Tuberculosis in Uganda: A Growing Concern

Tuberculosis Challenges in Uganda
PHOTO - HIV.GOV Tuberculosis Challenges in Uganda
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In Uganda, Tuberculosis (TB) is a significant health issue. Every day, around 240 people in the country contract TB, and approximately 30 individuals lose their lives due to this infectious disease. Alarmingly, over half of TB-related deaths occur among people living with HIV, even though TB is preventable and treatable.

Uganda is among the countries heavily burdened by TB, with an annual infection rate of approximately 91,000 people, including 15 percent who are children under 14 years old. Moreover, two out of every 100 TB patients in Uganda have drug-resistant TB, making them resistant to first-line drugs.

The COVID-19 pandemic posed an additional challenge to Uganda’s TB control efforts, leading to a 32 percent increase in TB cases in the country, as reported by Dr. Stavia Turyahabwe, the assistant commissioner for health services in Tuberculosis and Leprosy Control at the Ministry of Health.

According to Uganda’s Ministry of Health, more than 30 percent of Ugandans, which accounts for 12 million people, have latent (inactive) TB. This means they carry the TB bacteria without showing symptoms but can transmit it to others. This figure exceeds the global estimate set by the World Health Organization, which suggests that a quarter of a country’s population, roughly 10 million people in Uganda’s case, should have latent TB.

Even though latent TB doesn’t display symptoms, Dr. Turyahabwe emphasizes that it can spread through the air when an infected person coughs, speaks, laughs, sings, or sneezes, and it can become active if the person’s immune system weakens or if they contract an infection.

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To achieve the goal of ending TB in Uganda by 2030, the Ministry of Health has adopted a preventive treatment strategy for those with latent TB. This approach prioritizes vulnerable populations, including people living with HIV, children, adults living with TB patients, individuals in prison, and healthcare workers.

Rahma Nakazibwe, a nurse at the TB clinic at Kayunga Regional Referral Hospital, explains that TB preventive treatment is typically combined with antiretroviral therapy, reducing the risk of TB disease. This treatment is administered for three months for those living with HIV and six months for those who are not HIV-positive. It also provides protection for high-risk populations for two years.

Despite the longstanding existence of TB, limited awareness persists, leading to misconceptions about the disease, according to Joseph Ggita, a population scientist at the World Alliance for Lung and Intensive Care Medicine in Uganda. Many erroneously believe that TB only affects people with HIV, resulting in stigma and reluctance to seek treatment.

Moreover, some patients face challenges due to drug shortages for treating side effects, leading them to seek additional funds to purchase necessary medicines. Additionally, a 2018 study by Uganda’s Ministry of Health found that 53 percent of TB patients spent about 20 percent of their annual income on accessing TB services, largely due to the distance to healthcare centers.

To improve TB care accessibility and reduce costs, healthcare experts recommend decentralizing TB services and providing support through village health teams, health center IIs, clinics, and nearby pharmacies. This approach would make TB care more convenient for patients and potentially increase treatment adherence.

Ggita emphasizes the need for transforming the way TB services are accessed and delivered, including addressing overcrowded facilities that compromise patient privacy and confidentiality. He also advocates for comprehensive counseling and psychosocial support for TB patients throughout their six-month treatment period.

Uganda’s Minister of Health, Dr. Jane Ruth Aceng, called for increased awareness and domestic funding to combat TB. She stressed the importance of strengthening private not-for-profit facilities and community engagement, possibly by integrating TB programs with other healthcare initiatives like immunization.

In 2022, Uganda’s Ministry of Health conducted a door to door campaign to provide TB services, identifying 94,000 cases, surpassing the World Health Organization’s estimated number. Dr. Stavia Turyahabwe underlines the need to improve community strategies, surveillance, and contact tracing to better reach affected individuals and raise awareness about TB in Uganda.

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