Evidence map›Paper›PMID 41650118›Full record

ArticlePLOS global public health2026

Combination interventions to control the tuberculosis epidemic in the Karamoja subregion of Uganda: A modelling analysis.

Stella Zawedde-Muyanja, Letisha Najjemba, Tadeo Nsubuga, Brenda Picho, Etwom Alfred, David Dowdy, Theresa Ryckman

Abstract read
In one paragraph

Article in PLOS global public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

7 authors.

Stella Zawedde-MuyanjaDepartment of Research, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.ORCID https://orcid.org/0000-0002-8823-7082
Letisha NajjembaDepartment of Research, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
Tadeo NsubugaDepartment of Research, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
Brenda PichoDepartment of Research, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.ORCID https://orcid.org/0009-0003-8279-5424
Etwom AlfredDepartment of Research, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
David DowdyDivision of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
Theresa RyckmanDivision of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.

Funding

Research Mentoring and Building Capacity of underrepresented Minority Research Scientists in India.D43TW010540 · FIC · YALE UNIVERSITY · PI MICHELE BARRY, Eva Harris · 2017 to 2026
$15.5M
FIC NIH HHS D43 TW010540
6 · The paper itself

Abstract

The Karamoja subregion in northeastern Uganda is disproportionately affected by tuberculosis (TB), with an estimated TB prevalence >3 times the national average. Recently introduced health systems strengthening (HSS) interventions, including active symptom screening campaigns covering approximately 20% of the population annually, have substantially increased the number of people initiated on TB treatment, improved TB treatment completion and increased uptake of TB preventive therapy. However, to achieve further reductions in TB incidence and mortality, additional interventions are needed. We aimed to assess the impact of four additional interventions, layered onto existing HSS interventions, on TB incidence and mortality. We developed a dynamic compartmental model calibrated to TB epidemiology in Karamoja (population 1.4 million, 50% children <15 years old, 34% undernourished; estimated annual TB incidence 670 per 100,000). In addition to the existing HSS interventions, we modelled four interventions: adding chest X-ray with computer aided detection to current case-finding campaigns; increased home-based contact investigation to cover all persons diagnosed with TB plus nutritional support for undernourished persons with TB; community-wide testing and treatment of TB infection; and nutritional support to undernourished persons with TB infection. We estimated the number of TB disease episodes and deaths averted over 20 years. Over 20 years, continued implementation of HSS would reduce TB incidence by 2.4% per year to 339/100,000 (95% UI 222-475) and TB mortality by 3.2% per year to 13/100,000 (95% UI 6-20), compared to current incidence and mortality. Implementation of all four additional interventions could accelerate impact, bringing TB incidence to 161/100,000 (95% UI 61-299) and TB mortality to 5/100,000 (95% UI 2-10), thereby averting 47,450 (95% UI 18,030-76,640) TB episodes and 2,880 (95% UI 1,040-3980) TB deaths compared to HSS alone. Combination interventions to reduce undernutrition and find people with TB disease and infection can have a meaningful epidemiological impact in Karamoja.

Identifiers

PMID41650118
PMCPMC12880685

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.