Conference Abstract | Volume 8, Abstract NACNDC/19JASH059 (Poster) | Published: 08 Dec 2025
Mathias Ngobi Bogere 1,2,4, Francis Kyakulaga3,4, Alex Mulindwa4, Remmy Buhuguru7, Onzubo Paul5, Alex Odama6, Geofrey Amanya4, Resty Leone Nanyonjo4, Luzze Henry4
1IDEA: Consortium for Development of Sustainable Research-Based Fellowship Training on Infectious Disease Epidemiology and Biostatistics in Africa, Mbale, Uganda, 2Busitema University, Tororo, Uganda, 3Namutumba District Local Government, Busoga, Uganda, 4Ministry of Health / NTLP, Kampala, Uganda
&Corresponding author: Mathias Ngobi Bogere, IDEA: Consortium for Development of Sustainable Research-Based Fellowship Training on Infectious Disease Epidemiology and Biostatistics in Africa, Email: ngobikb@yahoo.com, ORCID: https://orcid.org/0009-0006-1650-6235
Received: 11 Sep 2025, Accepted: 20 Oct 2025, Published: 08 Dec 2025
Domain: Infectious Disease Epidemiology
Keywords: Integrated, community disease, surveillance, Teso, Uganda
©Mathias Ngobi Bogere 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: Mathias Ngobi Bogere et al., Integrated community surveillance and active case finding for tuberculosis, HIV, malaria and malnutrition in Teso sub-region, Uganda. Journal of Interventional Epidemiology and Public Health. 2025;8(ConfProc6):059. https://doi.org/10.37432/JIEPH-CONFPRO6-00059
Uganda started a Community Awareness, Screening Testing for TB (CAST-TB+) campaign held in March and September every year to find missing people with TB. Following the March 2025 campaign, Ministry of Health (MOH) was notified on 9th April, 2025 of a possible outbreak of TB in Maracha District, where 27/40 people diagnosed were school children from Kololo Primary school. The MOH therefore set out to investigate the scope of the outbreak and identify possible predictors associated with TB transmission in the school.
We applied a mixed-methods approach, including a case–control study, key informant interviews, desk reviews, and school/community TB screening using mobile digital X-ray vans. Environmental health assessments of the school were conducted. A case was defined as any pupil diagnosed with TB between October 2024 and April 2025. For the case–control study, we enrolled 30 cases and 81 controls (1:3 ratio).
A total of 111 participants were enrolled; 51.4% were female and 57.7% aged 10–14 years. 97.3% had normal nutritional status (MUAC-green) and BCG scars (92.8%). Contact with a person with TB outside the household was significantly associated with infection (AOR 8.66, 95% CI 2.46–30.45, p=0.001). Classroom assessments revealed severe overcrowding (e.g., P1 with 485 pupils; standard ≤45). The school lacked health policy guidelines, routine screening of coughing children was not practiced. A community TB case diagnosed in October 2024 and started on treatment on 30thNovember 2025 had frequent contact with pupils during football activities, likely introduced infection.
The TB outbreak originated from community-to-school. Transmission was amplified by classroom overcrowding and absence of routine TB screening in schools. We recommend providing more classrooms to reduce class sizes to meet standard occupancy, instituting regular school-based TB screening, and developing a comprehensive school health policy to mitigate future outbreaks.
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