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of SEPAR between 2017 and 2022 were included in a cross-central multicenter study&#46; The <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> test was used to analyze the gender differences&#44; considering that they were statistically significant if <span class="elsevierStyleItalic">p</span>-value &#60;0&#44;05&#46; A binary logistic regression was used and odds ratios &#40;OR&#41; and 95&#37; confidence intervals &#40;CI&#41; were computed&#46; The temporal trend of the variable was obtained using the <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> linear trend test&#46; IBM SPSS Statistics 22 statistical software was used to conduct the analysis&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The processing of personal data was in accordance with Spanish Organic Law 3&#47;2018&#44; of 5 December&#44; on the Protection of Personal Data and the Guarantee of Digital Rights and the European Data Privacy Directive&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">A sample of 1769 cases included in the registration between 2017 and 2020 was studied&#44; 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although the linear trend shows that it is decreasing in women &#40;<span class="elsevierStyleItalic">y</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1330<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>0&#46;66<span class="elsevierStyleItalic">x</span>&#41; while being positive in men &#40;<span class="elsevierStyleItalic">y</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>118<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>0&#46;06<span class="elsevierStyleItalic">x</span>&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">There have not been many studies on the relationship between gender and tuberculosis in Spain&#59; nonetheless&#44; certain data from national and autonomous TB control projects are accessible<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">4&#8211;6</span></a> showing numbers between 39&#46;6&#37; and 40&#37; of women and between 60&#37; and 60&#46;4&#37; of men between 2015 and 2017&#46; However&#44; they do not study the factors to which they may be related&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The SEPAR PII-TB&#38;MNT evaluation&#44; conducted between 2006 and 2016&#44; showed that the population studied had a significant declining trend in the number of cases in women&#46; The percentage of cases among women in the last two years of the evaluation &#40;2015&#8211;2016&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">7</span></a> was also lower than the figure reported in the World Health Organization&#39;s Global Tuberculosis Report 2019 &#40;30&#46;8&#37; and 25&#46;4&#37; vs 32&#37;&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">8</span></a> and the figures in our current study are also lower than those in the World Health Organization&#39;s Global Tuberculosis Report 2023 &#40;31&#37; vs 33&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">9</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">A constraint of this research is that&#44; apart from the variables examined here&#44; we also need to consider other studies that have identified additional characteristics related to gender&#46; One of them at University College London<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a> compared a short 4-month treatment to the 6-month standard and found gender differences in treatment outcomes without any objective biological causes&#46; Others conclude that there is an urgent need for a greater understanding of gender-related barriers&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">11</span></a> Another study found evidence that&#44; in low- and middle-income countries&#44; men are more at risk and have less access to screening and diagnostic services&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">12</span></a> Some speculate that the development of tuberculosis may include a variety of physiopathological processes<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">13</span></a> and according to some authors&#44; biological factors&#44; such as sex hormones and genetic factors&#44; could contribute to the host&#39;s immunity during