Barriers and Delays in Tuberculosis Diagnosis and Treatment Services: Does Gender Matter?
Gounder, Celine R.
De Neve, Jan-Walter
McIntire, Katherine N.
de Lima Pereira, Alan
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CitationYang, Wei-Teng, Celine R. Gounder, Tokunbo Akande, Jan-Walter De Neve, Katherine N. McIntire, Aditya Chandrasekhar, Alan de Lima Pereira, Naveen Gummadi, Santanu Samanta, and Amita Gupta. 2014. “Barriers and Delays in Tuberculosis Diagnosis and Treatment Services: Does Gender Matter?” Tuberculosis Research and Treatment 2014 (1): 461935. doi:10.1155/2014/461935. http://dx.doi.org/10.1155/2014/461935.
AbstractBackground:. Tuberculosis (TB) remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation. Methods:. Following a systematic review process, we: searched 12 electronic databases; included quantitative studies assessing gender differences in accessing TB diagnostic and treatment services; abstracted data; and assessed study validity. We defined barriers and delays at the individual and provider/system levels using a conceptual framework of the TB care continuum and examined gender-related differences. Results:. Among 13,448 articles, 137 were included: many assessed individual-level barriers (52%) and delays (42%), 76% surveyed persons presenting for care with diagnosed or suspected TB, 24% surveyed community members, and two-thirds were from African and Asian regions. Many studies reported no gender differences. Among studies reporting disparities, women faced greater barriers (financial: 64% versus 36%; physical: 100% versus 0%; stigma: 85% versus 15%; health literacy: 67% versus 33%; and provider-/system-level: 100% versus 0%) and longer delays (presentation to diagnosis: 45% versus 0%) than men. Conclusions:. Many studies found no quantitative gender-related differences in barriers and delays limiting access to TB services. When differences were identified, women experienced greater barriers and longer delays than men.
Citable link to this pagehttp://nrs.harvard.edu/urn-3:HUL.InstRepos:12406879
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