Tuberculosis in rural Uganda

Background: St Francis Hospital, a health facility in the rural district of Mayuge, Uganda.
Objectives: To evaluate the presentation, course and outcome of patients with tuberculosis hospitalized to receive the intensive phase of treatment.
Method: Observational analytical study of all patients admitted during June 2002-March 2005.
Results: There were 680 patients. Their median age was 31 years (range 2-75); 364 (54 %) were male. There were 564 (83 %) new patients, 60 (9 %) defaulters; 35 (5 %)relapses; 14 (2 %) transfers; four chronic patients; and three treatment failures. Three hundred and thirteen patients (58 %) had moderate or severe malnutrition on admission. Among 102 patients tested for the human immunodeficiency virus, 68 (67 %) were positive. At the end of hospitalization 593 patients (87 %) were to be followed-up at St Francis Hospital or were transferred to another health facility, 31 (5 %)had absconded and 56 (8 %) had died.
Conclusion: The severely limited resources of our patients and the human immunodeficiency virus co-infection are likely factors contributing to their late presentation and the severity of the disease. It is doubtful that in our setting tuberculosis can be effectively controlled without addressing and correcting these factors.