Conference Abstract | Volume 8, Abstract NACNDC/19JASH081 (Poster) | Published: 09 Dec 2025
Alex Mulindwa1,&, Seyoum Dejene Balcha1, Didas Tugumisirize1, Amanya Geofrey1, Lameck Mukisamuzaale1, Miriam Murungi1, Henry Luzze1, Stavia Turyahabwe2
1Ministry of Health, National Tuberculosis & Leprosy Program (NTLP), Kampala, Uganda, 2Ministry of Health, Communicable Disease Prevention and Control, Kampala, Uganda
&Corresponding author: Alex Mulindwa, Ministry of Health, National TB and Leprosy Program, Kampala, Uganda, Email: mulindwaalex@gmail.com, ORCID: https://orcid.org/0009-0006-2822-1798
Received: 11 Sep 2025, Accepted: 20 Oct 2025, Published: 09 Dec 2025
Domain: Infectious Disease Epidemiology
Keywords: Multidrug-resistant and rifampicin-resistant TB (MDR/RR-TB), computer-aided detection for tuberculosis (CAD4TB), mobile TB diagnostics, community TB transmission, TB surveillance
©Alex Mulindwa 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: Alex Mulindwa et al., Responding to MDR/RR-tuberculosis surge through epidemiological investigation: A case for Uganda. Journal of Interventional Epidemiology and Public Health. 2025;8(ConfProc6):081. https://doi.org/10.37432/JIEPH-CONFPRO6-00081
Uganda ranks among the top 30 high-TB and TB/HIV burden countries globally, with an incidence rate of 198 per 100,000 and approximately 96,000 cases notified annually. MDR/RR-TB cases rose from 643 (47%) in 2023 to819 (69%) in 2024, affecting 1.6% of new TB patients and 12% of previously treated cases. MDR/RR-TB contributes significantly to Post-TB Lung Disease (PTLD), increasing disability and rehabilitation needs. The 2024 CAST campaign revealed clusters of MDR/RR-TB in Buikwe and Kayunga, suggesting persistent community transmission linked to poor adherence, infection control gaps, and socio-cultural behaviours.
The National TB & Leprosy Program (NTLP) launched a multidisciplinary epidemiological investigation targeting MDR/RR-TB clusters. Mobile TB clinics equipped with CAD4TB digital X-rays and LabXpert electronic reporting tools facilitated active case finding. Contact tracing, risk factor analysis, and health facility assessments were conducted to identify gaps in service delivery. MDR/RR-TB was defined as resistance to rifampicin and isoniazid. Inaddition to hotspot testing, household contacts were line-listed, screened, and tested.
Across 96 hotspots, 2,912 samples were tested, identifying 174 bacteriologically confirmed TB patients, yielding a 6% positivity rate. Among these, 15MDR/RR-TB cases (5 from Buikwe, 10 from Kayunga) were diagnosed and linked to care. Risk factors included 80% alcohol use and 60% HIV co-infection. Several DS-TB cases were also identified. Community transmission was linked to overcrowded drinking joints and inadequate isolation practices. Mobile clinics enhanced early detection, linkage to care, and facilitated facility-level responses.
MDR/RR-TB in Buikwe and Kayunga was driven by community transmission and poor treatment adherence. Mobile diagnostics and surveillance interventions strengthened case detection and service delivery, underscoring the need for national scale-up. Sustained impact requires integrating CAD4TB and LabXpert into routine surveillance, reinforcing infection control measures, and engaging communities and local leaders to address the socio-cultural drivers of resistant TB.
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