762. Sex Differences in the Epidemiology of Tuberculosis in Tunisia

BACKGROUND: According to WHO, many more men than women are diagnosed with tuberculosis (TB) and die from it globally. In light of this fact, examining the gender differences among patients with TB is important to institute effective prevention, coverage and treatment. We aim to study sex differences in the epidemiology and clinical specificities of TB. METHODS: We conducted a retrospective study of patients with TB, of all ages between January 1995 and December 2016. Data were collected from the regional register of tuberculosis implanted at the anti tuberculosis center ATC of Sfax, Southern Sfax. RESULTS: We recorded 2,771 new cases of TB. Sex ratio was 1.2. Pulmonary Tuberculosis (PT) represented 40.5% of all cases of TB (n = 1,121) and was 2.5 times more frequent in men than women (50.3% vs. 28.7%; P < 0.001). The sex ratio for extra-pulmonary tuberculosis (EPT) was 0.83. Lymph node and abdominal TB were significantly more frequent in women with respectively 52.5% (vs. 37.4%; P < 0.001) and 12.6% (vs. 9.1%; P = 0.025). Pleural and urogenital TB were significantly more common in men (20.3% vs. 8.9%; P < 0.001 and 13.4% vs. 9.8%; P = 0.023 respectively). We did not found any gender differences in other EPT forms. Between 1995 and 2016, overall TB (P = 0.001; rho = 0.64), EPT (P = 0.02; rho = 0.63) and PT (P = 0.03; rho = 0.46) cases were increasingly notified in women while they were stable in men. Death rates were significantly more important in men (3.5 vs. 2.1; P = 0.02). Women experienced recovery more frequently (89.2% vs. 86.7%; P = 0.04) and duration of treatment was significantly higher in women (9 months vs. 8 months; P < 0.001). CONCLUSION: Our study highlighted sex differences of TB in the region of Sfax with a higher burden and morbidity in men. National TB programs should actively focus in these results with more routine diagnostic and screening. DISCLOSURES: All authors: No reported disclosures.