Treatment success and associated factors among Tuberculosis patients identified and linked to care using Mobile Chest X-Ray In East and Central Uganda.

Abstract

Introduction: Active case-finding (ACF) is an important component in fighting TB and is being piloted in several districts using mobile TB clinics equipped with Xray units. However, there is still limited information on treatment outcomes and the associated factors among persons identified and linked to care through this approach. Objectives: This study determined the treatment success rate and associated factors among TB cases screened and notified through an ongoing study doing ACF using mobile chest Xray in selected TB hotspot areas of East and central Uganda. Methods: This was a retrospective cohort study of 615 simple randomly selected TB patients identified and linked to care through ACF using mobile chest Xray between June 2022 and July 2023. This was done in 6 peri-urban TB hotspot districts namely; Iganga, Bugiri, Buikwe, Nakaseke, Sembabule, and Lwengo. Data was extracted from standard TB registers using a pretested data abstraction tool and analyzed using STATA 15 and factors associated assessed by modified Poisson regression at 95% confidence level. Results: The TB treatment success rate was 83.7% (95% CI: 80.6-86.5). Factors associated with treatment success were age groups; 25-44 years (aPR: 1.17, 95% CI: 1.05-1.31, p = 0.004), 45-64 years (aPR: 1.23, 95% CI: 1.08-1.40, p = 0.001), and above 64 years (aPR: 1.15, 95% CI: 1.00-1.32, p = 0.048), being identified through community-based screening (aPR: 1.09, 95% CI: 1.00-1.18), being HIV-negative (aPR: 1.12, 95% CI: 1.06-1.18), being under non-digital community Directly Observed Treatment (DOT) (aPR: 1.25, 95% CI: 1.19-1.31, p < 0.001), and having community volunteer support (aPR: 1.17, 95% CI: 1.12-1.21). Conclusion: Although the TB treatment success among patients linked through ACF is comparable to passive case finding (PCF), it is still lower than the national target of ≥ 90%. Efforts such as close follow-ups should be made among young and HIV positive patients to improve treatment success. Additionally, strengthening community-based screening, community DOTS and empowering family members to support TB patients could further improve treatment success.