Non-disclosure of tuberculosis diagnosis by patients to their household members in south western Uganda

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ABSTRACT Background Tuberculosis (TB) non-disclosure by adult patients to all household members is a setback to TB control efforts. It reduces the likelihood that household contacts will seek early TB screening, initiation on preventive or curative treatment, but also hinders the implementation of infection controls and home-based directly observed treatment. Therefore, this study aimed at determining the level of TB non-disclosure, its predictors and effects of disclosure to household members on adult patients at a large regional referral hospital in south-western Uganda. Methods Cross-sectional study. Questionnaires administered to collect patients’ sociodemographic and their TB disclosure data. Non-disclosure was considered if a patient did not reveal their TB diagnosis to all household members within 2 weeks post-treatment initiation. Univariate and multivariate logistic regression models were fitted for predictors of non-disclosure. Results Enrolled 62 patients, 74% males, mean age of 32 years, and median of five people per household. Non-disclosure rate was 30.6%. Post-disclosure experiences were positive in 98.3% of patients, while negative experiences suggestive of severe stigma occurred in 24.6% of patients. Being female (OR 6.5, 95% CI: 1.42-29.28) and belonging to Muslim faith (OR 12.4, 95% CI: 1.42-109.05) predicted TB non-disclosure to household members. Conclusions There is a high rate of TB non-disclosure to household members by adult patients in rural Uganda, with the highest vulnerability seen among female and Muslim patients. Interventions enhancing TB disclosure at household level while minimizing negative effects of stigma should be developed and prioritized.

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