A comparative analysis of two national tuberculosis reporting systems and their impact on tuberculosis case notification in Uganda.

Background: Before 2018, the use of parallel tuberculosis (TB) reporting systems was resource intensive with duplication of efforts and hence the need to select one that contributed to better TB case notification at the National TB and Leprosy Program (NLTP) in Uganda. We sought to analyse the difference in reporting rates between the two systems in order to improve NTLP TB case notification rates, logistics management, and planning for better health service delivery initiatives. Methods: We conducted a comparative study to assess TB case notification between the web-based DHIS2 and the district TB supervisor-led health management information system between January 2016 to December 2017. We used Poisson regression analysis to assess the statistical differences in reporting rates between the two reporting systems. Results: The association between TB case notification and the type of reporting system was statistically significant (Prob > chi2 = 0.0000). The Incident Rate Ratio (IRR) for the web-enabled DHIS2 system versus the district TB supervisor-led health management information system was 1.106625. Conclusion: The web-based integrated DHIS2 system was more effective in reporting missing TB cases. It presents an opportunity for better planning and allocation of resources for improved service delivery in a low-income setting.

A comparative analysis of two national tuberculosis reporting systems and their impact on tuberculosis case notification in Uganda

Background: Before 2018, the use of parallel tuberculosis (TB) reporting systems was resource intensive with duplication of efforts and hence the need to select one that contributed to better TB case notification at the National TB and Leprosy Program (NLTP) in Uganda. We sought to analyse the difference in reporting rates between the two systems in order to improve NTLP TB case notification rates, logistics management, and planning for better health service delivery initiatives. Methods: We conducted a comparative study to assess TB case notification between the web-based DHIS2 and the district TB supervisor-led health management information system between January 2016 to December 2017. We used Poisson regression analysis to assess the statistical differences in reporting rates between the two reporting systems. Results: The association between TB case notification and the type of reporting system was statistically significant (Prob > chi2 = 0.0000). The Incident Rate Ratio (IRR) for the web-enabled DHIS2 system versus the district TB supervisor-led health management information system was 1.106625. Conclusion: The web-based integrated DHIS2 system was more effective in reporting missing TB cases. It presents an opportunity for better planning and allocation of resources for improved service delivery in a low-income setting.

Roll-out of medical male circumcision (MMC) for HIV prevention in non-circumcising communities of Northern Uganda.

INTRODUCTION: Recent studies have shown that circumcision reduces HIV/AIDS infection rates by 60% among heterosexual African men. Public health officials are arguing that circumcision of men should be a key weapon in the fight of HIV/AIDS in Africa. Experts estimate that more than 3 million lives could be saved in sub-Saharan Africa alone if the procedure becomes widely used. Some communities in Uganda have misconceptions to MMC and resist the practice. METHODS: To roll out MMC to a non-circumcising population of Northern Uganda from June 2011 as a strategy to increase access and prevent the spread of HIV/AIDS. RESULTS: Circumcision in a non-circumcising communities of Lango and Acholi sub-regions with a population of about 0.5 million mature males 15-49 years. Enrolment was voluntary, clinical officers, nurses carried out MMC after training in the surgical procedure. Mass sensitization and mobilization was conducted through radios, community leaderships and spouses. Cervical cancer screening was incorporated at circumcision sites and used as incentive for the women. Circumcisions were conducted at static sites, camps and outreach services where VCT and adverse events (AEs) were recorded and managed. All clients assented/or consented. CONCLUSION: A total of 26, 150 males were circumcised in eight months. The AEs rate was 1.2% and was mild. 2,650 women were screened for cervical cancer and positive test rate was 1.7%. Mobilization and sensitization were by radios and spouses' involvement in cervical cancer screening exercise.