19 March 2019

Uganda: TB Infections Hit 90,000 a Year, Overtake HIV Rates

Photo: Daily Monitor
Inmates at Pece Prisons in Uganda's Gulu District (file photo).

Kampala — A new national survey shows that 89,000 Ugandans get infected with tuberculosis (TB) every year, surpassing the 50,000 who contract HIV annually.

Health experts say the situation could get worse unless action is taken to check the prevalence.

The 2014-2016 population-based tuberculosis prevalence survey indicates that at least 46 per cent of the infections are missed cases (not enrolled on treatment) who infect up to between 10 and 15 new people per year.

The report by University Research Council-USAID Defeat TB Project reveals that most TB prevalence is in urban areas due to their high population densities.

Wakiso, Kampala and Mukono districts (the metropolitan area) are among the urban centres with the highest TB infection rates.

In 2018, out of 11,212 people screened, 352 were diagnosed with TB representing 3 per cent. Wakiso had 5,108 people screened with 301 testing positive to TB, representing 6 per cent while Mukono had 958 people tested with 62 (6 per cent) confirmed TB positive. All the above were done through TB contact investigations screening.

Under the targeted community screening, 14,605 people were tested in Kampala with 277 were found infected with TB.

The research team screened 11,330 people in Wakiso with 566 testing positive to TB while in Mukono 16,568 were screened and 117 tested positive. The total population tested during the survey was 59,781 and 1,675 tested positive to tuberculosis.

The areas that presented the biggest TB infection rates are male congregated areas with 8.9 percent testing positive, followed by barracks at 5.6 per cent.

The survey cited hotspots for TB infections as taxi parks, slums, worship places, nightspots, workplaces and a number of other facilities that host large populations.

Dr Kaniel Okello, the Kampala Capital City Authority Director for Public Health, said the situation in the Kampala metropolitan area, poses a huge health risk of TB. He said a random test at New Taxi Park registered 22 people who tested positive.

"Imagine a scenario where each of those 22 actually got into a different taxi and each of them coughed. You are potentially going to have another twenty two cases who are going home [infected]. Because again four out of 10 don't know that they have TB, they will again cough in their homes and you have that multiplier effect," Dr Okello said.

Dr Abel Nkolo, chief of party for USAID Defeat TB in Uganda Project, said while the disease is curable, many people are reluctant to seek treatment and where they do, many don't complete the dosage.

He said Uganda is one of the few countries in the world with high TB disease burden and more must be done to combat the prevalence.

"In the last few years, the WHO reported that tuberculosis infection rates rival HIV-AIDS infections as a leading cause of deaths.

Several people with TB do not know that they have the disease. Uganda is one of the 30 high TB-HIV burden countries in the world with TB prevalence which is 1.5 times higher than the previously estimated by WHO," Dr Nkolo said.

He said TB is posing a huge problem because patients do not adhere to the treatment schedule.

"About 10 percent of patients with drug sensitive TB die every year and about 15 percent abandon treatment and remain in the community. About 80,000 people in Uganda develop tuberculosis every year but about 4 percent remain undetected.

They stay in the community and continue to spread the disease. Every untreated TB patient can spread disease to about 15 others every year. The good news is that TB is curable and treatment is freely available at all TB treatment facilities in the country. To identify and minimize TB infection among all people, there is an urgent need for individual and collective responsibility and the time is now," Dr Nkolo warned.

He said in September 2018 when they did TB screening outreach in the New Tax Park in Kampala they found 22 patients with TB out of the 366 people who were screened.

"This for TB is a very high number in one location given that it is a highly infectious disease. These findings highlight how close TB is to each one of us and the call for personal and community vigilance," he said.

Dr Kenneth Mutesasira, the senior technical advisor for the USAID Defeat TB Project, said community sensitization must be done and more people be advised to seek medical attention early.

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