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Gendered Pathways in TB Diagnosis: Insights from a School-Based Screening Initiative in Kakamega County, Kenya
Subject area: Arts, Social Sciences and Humanities · Area of research: Community Health and Development
DOI: https://doi.org/10.64388/IREV9I4-1711412-6021
Abstract
Background: Tuberculosis (TB) remains a major public health challenge in Kenya, with persistent gender disparities in diagnosis and treatment access. This study examines gendered pathways in TB detection through a school-based, child-led screening initiative in Kakamega County, highlighting how social norms, barriers, and health-seeking behaviors influence outcomes. This study is informed by feminist theory, with a focus on intersectional feminism, and guided by the Social Determinants of Health framework. It examines how overlapping social identities and structural conditions influence unequal access to tuberculosis diagnosis. Methods: A retrospective cross-sectional analysis was conducted on data from the Kenya Innovation Challenge TB project (2019?2024), involving 56,664 screened adults (28,394 males, 28,270 females). Descriptive statistics, Chi-square tests, and odds ratios were used to assess gender differences in TB diagnosis and treatment initiation. Results: Men accounted for 61.6% of 700 confirmed TB cases, with a significantly higher yield (1.52%) than women (0.95%; ?? = 36.21, p < 0.001; OR = 1.62, 95% CI: 1.38?1.90). Treatment initiation was equitable (>99% for both sexes). Conclusion: Despite balanced screening, women appear underdiagnosed, likely due to stigma, caregiving roles, and diagnostic biases. Gender-responsive strategies are essential for equitable TB control. This study underscores the value of integrating gender analysis into community-based interventions to address hidden inequalities.
Keywords
Tuberculosis, Gender disparities, School-based screening, Child-led intervention, Diagnostic yield, Treatment initiation
How to cite this paper
@article{1711412,
author = {Francis O. Barasa, PhD},
title = {Gendered Pathways in TB Diagnosis: Insights from a School-Based Screening Initiative in Kakamega County, Kenya},
journal = {Iconic Research And Engineering Journals},
year = {2025},
volume = {9},
number = {4},
pages = {911-921},
issn = {2456-8880},
url = {https://www.irejournals.com/formatedpaper/1711412.pdf},
abstract = {Background: Tuberculosis (TB) remains a major public health challenge in Kenya, with persistent gender disparities in diagnosis and treatment access. This study examines gendered pathways in TB detection through a school-based, child-led screening initiative in Kakamega County, highlighting how social norms, barriers, and health-seeking behaviors influence outcomes. This study is informed by feminist theory, with a focus on intersectional feminism, and guided by the Social Determinants of Health framework. It examines how overlapping social identities and structural conditions influence unequal access to tuberculosis diagnosis.
Methods: A retrospective cross-sectional analysis was conducted on data from the Kenya Innovation Challenge TB project (2019?2024), involving 56,664 screened adults (28,394 males, 28,270 females). Descriptive statistics, Chi-square tests, and odds ratios were used to assess gender differences in TB diagnosis and treatment initiation.
Results: Men accounted for 61.6% of 700 confirmed TB cases, with a significantly higher yield (1.52%) than women (0.95%; ?? = 36.21, p < 0.001; OR = 1.62, 95% CI: 1.38?1.90). Treatment initiation was equitable (>99% for both sexes).
Conclusion: Despite balanced screening, women appear underdiagnosed, likely due to stigma, caregiving roles, and diagnostic biases. Gender-responsive strategies are essential for equitable TB control. This study underscores the value of integrating gender analysis into community-based interventions to address hidden inequalities.},
keywords = {Tuberculosis, Gender disparities, School-based screening, Child-led intervention, Diagnostic yield, Treatment initiation},
month = {October},
doi = {https://doi.org/10.64388/IREV9I4-1711412-6021}
}