Incomplete sputum smear microscopy monitoring among smear-positive tuberculosis patients in Uganda
OBJECTIVES: To determine the frequency of, factors associated with and barriers related to incomplete anti-tuberculosis treatment sputum monitoring.
DESIGN: Data were abstracted from anti-tuberculosis treatment and laboratory registers of sputum smear-positive patients who started treatment between January 2009 and December 2011 in the study districts. Patients missing documentation for any smear results at 2 or 3, 5, and 6 or 8 months were classified as having incomplete monitoring. Health providers and patients were interviewed about barriers to sputum monitoring.
RESULTS: Overall, 272 (55%) of 492 patients had incomplete monitoring: 16% (78/492) at 2 or 3 months, 39% (181/465) at 5 months and 28% (119/428) at 6 or 8 months of treatment. More sputum results were recorded in laboratory than in TB treatment registers. Incomplete monitoring was significantly associated with being male, living in Kyankwanzi District and not receiving directly observed treatment. Patients' inability to produce sputum, long laboratory waiting times, and insufficient patient and provider education were primary reasons for incomplete monitoring.
CONCLUSION: Over half of patients missed at least one smear result during treatment, which has implications for treatment monitoring and treatment outcomes in Uganda.
Keywords: Uganda; monitoring; sputum smear; tuberculosis
Document Type: Research Article
Affiliations: 1: Kyankwanzi District, Uganda National TB and Leprosy Programme, Butemba Town, Uganda 2: US Centers for Disease Control and Prevention (CDC), Entebbe, Uganda 3: Division of Pulmonary Medicine, Department of Medicine, Makerere College of Health Sciences, Kampala, Uganda 4: CDC, Atlanta, Georgia, USA
Publication date: 01 May 2016
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