Evidence map›Paper›PMID 41849373›Full record

Observational studyPloS one2026

Effectiveness of routine tuberculosis education in a high-burden setting: A prospective observational cohort study.

Tyler Scott Johnson, Leah Nanziri, Amanda J Gupta, Joseph M Ggita, Mari Armstrong-Hough, Irene Ayakaka, Sheela V Shenoi, Achilles Katamba, J Lucian Davis

Abstract readObservational Study
In one paragraph

Observational study in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Tyler Scott JohnsonDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America.ORCID https://orcid.org/0000-0002-0542-8300
Leah NanziriWorld Alliance for Lung and Intensive Care Medicine in Uganda (WALIMU), Kampala, Uganda.
Amanda J GuptaDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America.ORCID https://orcid.org/0000-0003-2318-1783
Joseph M GgitaWorld Alliance for Lung and Intensive Care Medicine in Uganda (WALIMU), Kampala, Uganda.
Mari Armstrong-HoughWorld Alliance for Lung and Intensive Care Medicine in Uganda (WALIMU), Kampala, Uganda.
Irene AyakakaWorld Alliance for Lung and Intensive Care Medicine in Uganda (WALIMU), Kampala, Uganda.
Sheela V ShenoiAIDS Program, Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, United States of America.ORCID https://orcid.org/0000-0001-7654-4344
Achilles KatambaWorld Alliance for Lung and Intensive Care Medicine in Uganda (WALIMU), Kampala, Uganda.
J Lucian DavisDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America.ORCID https://orcid.org/0000-0002-8629-9992

Funding

Using Coincidence Analysis to Investigate Factors Affecting PrEP Initiation and Continuation in Southern ending the Epidemic CountiesP30MH062294 · NIMH · YALE UNIVERSITY · PI Trace S Kershaw · 2001 to 2026
$48.5M
Peer-led Implementation of TB-HIV Education and Adherence Counseling in UgandaR01HL176337 · NHLBI · YALE UNIVERSITY · PI John Lucian Davis, Achilles Katamba · 2024 to 2026
$1.8M
NHLBI NIH HHS R01 HL176337NIMH NIH HHS P30 MH062294
6 · The paper itself

Abstract

backgroundLow adherence to tuberculosis (TB) treatment remains a major driver of adverse health outcomes in high-burden countries. While guidelines recommend routine client education, its effectiveness and the knowledge constructs that influence adherence remain poorly defined.

methodsWe conducted a prospective cohort study of adults (≥18 years) initiating treatment for drug-susceptible TB in Kampala, Uganda. We assessed clients' TB knowledge before and after routine education and at the two-week, two-month, and five-month follow-up visits. We recorded self-reported seven-day medication adherence at each visit and final treatment outcomes. We used paired t-tests to compare knowledge scores (0-100) before and after education. We constructed multivariable Poisson and logistic regression models to examine the association of knowledge with the outcomes of nonadherence and WHO-defined treatment success.

resultsWe enrolled 80 participants (28% female; 36% living with HIV). Overall TB knowledge scores increased by 25 points (95% CI 22-28), from 53 to 78, yet only 9% achieved TB literacy (an overall TB knowledge score ≥90) after TB education, peaking at 18% at two weeks, before declining to just 3.6% at five months. Each 10-point increase in post-education knowledge was associated with a reduction in nonadherence of 15% (IRR0.1 0.85; 95% CI 0.72-1.00, p = 0.048) at the two-week visit and 32% (IRR0.1 0.68; 95% CI 0.50-0.89, p = 0.005) at the two-month visit. Ultimately, 71% completed treatment, but knowledge was not a significant predictor of treatment success (OR = 1.77, 95% CI 0.01-314.6, p = 0.83).

conclusionsRoutine client education significantly increased TB knowledge, yet less than 10% achieved TB literacy. Post-education knowledge was independently associated with better early adherence, highlighting the need for more robust education interventions to optimize TB treatment outcomes.

Indexed as

Patient Education as TopicTuberculosisAdultAntitubercular AgentsFemaleHealth Knowledge, Attitudes, PracticeHumansMaleMedication AdherenceMiddle AgedProspective StudiesTreatment OutcomeUgandaYoung AdultAntitubercular Agents

Identifiers

PMID41849373
PMCPMC12998860

What OpenQuestion holds

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Registered trials

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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.