Effect of community awareness, screening, diagnosis, and treatment campaigns on TB care in Uganda.

Abstract

Eight districts in central Uganda with 105 health facilities.To evaluate the effectiveness of the community awareness, screening, testing, diagnosis, and treatment (CAST-TB) campaigns on the number of people screened for, presumed to have, and diagnosed with TB disease.We designed a quasi-experimental study and utilised Bayesian Structural Time-Series analysis for counterfactual predictions over 24 months (12 months before vs 12 months during intervention). The intervention was the CAST-TB campaigns. The outcomes included the number of people screened for, presumed to have, and diagnosed with TB disease.The intervention led to a 36% (95% credible interval [CrI] 8.4-65, P = 0.005) increase in the number of people screened for TB disease (1,194,257 observed vs 875,211 predicted), a 29% (95% CrI 5.3-52, P = 0.01) increase in the number of people presumed to have TB disease (25,784 observed vs 19,997 predicted), and a 49% (95% CrI 25-75) increase in the number of people diagnosed with TB disease (2,566 observed vs 1,719 counterfactual).CAST-TB campaigns improved the number of people screened for, presumed to have, and diagnosed with TB disease in central Uganda, supporting scale-up efforts nationally and across sub-Saharan Africa where such indicators are suboptimal..