To help achieve the End TB Strategy target of a 90% reduction in tuberculosis (TB) incidence by 2030, member states of the United Nations High-Level Meetings on TB called for improving provision of TB preventive treatment (TPT) for household contacts of persons with TB, who are at increased risk for infection and disease. However, TPT use among household contacts worldwide remained at 21% in 2023. The International Union Against Tuberculosis and Lung Disease, the Uganda Ministry of Health, and CDC piloted a comprehensive approach for increasing case finding and TPT coverage among household contacts of persons with TB. During November 1, 2023-September 30, 2024, a total of 521 index patients with TB disease were registered at six health facilities in Uganda. Home visits to index patients identified 1,913 household contacts, 1,739 (91.0%) of whom underwent TB symptom screening at home; 321 (18.5%) reported TB symptoms. Of 309 (96.3%) persons with TB symptoms who were further evaluated, 284 (91.9%) provided a sputum specimen for laboratory testing, including 270 (84.1% of those with symptoms) who did so during the home visit; 214 (69.3%) underwent chest radiography. Overall, 80 TB cases were diagnosed; in 61 (76.3%) persons, the diagnosis was based on radiographic findings. Among 1,496 HHCs eligible for TPT, 1,239 (82.8%) initiated treatment and 1,178 (95.1%) completed it. Global scale-up of this approach might help reach global TB elimination goals.

We report that unsuccessful treatment outcomes were 11.8% for tuberculosis (TB) disease and 21.8% for TB infection among persons deprived of liberty in Uganda Prisons Service facilities. Remedial efforts should include enhancing referral networks to ensure treatment continuity, strengthening data systems for complete outcome documentation, and prioritizing short-course treatment regimens.

During October 2016-March 2022, Uganda increased tuberculosis (TB) preventive therapy coverage among persons living with HIV from 0.6% to 88.8%. TB notification rates increased from 881.1 to 972.5 per 100,000 persons living with HIV. Timely TB screening, diagnosis, and earlier treatment should remain high priorities for TB/HIV prevention programming.