A quasi-experimental study evaluating the effectiveness of a male-specific tuberculosis screening and diagnosis intervention in Uganda (IGNITE).
10 affiliations
- 1Department of Research and Innovation, Makerere University Lung Institute, Kampala, Uganda. [email protected].
- 2Department of Clinical Sciences, Liverpool School of Tropical Medicine of Great Britain and Northern, Liverpool, United Kingdom of Great Britain and Northern Ireland. [email protected].
- 3Centre for Tuberculosis Research, Departments of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom of Great Britain and Northern Ireland.
- 4Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
- 5Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom of Great Britain and Northern Ireland.
- 6Department of Clinical Sciences, Liverpool School of Tropical Medicine of Great Britain and Northern, Liverpool, United Kingdom of Great Britain and Northern Ireland.
- 7Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom of Great Britain and Northern Ireland.
- 8Department of Research and Innovation, Makerere University Lung Institute, Kampala, Uganda.
- 9Statistical Support Unit, Malawi Liverpool Wellcome Research Programme, Blantyre, Malawi.
- 10Department of Internal Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
Abstract
Background
Despite men having a higher burden of TB, they are frequently missed by TB services due to social, behavioural, and health system factors that limit healthcare access. In Uganda, where there are no gender-specific guidelines for TB, we implemented and evaluated a gender-specific intervention to find and treat men with TB.Methods
We conducted a quasi-experimental study comparing TB notifications before (January-June 2023) and after (July-December 2023) the intervention at both intervention (Gombe and Mityana hospitals) and control (Luwero and Kiboga hospitals) sites. The intervention package aimed to enhance TB screening documentation by using checklist stamps, distribute TB educational materials, and introduce male-friendly TB clinics with evening opening hours, health education delivered by male champions, and integrated screening for TB, HIV, diabetes, and hypertension. We extracted data from TB registers and fitted a quasi-Poisson regression model, adjusting for catchment population dynamics by gender, to assess the intervention's effects on TB case notification rates.Results
Overall, 6,415 people in the participating hospitals were presumed to have TB, and 53.3% of these were females. Post-intervention, TB notifications increased by 46.3% (Female 0%, Male 88.4%) in Gombe and 36.4% (Female 26.3%, Male 45.1%) in Mityana; while they reduced by 26.7% (Female 28.8%, Male 25.5%) in Luwero and by 15.4% (Female + 23.9%, Male - 31.8%) in Kiboga. The baseline case notification rate was 246/100,000 population. Post-intervention analysis demonstrated that the intervention significantly increased TB case notification rates (RR: 1.51, 95% CI: 1.03-2.22), and males had a higher notification rate than females (RR: 1.5, 95% CI: 1.23-1.83). The treatment initiation rates pre- and post-intervention ranged between 97.4% and 100% in women, and 91.4% to 97.7% in men.Conclusions
Gender-specific interventions for screening people with TB and linking them to care can be mutually beneficial at improving notifications among men and women.Trial registration
The trial was registered retrospectively on the Pan African Clinical Trial Registry (PACTR202509682831484) on 29th September 2025.
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BibTeX
@article{nidoi2026quasiexperimental,
title = {{A quasi-experimental study evaluating the effectiveness of a male-specific tuberculosis screening and diagnosis intervention in Uganda (IGNITE).}},
author = {Jasper Nidoi and Tom Wingfield and Rachael Thomson and Justin Pulford and Winters Muttamba and Marc Henrion and Ranga Solomon Owino and Edrine Akera and Bruce Kirenga},
journal = {BMC public health},
year = {2026},
month = jul,
doi = {10.1186/s12889-026-28658-6},
url = {https://europepmc.org/article/MED/42894177},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - A quasi-experimental study evaluating the effectiveness of a male-specific tuberculosis screening and diagnosis intervention in Uganda (IGNITE).
AU - Jasper Nidoi
AU - Tom Wingfield
AU - Rachael Thomson
AU - Justin Pulford
AU - Winters Muttamba
AU - Marc Henrion
AU - Ranga Solomon Owino
AU - Edrine Akera
AU - Bruce Kirenga
PY - 2026
DA - 2026/07/01
JO - BMC public health
DO - 10.1186/s12889-026-28658-6
UR - https://europepmc.org/article/MED/42894177
AB - Background Despite men having a higher burden of TB, they are frequently missed by TB services due to social, behavioural, and health system factors that limit healthcare access. In Uganda, where there are no gender-specific guidelines for TB, we implemented and evaluated a gender-specific intervention to find and treat men with TB.Methods We conducted a quasi-experimental study comparing TB notifications before (January-June 2023) and after (July-December 2023) the intervention at both intervention (Gombe and Mityana hospitals) and control (Luwero and Kiboga hospitals) sites. The intervention package aimed to enhance TB screening documentation by using checklist stamps, distribute TB educational materials, and introduce male-friendly TB clinics with evening opening hours, health education delivered by male champions, and integrated screening for TB, HIV, diabetes, and hypertension. We extracted data from TB registers and fitted a quasi-Poisson regression model, adjusting for catchment population dynamics by gender, to assess the intervention's effects on TB case notification rates.Results Overall, 6,415 people in the participating hospitals were presumed to have TB, and 53.3% of these were females. Post-intervention, TB notifications increased by 46.3% (Female 0%, Male 88.4%) in Gombe and 36.4% (Female 26.3%, Male 45.1%) in Mityana; while they reduced by 26.7% (Female 28.8%, Male 25.5%) in Luwero and by 15.4% (Female + 23.9%, Male - 31.8%) in Kiboga. The baseline case notification rate was 246/100,000 population. Post-intervention analysis demonstrated that the intervention significantly increased TB case notification rates (RR: 1.51, 95% CI: 1.03-2.22), and males had a higher notification rate than females (RR: 1.5, 95% CI: 1.23-1.83). The treatment initiation rates pre- and post-intervention ranged between 97.4% and 100% in women, and 91.4% to 97.7% in men.Conclusions Gender-specific interventions for screening people with TB and linking them to care can be mutually beneficial at improving notifications among men and women.Trial registration The trial was registered retrospectively on the Pan African Clinical Trial Registry (PACTR202509682831484) on 29th September 2025.
SN - 1471-2458
ER -