Published in PLOS One on 2026-04-20, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Munanura Turyasiima, Daniel Muliika, Gaston Turinawe, Miriam Acheng, Antony Ikiriza, Agnes Alinde, Precious Natureeba, Amon Nkwansiibwe, Balbina Gillian Akot, Susan Wendy Wandera Kayizzi, Derrick Asaasira, Shamim Nantege, Iloit Daniel Oode, Hilda Barbara Wesonga, Raymond Kamara Atuhaire, Ronald Kooko
Source: PLOS One • DOI 10.1371/journal.pone.0347022
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Tuberculosis (TB) treatment completion rates in high-burden countries like Uganda often fall short of the WHO End TB Strategy target of ≥90%. This study evaluated multilevel determinants of treatment completion to guide evidence-based improvement strategies in rural Western Uganda.
We conducted a cross-sectional, multi-center analytical study of 224 patients with drug-susceptible TB across four public health facilities in Kakumiro District. Eligible participants had been on treatment for at least six months. Data collected via structured questionnaires were validated against facility TB registers. Multivariable logistic regression identified independent predictors, reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI).
The treatment completion rate was 82.6% (185/224), with a 30.4% TB-HIV co-infection rate. Significant positive predictors included high TB knowledge (AOR = 14.0; 95% CI: 3.06–24.5), high economic status (AOR = 7.2; 95% CI: 1.63–31.5), belief in treatment efficacy (AOR = 6.2; 95% CI: 2.02–18.8), and respectful health worker behavior (AOR = 5.0; 95% CI: 2.15–11.83). Community-level support was critical, specifically religious/community leader advocacy (AOR = 4.2; 95% CI: 1.84–9.51) and community health worker (CHW) home visits (AOR = 3.5; 95% CI: 1.64–7.72). Waiting time less than 30 minutes (AOR = 6.3, 95% CI: 1.91–20.96) also positively impacted TB treatment completion. Major negative predictors were male gender (AOR = 0.3; 95% CI: 0.11–0.86), drug stockouts (AOR = 0.3; 95% CI: 0.11–0.70), belief in traditional cures (AOR = 0.3; 95% CI: 0.13–0.71), and stigma (AOR = 0.4; 95% CI: 0.16–0.80).
Achieving the WHO End TB targets requires integrated, multilevel interventions. Efforts should focus on male-targeted engagement, strengthening supply chains to eliminate drug stockouts, enhancing CHW-led community outreach, and reducing stigma to ensure equitable treatment success.
Background
Globally, Tuberculosis (TB) remains a leading cause of death from a single infectious agent, surpassing HIV/AIDS, and is among the top ten causes of mortality [1–3]. The burden is disproportionately high in low- and middle-income countries (LMICs), where structural health system weaknesses, socio-economic disparities, and high TB/HIV co-infection rates contribute to ongoing transmission and treatment challenges [1].
While pulmonary TB is the most common form, the infection can also affect other organs such as the brain, kidneys, and spine [1]. Vulnerable populations include individuals living with HIV, those with malnutrition or diabetes, healthcare workers, and people residing in poverty or overcrowded settings that facilitate transmission [3,4]. Beyond its clinical impact, TB imposes profound social and economic burdens, including reduced productivity, catastrophic treatment costs, and persistent stigma [5,6].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Munanura Turyasiima, Daniel Muliika, Gaston Turinawe, Miriam Acheng, Antony Ikiriza, Agnes Alinde, Precious Natureeba, Amon Nkwansiibwe, Balbina Gillian Akot, Susan Wendy Wandera Kayizzi, Derrick Asaasira, Shamim Nantege, Iloit Daniel Oode, Hilda Barbara Wesonga, Raymond Kamara Atuhaire, Ronald Kooko. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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