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Prevalence of Tuberculosis Risk Factors among Bacteriologically Negative and Bacteriologically Confirmed Tuberculosis Patients from Five Regional Referral Hospitals in Uganda

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  • 1 Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda;
  • | 2 Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda;
  • | 3 School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda

Understanding risk factors for tuberculosis (TB) and their prevalence helps guide early diagnosis. We determined their prevalence among bacteriologically negative and bacteriologically confirmed TB patients in five regional referral hospitals in Uganda. This cross-sectional study considered 1,862 adult presumptive TB participants. We performed fluorescent microscopy, Xpert MTB/RIF (Xpert), Lowenstein–Jensen culture, human immunodeficiency virus, and random blood sugar testing on recruited patients. Prevalence and prevalence ratios of risk factors were compared among bacteriologically negative and confirmed cases. Odds ratios and 95% confidence interval (CI) were determined for significant risk factors in bacteriologically confirmed patients. Of the 1,862 participants, 978 (55%) were male and the median age of the participants was 36 years (interquartile range: 27–48). Up to 273 (15%) had a positive result on all three TB tests. Most prevalent risk factors (prevalence ratio [PR] > 1.0) among bacteriologically negative and positive TB patients were cigarette smoking (9.3% versus 2.1%; PR = 2.1), biosmoke (24% versus 39.7%; PR = 1.7), contact (4.2% versus 6.5%; PR = 1.6), male gender (51.4% versus 72.5%; PR = 1.4), alcohol use (17.2% versus 24.4%; PR = 1.4), diabetes (0.7% versus 0.9%; PR = 1.3), and family history of TB (12.1% versus 13.7%; PR = 1.1). The risk factors and their adjusted prevalence rate ratios (95% CI) of being bacteriologically positive were male (1.8 [1.4–2.4]), biosmoke exposure (1.5 [1.2–2.0]), and history of cigarette smoking (1.6 [1.1–2.4]). Among bacteriologically confirmed patients in Uganda, cigarette smoking, biosmoke exposure, contact, male gender, alcohol use, diabetes, and family history of TB are important risk factors for TB. Interventions for TB control in people with these risk factors would help in TB control efforts.

Author Notes

Address correspondence to Winters Muttamba, Makerere University Lung Institute, College of Health Sciences, Makerere University, P.O. Box 7749, Kampala, Uganda. E-mail: muttamba@gmail.com

Financial support: This study was conducted with funding from the World Bank under the East African Public Health Laboratory Networking Project (EAPHLNP).

Authors’ addresses: Winters Muttamba, Bruce Kirenga, and Rogers Sekibira, Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda, E-mails: muttamba@gmail.com, brucekirenga@yahoo.co.uk, and sekibira@gmail.com. Willy Ssengooba and Moses L. Joloba, Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda, E-mails: willyssengooba@gmail.com and m.joloba@gmail.com. Achilles Katamba, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda, E-mail: akatamba@yahoo.com.

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