TUBERCULOSIS: Women and children statistics

Globally, 700 000 women die from tuberculosis every year;1 this disease kills more women than do all causes of maternal mortality combined.2 Case-fatality rates seem to be higher in women than in men, and women are more often diagnosed with extrapulmonary tuberculosis.2 This sex difference might indicate under-reporting, because access barriers are higher for women because of sociocultural disempowerment, stigma, different patterns of health-care use, or lack of financial resources; however, poorly elucidated biological factors could account for some of the sex differences.3—6
In tuberculosis-endemic areas, such as sub-Saharan Africa and India, the greatest burden of tuberculosis in women is during the childbearing years (15—49 years); this burden has been greatly exacerbated because of epidemiological changes induced by the global HIV/AIDS epidemic.1, 7 Women account for up to 70% of HIV-infected adults in sub-Saharan Africa, which has shifted the male-to-female case-notification ratio such that more female than male cases of tuberculosis are now detected in countries where the HIV prevalence exceeds 1%.1 Tuberculosis in pregnancy has been associated with increased risk of low birthweight, prematurity, intrauterine growth retardation, and fetal death.8 Maternal tuberculosis is also an important risk factor for tuberculosis and mortality in infants, particularly in babies born to HIV-infected women.9 Targeted strategies to prevent, diagnose, and treat tuberculosis in HIV-infected pregnant women should promote both maternal and child health. Operations research with robust cost-effectiveness analysis is urgently needed to guide the nature and prioritisation of interventions in resource-restricted settings—eg, to assess the value of finding active tuberculosis cases and screening for latent tuberculosis infection, with provision of preventive treatment in HIV-infected women accessing antenatal care.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60579-X/fulltext