Effect of community awareness, screening, diagnosis, and treatment campaigns on TB care in Uganda

<sec><title>SETTING</title>Eight districts in central Uganda with 105 health facilities.</sec><sec><title>OBJECTIVE</title>To evaluate the effectiveness of the community awareness, screening, testing, diagnosis, and treatment (CAST-TB) campaigns on the number of people screened for, presumed to have, and diagnosed with TB disease.</sec><sec><title>DESIGN</title>We designed a quasi-experimental study and utilised Bayesian Structural Time-Series analysis for counterfactual predictions over 24 months (12 months before vs 12 months during intervention). The intervention was the CAST-TB campaigns. The outcomes included the number of people screened for, presumed to have, and diagnosed with TB disease.</sec><sec><title>RESULTS</title>The intervention led to a 36% (95% credible interval [CrI] 8.4-65, <i>P</i> = 0.005) increase in the number of people screened for TB disease (1,194,257 observed vs 875,211 predicted), a 29% (95% CrI 5.3-52, <i>P</i> = 0.01) increase in the number of people presumed to have TB disease (25,784 observed vs 19,997 predicted), and a 49% (95% CrI 25-75) increase in the number of people diagnosed with TB disease (2,566 observed vs 1,719 counterfactual).</sec><sec><title>CONCLUSION</title>CAST-TB campaigns improved the number of people screened for, presumed to have, and diagnosed with TB disease in central Uganda, supporting scale-up efforts nationally and across sub-Saharan Africa where such indicators are suboptimal.</sec>.