Conference Abstract | Volume 8, Abstract NACNDC/19JASH031 (Poster B5) | Published: 20 Nov 2025
David Semugabi1 Akello Annet1, Francis Ocen2, David Namuwerezi3, Brian Wamala1, Christopher Mukama1, Ignatius Senteza1, Mary Nabukenya Mudiope1
1Infectious Diseases Institute (IDI), College of Health Sciences Makerere University, Uganda, 2Africa society for laboratory medicine, 3Mukono District Local Government Kampala, Uganda
&Corresponding author: David Semugabi, Infectious Diseases Institute (IDI), College of Health Sciences Makerere University, Uganda, Email: dsemugabi@gmail.com
Received: 25 Aug 2025, Accepted: 20 Oct 2025, Published: 20 Nov 2025
Domain: Infectious Disease Epidemiology
Keywords: Bacteriologically confirmed TB patients, Sputum smear monitoring, drug susceptibility testing, genome sequencing
©David Semugabi et al Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: David Semugabi et al., Enhancing detection of TB treatment resistance through intensifying sputum smear monitoring: Insights from Mukono district, Uganda. Journal of Interventional Epidemiology and Public Health. 2025;8(ConfProc6):031. https://doi.org/10.37432/JIEPH-CONFPRO6-00031
In Uganda, the proportion of bacteriologically confirmed pulmonary TB patients reported as cured each year remains sub-optimal at 80%, below the WHO target of ≥90%. Additionally, smear follow-up microscopy is underutilized for monitoring sputum conversion and cure rates. We share findings following the improvement of sputum smear monitoring from 62% to 83% in Mukono district.
Between December 2022 and January 2024, sputum smear monitoring was strengthened at 8 health facilities. Samples from 318 of the 384 patients (83%) due for 5-month monitoring were examined. Six patients tested smear-positive, and additional samples for GeneXpert and phenotypic drug susceptibility testing (DST) were collected.
Among the six smear-positive patients, two cases of MDR-TB were identified. One MDR case exhibited a discrepancy, where the MTB Xpert assay did not detect resistance. The remaining four patients tested positive by microscopy, MTB GeneXpert, and culture, with no resistance detected, indicating possible poor adherence to treatment.
There is a need to strengthen sputum smear monitoring nationwide to enable more effective monitoring of treatment response. In addition to rapid molecular and phenotypic drug susceptibility testing techniques, expanding access to genome sequencing is essential for rapid, detailed profiling and mapping of resistant mycobacterial strains. These measures will improve early detection and management of drug-resistant TB, ultimately contributing to better treatment outcomes.
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