The burden of drug resistant tuberculosis in a predominantly nomadic population in Uganda: a mixed methods study

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dc.contributor.authorNakafeero Simbwa, Brenda
dc.contributor.authorKatamba, Achilles
dc.contributor.authorKatana, Elizabeth B.
dc.contributor.authorLaker, Eva A. O.
dc.contributor.authorNabatanzi, Sandra
dc.contributor.authorSendaula, Emmanuel
dc.contributor.authorOpio, Denis
dc.contributor.authorIctho, Jerry
dc.contributor.authorLochoro, Peter
dc.contributor.authorKaramagi, Charles A.
dc.contributor.authorKalyango, Joan N.
dc.contributor.authorWorodria, William
dc.date.accessioned2022-02-03T20:30:22Z
dc.date.available2022-02-03T20:30:22Z
dc.date.issued2021
dc.description.abstractEmergence of drug resistant tuberculosis (DR-TB) has aggravated the tuberculosis (TB) public health burden worldwide and especially in low income settings. We present findings from a predominantly nomadic population in Karamoja, Uganda with a high-TB burden (3500 new cases annually) and sought to determine the prevalence, patterns, factors associated with DR-TB. Methods: We used mixed methods of data collection. We enrolled 6890 participants who were treated for tuberculosis in a programmatic setting between January 2015 and April 2018. A cross sectional study and a matched case control study with conditional logistic regression and robust standard errors respectively were used to the determine prevalence and factors associated with DR-TB. The qualitative methods included focus group discussions, in-depth interviews and key informant interviews. Results: The overall prevalence of DR-TB was 41/6890 (0.6%) with 4/64,197 (0.1%) among the new and 37/2693 (1.4%) among the previously treated TB patients respectively. The drug resistance patterns observed in the region were mainly rifampicin mono resistant (68.3%) and Multi Drug-Resistant Tuberculosis (31.7%). Factors independently associated with DR-TB were previous TB treatment, adjusted odds ratio (aOR) 13.070 (95%CI 1.552–110.135) and drug stock-outs aOR 0.027 (95%CI 0.002–0.364). The nomadic lifestyle, substance use, congested homesteads and poor health worker attitudes were a great challenge to effective treatment of TB. Conclusion: Despite having the highest national TB incidence, Karamoja still has a low DR-TB prevalence. Previous TB treatment and drug stock outs were associated with DR-TB. Regular supply of anti TB medications and health education may help to stem the burden of TB disease in this nomadic population.en_US
dc.identifier.citationSimbwa, B. N., Katamba, A., Katana, E. B., Laker, E. A., Nabatanzi, S., Sendaula, E., ... & Worodria, W. (2021). The burden of drug resistant tuberculosis in a predominantly nomadic population in Uganda: a mixed methods study. BMC Infectious Diseases, 21(1), 1-11. https://doi.org/10.1186/s12879-021-06675-7en_US
dc.identifier.urihttps://doi.org/10.1186/s12879-021-06675-7
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/1859
dc.language.isoenen_US
dc.publisherBMC Infectious Diseasesen_US
dc.subjectDrug resistant Tuberculosisen_US
dc.subjectNomadicen_US
dc.subjectUgandaen_US
dc.subjectKaramojaen_US
dc.subjectGene-Xperten_US
dc.subjectLow prevalenceen_US
dc.subjectAlcoholen_US
dc.subjectDrug stock outen_US
dc.subjectStigmaen_US
dc.titleThe burden of drug resistant tuberculosis in a predominantly nomadic population in Uganda: a mixed methods studyen_US
dc.typeArticleen_US
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