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Social Determinants Put Women At Risk of Tuberculosis

By Bobby Ramakant  

It is no coincidence but rather an ill-synergy of a range of factors that increase the risk for a woman to get tuberculosis (TB). In India, sixty per cent of women are poor which often means poor living conditions, long working hours and ignoring health overtime. Fifty five per cent of women are anaemic. Anaemia is a cause of TB as it accelerates progression from latent TB infection to active TB disease. Forty eight per cent of women are malnourished. Fifty six per cent of India's total population lives in urban slums.

At a meeting on importance of addressing TB in context of women's health organized by Global Health Advocates (GHA) to mark the International Women's Day (8th March), the bootom line was written on the wall: TB is the third leading cause of death globally among women aged 15-44. In some settings, women who become ill with TB may be stigmatized and discriminated by their families and communities.

In most countries men carry more of the TB burden, however more women are detected with TB in some settings such as Afghanistan, and parts of Pakistan and these conditions merit further investigation.

"Universal access won't be achieved if women don't have access to services" said Mamta Jacob from Global Health Advocates (GHA). "Due to social determinants and existing disparities, a woman is at higher risk of getting infected with TB, developing active TB disease from a latent TB infection, and delaying TB diagnosis and initiation of standard treatment for TB," said Mamta Jacob.

"Most slum houses are poorly ventilated. Men relatively stay for a shorter time in slum houses and women spend much more time because of her role in house," said Mamta Jacob.

TB progresses faster in women than men from latent TB infection to active TB disease.

Another major modifiable risk factor for TB is use of solid fuel for cooking - and - it is the women who are most exposed to solid fuel emissions. Ninety per cent rural population and thirty one per cent urban population use solid fuels in India. Reducing smoking and solid-fuel use can substantially lower not only TB risk but also the risk of developing chronic obstructive pulmonary disease (COPD) and lung cancer. (CNS)

Bobby Ramakant - is CNS Policy Adviser and writes extensively on health and development