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Tuberculosis remains the greatest killer globally. Uganda, one of the highest TB burden countries has a rapidly growing private medical sector. Although a large proportion of patients first seek care from the private sector, there is very little if any literature about participation of private independent laboratories in diagnosis of TB. We aimed at assessing this and the extent to which diagnosed TB patients are linked to care. Methods: We conveniently sampled and reviewed records for seven independent private laboratories registered with the ministry of health covering January-June 2015 period. Data was collected on patient demographics, number of sputum samples analyzed in each and those testing positive for TB. We also collected data on where the diagnosed patients were registered for treatment. Results: A total of 33,071 samples were analyzed of which 562 were for sputum. Of these, 271 (48%) were for males, 227 (40%) females and 64 (12%) records missed sex classification. The ≤ 14-year-old contributed only 8 (1.4%) and 301 (54%) of the samples did not have age registered. Four hundred and thirty-six (78%) samples were from private for-profit health units and others were self-referrals. Thirty-four (6%) samples analyzed tested positive of which 21 were not traceable in the unit TB registers. About half of the laboratories were enrolled on the national EQA scheme and about half processed two pre-treatment smears required by the NTLP. Conclusion: Independent private laboratories in Kampala participate in sputum-smear microscopy for TB diagnosis but majority do not follow national guidelines. Majority of the diagnosed patients are not traceable in the known TB care centers. Introduction and Background Tuberculosis is the second greatest killer globally and 95% of the TB deaths do occur in lowand middle-income countries [1]. Uganda, like other developing countries has a large and growing private medical sector. Literature has shown that a large proportion of tuberculosis patients in many high TBburden countries seek care from private health care providers first [2-4]. Kampala city with the highest incidence of TB in Uganda (450-550 TB cases/100,000 population) has reported slow increase in annual TB case notification over the past six years. TB in this city is mainly diagnosed in public and NGO health facilities. It has been observed that private health facilities also participate in TB diagnosis and treatment in this setting, but there is no published data/evidence on participation of independent private laboratories in TB diagnosis. It was assumed that a big number of TB patients are diagnosed in these laboratories and not linked to health facilities that report to RESEARch ARticLE

Tuberculosis Diagnosis in Private Independent Laboratories in Kampala- Uganda Implications for TB Control in the City