ArticleHealth policy and planning2025
Finding the missing men with tuberculosis: a participatory approach to identify priority interventions in Uganda.
Article in Health policy and planning, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Differences in tuberculosis prevalence by sex in low- and middle-income countries over 1993-2025: A systematic review and meta-analysis.PLoS medicine · 2026Pooled it
- Providing person-centred TB care: a participatory study with healthcare workers in Nairobi, Kenya.BMJ open · 2026Article
- User engagement in the tuberculosis treatment support tools intervention and its impact on treatment outcomes: A secondary analysis of a pragmatic trial.PLOS digital health · 2026Article
- Modelling the impact of increasing tuberculosis treatment coverage and addressing determinants of risk in men.Communications medicine · 2026Article
- Tuberculosis in transit: risk factors in Tanzania's high-mobility border regions.The Pan African medical journal · 2025Article
- Clinic and Provider Innovations to Improve Tuberculosis Infection Screening and Preventive Therapy Uptake in Brazil: Qualitative Findings From the PREVINE-TB Study.Journal of the International Association of Providers of AIDS CareArticle
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Authors and funding
10 authors.
Funding
Abstract
Gender impacts exposure and vulnerability to tuberculosis (TB) evidenced by a higher prevalence of both TB disease and missed TB diagnoses among men, who significantly contribute to new TB infections. We present the formative research phase of a study, which used participatory methods to identify gender-specific interventions for systematic screening of TB among men in Uganda. Health facility-level data were collected at four Ugandan general hospitals (Kawolo, Gombe, Mityana and Nakaseke) among 70 TB stakeholders, including healthcare workers, TB survivors, policymakers and researchers. Using health-seeking pathways, they delineated and compared men's ideal and actual step-by-step TB health-seeking processes to identify barriers to TB care. The stepping stones method, depicting barriers as a 'river' and each 'steppingstone' as a solution, was employed to identify interventions which would help link men with TB symptoms to care. These insights were then synthesized in a co-analysis meeting with 17 participants, including representatives from each health facility to develop a consensus on proposed interventions. Data across locations revealed the actual TB care pathway diverted from the ideal pathway due to health system, community, health worker and individual-level barriers such as delayed health seeking, unfavourable facility operating hours and long waiting times that conflicted with men's work schedules. Stakeholders proposed to address these barriers through the introduction of male-specific services; integrated TB services that prioritize X-ray screening for men with cough; healthcare worker training modules on integrated male-friendly services; training and supporting TB champions to deliver health education to people seeking care; and engagement of private practitioners to screen for TB. In conclusion, our participatory co-design approach facilitated dialogue, learning and consensus between different health actors on context-specific, person-centred TB interventions for men in Uganda. The acceptability, effectiveness and cost effectiveness of the package will now be evaluated in a pilot study.
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