The Challenge of Re-Treatment Pulmonary Tuberculosis at two Teaching and Referral Hospitals in Uganda

ABSTRACT

Background With an annual tuberculosis (TB) incidence of about 350 cases per 100;000 of the population; Uganda is a high burden country. Moreover; it is evident that some TB patients have been treated for a previous episode of the disease. Objective To highlight the burden of re-treatment pulmonary TB and examine patient factors associated with re-treatment among adults at two teaching and referral hospitals; Mbarara and Mulago Methods A descriptive cross sectional study with data collection between September 2004 and March 2005; we calculated the prevalence and used logistic regression to explore factors associated with re-treatment. Results The prevalence of re-treatment pulmo-naryTB at Mbarara based on medical records was 30.0(95CI 21.2 to 40.0); and 21.3(95CI 12.9 to 31.8) from exit interviews.The corresponding estimates at Mulago hospital were 12.0(95CI 6.4 to 20.0) and 43.9(33.0 to 55.3). Compared to the 18-26 year age category; the prevalence odds ratio (POR) for a seven-year increase in age was 1.54 (95CI 1.04-2.28; p = 0.027); while female patients were 0.39 (95CI 0.17-0.90; p = 0.025) times less likely to report re-treatment disease than males; in this facility-based study. Conclusions Re-treatment pulmonary TB is frequent at the two teaching and referral hospitals.A contribution to re-treatment prevention should entail more rigorous management of new TB cases; particularly at lower levels of care