tuberculosis&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">14</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Despite the decline in the inclusion of cases during the Covid pandemic<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">15</span></a> &#40;overload of medical services&#44; possible reduction of cases due to the wearing of facemasks&#44; decreased contact in public places or delayed diagnosis&#41; and weakened TB control systems&#44;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">16&#44;17</span></a> it can be concluded that there are significant gender differences in the incidence&#44; age&#44; living situation&#44; tobacco and alcohol consumption and the localization of tuberculosis patients and that the trend in the number of cases in women continues to decrease&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical Approval</span><p id="par0055" class="elsevierStylePara elsevierViewall">The Biomedical Research Ethics Committees of the different participating centres approved this study&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors&#8217; Contributions</span><p id="par0060" class="elsevierStylePara elsevierViewall">Teresa Rodrigo&#58; conception and design of the study&#59; acquisition&#44; analysis and interpretation of data&#44; and writing of the article&#46;</p><p id="par9065" class="elsevierStylePara elsevierViewall">Eva M&#46; Tabernero&#44; Luis Anibarro&#44; Jos&#233; A&#46; Gull&#243;n&#44; Juan F Medina&#44; Joan P&#46; Millet&#44; Marta M&#46; Garc&#237;a-Clemente&#44; Joan A Cayl&#224;&#44; Jos&#233; M&#46; Garc&#237;a-Garc&#237;a&#58; critical review of the intellectual content&#44; final approval of the version presented&#46;</p><p id="par8065" class="elsevierStylePara elsevierViewall">Antonia S&#225;ez&#58; methodology design and statistical analysis of data&#46; Working Group of the Integrated Tuberculosis and NMT Research Program &#40;PII-TB &#38; NMT&#41;&#58; collection and contribution of data&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Funding</span><p id="par0065" class="elsevierStylePara elsevierViewall">Grant from the <span class="elsevierStyleGrantSponsor" id="gs1">Spanish Society of Pulmonology and Thoracic Surgery</span> &#40;<span class="elsevierStyleGrantNumber" refid="gs1">880&#47;2019</span>&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conflicts of Interest</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest&#46;</p></span></span>"
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            "apendice" => "<p id="par0075" class="elsevierStylePara elsevierViewall">Abigail Mac&#237;as Paredes &#40;Hospital Comarcal Sant Jaume de Calella&#41;&#59; Adri&#225;n S&#225;nchez Montalv&#225; &#40;Hospitales Vall d&#8217;Hebr&#243;n&#41;&#59; &#193;lvaro Cecilio Irazola &#40;Hospital Universitario Lozano Blesa&#41;&#59; &#193;ngel Dom&#237;nguez Castellanos &#40;Hospital Universitario Virgen Macarena&#41;&#59; Ant&#243;n Penas Truque &#40;Hospital Universitario Lucus Augusti&#41;&#59; Antoni Soriano Arandes &#40;Hospitales Vall d&#8217;Hebr&#243;n&#41;&#59; Bel&#233;n M&#170; Navas Bueno&#40;Hospital General B&#225;sico Santa Ana&#41;&#59; Dunibel Morillo &#40;Hospital Ernest Lluch&#59; Mart&#237;n Elvira P&#233;rez Escolano &#40;Hospital del SAS de Jerez&#41;&#59; Estefan&#237;a S&#225;nchez Mart&#237;nez &#40;Parc Sanitari Sant Joan de Deu de Sant Boi&#41;&#59; Francisco Sanz Herrero &#40;Hospital General Universitario de Valencia&#41;&#59; Guillermo J P&#233;rez &#40;Hospital Universitario de Gran Canaria &#8220;Dr&#46; Negr&#237;n&#8221;&#41;&#44; Igor Iturbe Susilla &#40;Hospital Universitario de Basurto&#41;&#59; Isabel L&#243;pez Aranaga &#40;Hospital Universitario de Basurto&#41;&#59; Isabel Santamar&#237;a Mas &#40;Hospital de Txagorritxu&#41;&#59; Isabel Su&#225;rez Toste &#40;Hospital Universitario de Canarias&#41;&#59; Israel Molina Pinagorte &#40;Serveis Clinics de Barcelona&#41;&#59; Javier Garros Garay &#40;Hospital Santa Marina&#41;&#59; Jonathan C&#225;mara Fern&#225;ndez &#40;Parc Sanitari Sant Joan de Deu&#41;&#59; Jos&#233; Antonio Caminero Luna &#40;Hospital Universitario de Gran Canaria &#8220;Dr&#46; Negr&#237;n&#8221;&#41;&#59; Jos&#233; David Cardoso Landivar &#40;Hospital Universitario Vall d&#8217;Hebr&#243;n&#41;&#59; Jos&#233; Luis Vidal P&#233;rez &#40;Complejo Hospitalario La Paz-Cantoblanco-Carlos III&#41;&#59; Josefina