Factors Influencing Early Pulmonary Tuberclosis Detection Among Uganda Peoples Defence Force Patients in Bombo General referral Military Hospital.

Abstract

Introduction Pulmonary tuberculosis is a contagious disease which attacks mainly the respiratory system and any part of the body as extra pulmonary TB. Delayed early case detection increases the probability of cross infection and secondary complications and ensuing into high rates of morbidity and mortality thus hampering the productivity of human resource. Methodology A cross sectional study design was used to investigate factors influencing early PTB case detection among 368 respondents of the UPDFs at Bombo Military Hospital. The respondents who consented to participate in this study were sampled using convenient sampling method. A pre-tested researcher administered questionnaire was used to collect quantitative data on early TB case detection and associated factors. Results This study revealed that 48% of the UPDFs patients at Bombo were detected with PTB in about two weeks or less than two weeks and 52% were detected with PTB in more than two weeks. Henceforth, early PTB case detection amongst UPDFs patients at Bombo was found to be influenced by Patient related factors such as knowledge about early signs and symptoms of PTB (P<0.001) and whether early PTB case detection was necessary (OR=1, P=0.023). Social demographic related factors include: age of UPDFs being 34 or more (OR= 1.58, CI = 1.05-2.39, P = 0.03) the married, (OR = 1.42, CI= 0.73-0.2.73, P=0.001), less or equal 10 years of service in the UPDF, (OR= 2.19, CI= 1.43-3.36),>3years spent in same unit (OR=2.38, CI=1.47-3.88, P=0.001), rank of the UPDFs. (OR=1.94, CI=1.02-3.69, P=0.008) Life style factors which included cigarette smoking (OR=0.57, CI=0.37-0.86, P=0.008) Alcohol intake (OR=0.38, CI=0.23-0.62, P<0.001), and fear of stigma (OR=0.64, CI=0.41-0-99, P=0.046).

Health facility related factors include: availability of medical supply (OR=1.66, CI=1.05-2.61, P=0.030), provision of health education (OR=6.04, CI=3.65-10.01, P <0.001), distance of >5Km of reach to the health facility (OR= 5.65, CI=3.5-9.12, P<0.001), attitude of health workers (P<0.001), had significant statistical association between early PTB case detection and UPDFs patients. Conclusion Early PTB case detection amongst the UPDF’s at Bombo was low. This was influenced by lack of knowledge about early signs and symptoms of PTB, patients’ ability to know whether early detection of PTB was necessary, being more than 34 years old, married, divorced or widowed, years spent in service, years spent in a present unit, rank in the army, life style factors such as smoking and alcohol intake, fear of stigma, and distance of 5km reach of health facility, attitude of health workers, waiting time and provision of health education and consequently influencing health seeking behavior. Recommendations To advocate for regular health education activities through all unit establishments about PTB among all UPDF’s, sensitization of commanders about PTB and availability of TB services. This should be based on adequate dissemination of appropriate information to all levels of UPDFs ranks geared at implementing outreach services to reach out especially those affected by distance and assuage the fear of stigma by creating awareness about TB.