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Volume 29, Number 5—May 2023
Research

Influence of Sex and Sex-Based Disparities on Prevalent Tuberculosis, Vietnam, 2017–2018

Hai Viet NguyenComments to Author , Daniella Brals, Edine Tiemersma, Robert Gasior, Nhung Viet Nguyen, Hoa Binh Nguyen, Hung Van Nguyen, Ngoc Anh Le Thi, and Frank Cobelens
Author affiliations: Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands (H.V. Nguyen, D. Brals, F. Cobelens); Vietnam National Tuberculosis Program, Hanoi, Vietnam (H.V. Nguyen, N.V. Nguyen, H.B. Nguyen, H.V. Nguyen, N.A. Le Thi); KNCV Tuberculosis Foundation, Den Haag, the Netherlands (E. Tiemersma); National Academies of Sciences, Engineering, and Medicine, Washington, DC, USA (R. Gasior).

Main Article

Table 3

Structural equation model full estimation results of the relationships between sex, clinical symptoms, behavioral and environmental risks, access to healthcare, SES, and Xpert-positive prevalent tuberculosis, Vietnam, 2017–2018*

Outcomes
Xpert-postive prevalent TB

Clinical symptoms

Access to healthcare

Behavioral and environmental risks

Socioeconomic status
aOR
(95% CI)
p value
aOR
(95% CI)
p value
aOR
(95% CI)
p value
aOR
(95% CI)
p value
aOR
(95% CI)
p value
Male sex
3.0
(1.7–5.0)
<0.001

1.2
(0.9–1.7)
0.281

1.4
(1.1–1.7)
0.005

7.7
(6.0–9.8)
<0.001

0.8
(0.6–1.0)
0.172
Age groups, y
15–24 Referent Referent Referent Referent Referent
25–34 1.1
(0.4–2.8)
0.824 1.2
(0.5–2.4)
0.706 1.1
(0.7–1.7)
0.611 1.3
(0.7–2.2)
0.395 1.3
(0.7–2.4)
0.481
35–44 0.9
(0.4–2.3)
0.874 1.1
(0.5–2.7)
0.776 1.1
(0.8–1.7)
0.562 1.9
(1.0–3.4)
0.042 3.7
(2.1–6.3)
<0.001
45–54 1.1
(0.4–3.0)
0.755 1.3
(0.6–3.0)
0.459 1.1
(0.7–1.7)
0.651 2.6
(1.5–4.5)
0.001 5.0
(2.9–8.8)
<0.001
55–64 1.2
(0.4–3.4)
0.767 1.8
(0.9–3.6)
0.112 1.2
(0.8–2.0)
0.372 1.7
(0.9–3.1)
0.089 6.5
(3.6–11.5)
<0.001
≥65
1.9
(0.8–5.2)
0.164

1.8
(0.8–4.1)
0.173

1.3
(0.7–2.3)
0.429

1.4
(0.7–2.7)
0.315

15.8
(7.7–32.2)
<0.001
Area
Urban Referent Referent Referent Referent Referent
Remote 1.4
(0.8–2.5)
0.212 0.9
(0.5–1.4)
0.531 1.1
(0.6–2.1)
0.801 1.0
(0.6–1.8)
0.940 1.7
(0.9–2.9)
0.067
Rural
1.6
(0.9–3.1)
0.141

0.8
(0.5–1.4)
0.440

1.3
(0.8–2.2)
0.235

0.9
(0.6–1.4)
0.620

0.6
(0.4–0.8)
0.002
Region
North Referent Referent Referent Referent Referent
Central 1.0
(0.5–2.2)
0.922 0.6
(0.4–0.9)
0.039 0.9
(0.5–1.6)
0.771 1.6
(0.8–3.2)
0.148 4.0
(2.2–7.3)
<0.001
South
1.9
(1.1–3.7)
0.030

0.4
(0.2–0.6)
<0.001

1.1
(0.6–2.0)
0.684

1.7
(1.1–2.6)
0.025

4.0
(2.7–6.0)
<0.001
Clinical symptoms
Least severe Referent
Moderate 
severe 5.0
(2.8–8.7)
<0.001
Most severe
13.2
(5.9–29.2)
<0.001






Access to healthcare
Good Referent Referent
Moderate 2.5
(1.4–4.4)
0.002 1.2
(0.8–1.9)
0.343
Poor
13.4
(7.0–25.6)
<0.001

1.6
(1.1–2.4)
0.016




Behavioral and environmental risks
Low Referent Referent Referent
Moderate 2.1
(1.1–3.9)
0.017 1.5
(1.1–2.2)
0.015 1.2
(0.8–1.6)
0.336
High
2.9
(1.5–5.6)
0.001

2.4
(1.6–3.6)
<0.001

1.5
(1.0–2.1)
0.029


Socioeconomic status
High Referent Referent Referent Referent
Medium 1.0
(0.6–1.7)
0.992 1.2
(0.9–1.6)
0.326 0.8
(0.6–1.1)
0.172 1.4
(1.1–1.9)
0.020
Low
1.2
(0.6–2.3)
0.526

2.2
(1.4–3.5)
0.001

1.4
(1.0–2.0)
0.045

2.0
(1.4–2.8)
<0.001

Bootstrapped AUC 0.90
(0.89–0.92)


*aOR, adjusted odds ratio; AUC, area under the curve. †Variable was not included as predictor for the respective outcome. Sex, age, area, and region were not an outcome in this structural equation model. Model results were weighted using sampling and lost-to-follow-up weights.

Main Article

Page created: March 17, 2023
Page updated: April 18, 2023
Page reviewed: April 18, 2023
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