Sabria Mestras &#40;Hospital de Sant Joan Desp&#237; Mois&#232;s Broggi&#41;&#59; Juan Diego &#193;lvarez Mav&#225;rez &#40;Hospital Carmen y Severo Ochoa&#41;&#59; Juan Rodr&#237;guez L&#243;pez &#40;Hospital San Agust&#237;n&#41;&#59; Lander Altube Urrengoetxea &#40;Hospital de Galdakao&#41;&#59; Lydia Luque Chac&#243;n &#40;Hospital de Sant Joan Desp&#237; Mois&#232;s Broggi&#41;&#59; M&#170; &#193;ngeles Jim&#233;nez Fuentes &#40;Unitat de Tuberculosi Vall d&#8217;Hebr&#243;n-Drassanes&#41;&#59; M&#170; Jes&#250;s Ruiz Serrano &#40;Hospital General Universitario Gregorio Mara&#241;&#243;n&#41;&#59; M&#170; Luisa de Souza Galvao &#40;Unitat de Tuberculosi Vall d&#8217;Hebr&#243;n-Drassanes&#41;&#59; Magnolia Nieto Marcos &#40;Hospital Dr Moliner&#41;&#59; Mar&#237;a Somoza Gonz&#225;lez &#40;Consorcio Sanitario de Tarrasa&#41;&#59; Marina Lumbierres Burgu&#233;s &#40;Serveis Clinics de L&#233;rida&#41;&#59; Miguel Sant&#237;n Cerezales &#40;Hospital Universitario de Bellvitge&#41;&#59; Miguel Zabaleta Murgiondo &#40;Hospital Universitario de Valdecilla&#41;&#59; Neus Altet G&#243;mez &#40;Serveis Clinics de Barcelona&#41;&#59; Pablo Fern&#225;ndez &#193;lvarez &#40;Hospital &#193;lvarez-Buylla&#41;&#59; Paloma Gij&#243;n Vidaurreta &#40;Hospital General Universitario Gregorio Mara&#241;&#243;n&#41;&#59; Roc&#237;o Mart&#237;nez Guti&#233;rrez &#40;Hospital San Agust&#237;n de Avil&#233;s&#41;&#59; Sarai Quir&#243;s Fern&#225;ndez &#40;Hospital de Basurto&#41;&#59; Silvia Dorronsoro Quintana &#40;Hospital de Zum&#225;rraga&#41;&#59; Vanesa Deya Vadel l &#40;Hospital Son Llatzer&#41;&#59; Virginia Pomar Solchaga &#40;Hospital Universitario de la Santa Creu y Sant Pau&#41;&#59; Xavier Casas Garc&#237;a &#40;Serveis Clinics de Barcelona&#41;&#59; Yoel Gonz&#225;lez D&#237;az &#40;Serveis Clinics de Barcelona&#41;&#46;</p>"
            "etiqueta" => "Appendix A"
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total<span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1769 &#40;100&#37;&#41;</th><th class="td" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">OR &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">910&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">51&#46;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">47&#46;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">329&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">59&#46;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Ref&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="11" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Drug use</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">6&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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Journal Information
Vol. 60. Issue 5.
Pages 312-315 (May 2024)
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Vol. 60. Issue 5.
Pages 312-315 (May 2024)
Scientific Letter
Analysis of the Evolution of Tuberculosis in Men and Women in Spain Between 2017 and 2022. Is There a Different Incidence Decline by Gender?
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597
Teresa Rodrigoa,b,c,
Corresponding author
pii_tb_teresa_rodrigo@separ.es

Corresponding author.
, Eva M.a Taberneroa,d, Luis Anibarroa,e, José A. Gullóna,f, Juan F. Medinaa,g, Joan P. Milleta,h, Marta M.a García-Clementea,i, Antonia Sáeza,j, Joan A. Caylàb, José M.a García-Garcíaa, Integrated Tuberculosis, Non-Tuberculous Mycobacteria Research Programme Working Group PII-TB MNT of SEPAR 1
a Programa Integrado de Investigación en Tuberculosis y Micobacterias no Tuberculosas (PII-TB&MNT) de SEPAR, Barcelona, Spain
b Unidad de Investigación en Tuberculosis de Barcelona (fUITB), Barcelona, Spain
c Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
d Hospital Universitario de Cruces, Bilbao, Spain
e Complejo Hospitalario de Pontevedra, Pontevedra, Spain
f Hospital San Agustín, Avilés, Spain
g Hospital Universitario Virgen del Rocío, Sevilla, Spain
h Serveis Clinics de Barcelona, Barcelona, Spain
i Hospital Central de Asturias, Oviedo, Spain
j Axioma Comunicaciones, Sevilla, Spain
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Table 1. Sociodemographic, Epidemiological, Clinical, Diagnostic and Treatment Characteristics and Risk Factors by Gender.

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