, Sabra L Klein⁵, Jane L Holl⁶, Souleymane Diallo¹, Robert L Murphy^{3

6}, Yacouba Toloba^{1

2}, Djeneba Dabitao¹

Affiliations

¹ University Clinical Research Center (UCRC), Faculty of Pharmacy and Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques, and Technologies of Bamako (USTTB), Mali, West Africa.
² Department of Pneumophtisiology, University Teaching Hospital of Point-G, Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques, and Technologies of Bamako (USTTB), Mali, West Africa.
³ Northwestern University (NU), Division of Infectious Diseases and Havey Institute for Global Health, Feinberg School of Medicine, Chicago, IL, USA.
⁴ Johns Hopkins School of Medicine, Department of Infectious Diseases, Center for Tuberculosis Research, Baltimore, MD, USA.
⁵ Johns Hopkins Bloomberg School of Public Health, W. Harry Feinstone Department of Molecular Microbiology and Immunology, Baltimore, MD, USA.
⁶ University of Chicago, Biological Sciences Division, Chicago, IL, USA.

Abstract

Background: Contribution of host factors in mediating susceptibility to extrapulmonary tuberculosis is not well understood.

Objective: To examine the influence of patient sex on anatomical localization of extrapulmonary tuberculosis.

Methods: We conducted a retrospective cross-sectional study in Mali, West Africa. Hospital records of 1,304 suspected cases of extrapulmonary tuberculosis, available in TB Registry of a tertiary tuberculosis referral center from 2019 to 2021, were examined.

Results: A total of 1,012 (77.6%) were confirmed to have extrapulmonary tuberculosis with a male to female ratio of 1.59:1. Four clinical forms of EPTB predominated, namely pleural (40.4%), osteoarticular (29.8%), lymph node (12.5%), and abdominal TB (10.3%). We found sex-based differences in anatomical localization of extrapulmonary tuberculosis, with males more likely than females to have pleural TB (OR: 1.51; 95% CI [1.16 to 1.98]). Conversely, being male was associated with 43% and 41% lower odds of having lymph node and abdominal TB, respectively (OR: 0.57 and 0.59).

Conclusion: Anatomical sites of extrapulmonary tuberculosis differ by sex with pleural TB being associated with male sex while lymph node and abdominal TB are predominately associated with female sex. Future studies are warranted to understand the role of sex in mediating anatomical site preference of tuberculosis.

Keywords: Africa; Disease; Gender; Localization; Mycobacterium.

Grants and funding

K43 TW011426/TW/FIC NIH HHS/United States