More than half of newly diagnosed tuberculosis patients in Kampala, Uganda, waited longer than two weeks to receive a diagnosis, according to a cross-sectional study conducted between July 2021 and June 2022. The research, published in BMC Infectious Diseases, found that diagnostic delay was the principal bottleneck to timely tuberculosis care in the Ugandan capital, while delays between diagnosis and the start of treatment were comparatively rare.
Their median age was 35 years, with an interquartile range of 27 to 43, and 59.0 percent were male. Notably, 60.1 percent reported a tuberculosis episode in the previous 12 months, underscoring the burden of recurrent disease in this urban population.
By these thresholds, diagnostic delays occurred in 58.2 percent of participants, treatment delays in 20.7 percent and total delays in 61.7 percent. The median diagnostic delay was 30 days, while the median treatment delay was just 1 day. In other words, once a diagnosis was made, treatment typically began almost immediately, but reaching that diagnosis often took a month or more.
Diagnostic delay was associated with a previous tuberculosis episode (adjusted prevalence ratio 1.78, 95% confidence interval 1.46–2.18), first consulting a private facility (aPR 1.27, 95% CI 1.06–1.53), self-reported severe illness (aPR 1.27, 95% CI 1.02–1.58), current smoking (aPR 1.23, 95% CI 1.01–1.51) and good tuberculosis knowledge (aPR 1.31, 95% CI 1.12–1.54). HIV-positive participants were less likely to experience a diagnostic delay (aPR 0.82, 95% CI 0.69–0.96).
Treatment delay showed a partly different pattern of associations. It was linked with peri-urban residence (aPR 2.16, 95% CI 1.42–3.30), previous tuberculosis (aPR 1.61, 95% CI 1.02–2.57) and current smoking (aPR 1.86, 95% CI 1.18–2.95). The authors note that Uganda’s tuberculosis case detection rate remains below the World Health Organization target, and that delays in diagnosis and treatment sustain community transmission. They also point out that evidence from high-burden urban settings such as Kampala has been limited, and that earlier Ugandan studies predated the expanded rollout of rapid WHO-recommended molecular and antigen diagnostics.
Based on these findings, the authors conclude that interventions should target diagnosis in the private sector and provide financial support and targeted education for people with a previous tuberculosis episode. As a cross-sectional study relying on self-reported intervals among adults with microbiologically confirmed pulmonary tuberculosis recruited from facilities in Kampala, the findings describe associations within this specific population and period and do not establish causal effects.
Subject of Research: Diagnostic and treatment delays among newly diagnosed tuberculosis patients in Kampala, Uganda
Article Title: Delays in the diagnosis and treatment of newly diagnosed tuberculosis patients in Kampala, Uganda between July 2021 and June 2022: a cross-sectional study
Article References: Nsawotebba, A., Ibanda, I., Mujuni, D., Kabugo, J., Adam, I., Wekiya, E., Orishaba, P., Galiwango, J. B., Nabadda, S., Kasang, C., Joloba, M., & Turyahabwe, S. (2026). Delays in the diagnosis and treatment of newly diagnosed tuberculosis patients in Kampala, Uganda between July 2021 and June 2022: a cross-sectional study. BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14708-2
Image Credits: AI Generated
DOI: 10.1186/s12879-026-14708-2
Keywords: tuberculosis, diagnostic delay, treatment delay, Kampala, Uganda, cross-sectional study, public health, private health facilities, previous TB episode, BMC Infectious Diseases, Delays, diagnosis
News Source: Ophelia Keating. (October 29, 2026). Most new tuberculosis patients in Kampala face long diagnostic delays, study finds. Scienmag.
