Trends of notification rates and treatment outcomes of tuberculosis cases with and without HIV co-infection in eight rural districts of Uganda (2015 – 2019)

Abstract

Background The End TB Strategy aims to reduce new tuberculosis (TB) cases by 90% and TB-related deaths by 95% between 2015 – 2035. We determined the trend of case notification rates (CNRs) and treatment outcomes of TB cases with and without HIV co-infection in rural Uganda to provide an interim evaluation of progress towards this global target in rural settings. Methods We extracted retrospective programmatic data on notified TB cases and treatment outcomes from 2015 – 2019 for eight districts in rural Uganda from the District Health Information System 2. We estimated CNRs as the number of TB cases per 100,000 population. Treatment success rate (TSR) was calculated as the sum of TB cure and treatment completion for each year. Trends were estimated using the Mann–Kendall test. Results A total of 11,804 TB cases, of which 5,811 (49.2%) were HIV co-infected, were notified. The overall TB CNR increased by 3.7-fold from 37.7 to 141.3 cases per 100,000 population in 2015 and 2019 respectively. The increment was observed among people with HIV (from 204.7 to 730.2 per 100,000, p = 0.028) and HIV-uninfected individuals (from 19.9 to 78.7 per 100,000, p = 0.028). There was a decline in the TSR among HIV-negative TB cases from 82.1% in 2015 to 63.9% in 2019 (p = 0.086). Conversely, there was an increase in the TSR among HIV co-infected TB cases (from 69.9% to 81.9%, p = 0.807). Conclusion The CNR increased among people with and without HIV while the TSR reduced among HIV-negative TB cases. There is need to refocus programs to address barriers to treatment success among HIV-negative TB cases.

Burden of HIV and treatment outcomes among TB patients in rural Kenya: a 9-year longitudinal study.

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“…Dar es Salaam, Nakaseke, Kiboga, Siaya, Dire Dawa, and Addis Ababa cities/states were selected because they have highest TB rates and human immunode ciency virus (HIV) co-infection in the region [3,[13][14][15].…”

“…Interview transcripts were deidenti ed, pseudonyms were generated for each participant, and the data was uploaded into the NVivo 12 software (QSR International) for management and deductive thematic coding. A stepwise approach was used for the thematic analysis of the interview transcripts [15]. First, the research team examined the research questions and generated several themes based on consensus.…”

Analysis of Tuberculosis Trends and Treatment outcomes data in The Gambia reported in the DHIS2 from 2017 to 2021

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