Excess-tuberculosis-mortality in young women: high accuracy exploration

TL;DR

This paper identifies a consistent anomaly where young women have higher tuberculosis mortality rates than men across multiple countries and time periods, suggesting potential issues with data accuracy and record reliability.

Contribution

It uncovers a universal pattern of higher TB mortality in young women, providing a new method to assess the reliability of mortality data across countries.

Findings

Young women aged 5-25 have twice the TB mortality rates of men in multiple countries.

The anomaly persists despite reductions in overall TB deaths over time.

The pattern can be used to detect under-reporting in mortality records.

Abstract

In a general way at all ages and for almost all diseases, male death rates are higher than female death rates. Here we report a case in which the opposite holds, namely for tuberculosis (TB) mortality between the ages of 5 and 25, female death rates are about two times higher than male rates. What makes this observation of interest is that it occurs in all countries for which data are available (e.g. Britain, Switzerland and United States), and in all years from the end of the 19th century up to the time in the 1960s when TB became a very rare disease in all developed countries. The fact that this regularity holds despite a drastic reduction in the number of deaths is also noteworthy. What is the practical usefulness of this investigation? So far, the reason of this anomaly remains an open question but the effect is so accurate that it can be used for probing the reliability and accuracy of mortality records. This will be explained in the case of developing countries. For instance, it turns out that in South African TB death data as published (and revised) by the "World Health Organization", female deaths were certainly under-estimated by a factor of two.