Certain infectious diseases prevalent in low- and middle-income countries affect men in greater numbers than women. Such is the case with tuberculosis (TB), a public health concern in West Africa where incidence among men averages two to three times higher than among women. \u201cThe field of sex-based biology is rapidly expanding with strong evidence showing that men and women respond differently to microbial challenges, therapeutics and vaccines,\u201d observed Dr. Djeneba Dabitao of the University of Sciences, Techniques and Technologies of Bamako. Dabitao\u2019s Global Emerging Leader Award from Fogarty is enabling her to examine the sex differences of TB in Mali.<\/p>\n\n\n\n
Dabitao hypothesizes that sex hormones influence immune responses to TB. \u201cWhen you look at immune cells, most, if not all, have a receptor for hormones and we think that there is crosstalk between hormonal responses and immune responses.\u201d Sex hormones can play a protective role in some contexts yet a pathogenic role in certain diseases. \u201cTeasing out those different effects will provide new strategies to develop sex-specific therapies to treat or prevent infectious diseases. This means that doses of vaccines and drugs could become sex-specific in the near future,\u201d said Dabitao.<\/p>\n\n\n\n
In Mali, the rate of TB is 52 per 100,000 people, according to the WHO. Dabitao and her team have screened more than 300 people for TB and have enrolled 120 in the study. More than half have completed the protocol, which consists of a baseline visit, a check at two months after beginning treatment and a final examination at six months corresponding to the end of TB treatment. Dabitao also think that hormonal responses may not be the only explanation of the observed male bias in TB. \u201cThere could be a genetic component, too. Some immune genes located on the sex chromosomes have been involved in the pathogenesis of TB and we do not know whether they could be influencing disease outcomes in a sex-specific manner,\u201d said Dabitao. She believes her study is proof of concept that can be used to examine pathogenesis of other major infectious diseases, such as HIV and COVID-19.<\/p>\n\n\n\n
Across the globe in Vietnam, gender is a huge determining factor for tobacco consumption, behavior that poses health risks. About half of men in the country smoke, compared with only 2% of women. In the Red River Delta region, Dr. Rajani Sadasivam of the University of Massachusetts has conducted a randomized control trial of an mHealth intervention that provided smokers with counseling, Quitline phone support and nicotine replacement therapy (NRT). Imbalanced smoking rates rendered men\u2019s participation essential to this research funded through Fogarty\u2019s tobacco research program, with additional support from the NIH\u2019s Office of the Director and the National Cancer Institute.<\/p>\n\n\n\n
Enlisting men to participate in the study was easy, said Jessica Wijesundara, project director. \u201cThere was a lot of interest being able to access NRT.\u201d Co-investigator Dr. Hoa Nguyen said volunteers believe their participation helps themselves and their community. Recruitment efforts relied on trusted community health workers. \u201cThey are also helpful in terms of follow-up, which reached 99%,\u201d she said.<\/p>\n\n\n\n
The intervention included six months of text messaging. \u201cTexting is attractive to us because it’s low tech and most people can access it,\u201d explained Sadasivam. Messages are written by both experts and peers. \u201cPeers talk about their own experiences and are direct: \u2018You will die from this.\u2019 \u2018You will get seriously ill.\u2019 Experts cannot say things that way.\u201d<\/p>\n\n\n\n
To build capacity, the team developed a program for the Vietnamese Quitline counselors that included training with their U.S. counterparts. \u201cWe were lucky that Vietnam did a great job managing COVID-19 in their alpha period. Thus, we only had to pause for brief periods before we could resume our data collection.\u201d said Sadasivam. Having completed data collection and qualitative interviews, the team is working on analysis and preparing results for publication. They\u2019ve also begun another Vietnamese mHealth intervention for people living with HIV who smoke. \u201cWe will try to address not only smoking-cessation but also stigma related to HIV,\u201d said Nguyen.<\/p>\n\n\n\n
https:\/\/www.fic.nih.gov\/News\/GlobalHealthMatters\/january-february-2022\/Pages\/sex-behavior-differences-impact-mens-health.aspx<\/p>\n","protected":false},"excerpt":{"rendered":"
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