{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T04:12:52Z","timestamp":1786939972031,"version":"build-2736575974"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Private Health Facilities (PHFs), Uganda\u2019s main healthcare providers, are indispensable stakeholders in the national tuberculosis (TB) program\u2019s efforts to improve TB case notification and combat the epidemic. However, notification rates remain relatively low in PHFs compared to public providers. In this study, we sought to assess facilitators and barriers to TB case notification among private facilities in Kampala Capital City.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a cross-sectional study utilizing a mixed-methods approach to assess facilitators and barriers to TB notification in Kampala Capital City between March and July 2022. For the quantitative strand of the study, we interviewed the TB focal persons at 224 PHFs using a structured questionnaire and for the qualitative, we conducted 14 key informant and in-depth interviews with Ministry of Health-Uganda staff, and TB focal persons at the Kampala Division administration level and at the PHFs. The quantitative analysis involved Modified Poisson regression and the qualitative analysis was carried out using thematic analysis to identify the facilitators and barriers to TB case notification.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of the 224 PHFs surveyed, the majority, 39.3%(88), were facilities in Nakawa division and 55.4% (124) of the respondents were male, with a mean age of 32.6 years (SD = 8.6). We found that the prevalence of TB case notification was significantly lower for facilities in Kawempe (PR 0.16; 95%CI 0.05,0.47) and Nakawa (PR 0.39, 95%CI 0.21,0.73). Notification was lower among facilities that had no guide for TB screening and diagnosis (PR 0.50; 95%CI 0.25,0.97) and among those facilities where training of other health workers at the facility in TB diagnosis was unknown (PR 0.35; 95%CI 0.13,0.93). Qualitative data showed that the main facilitators of TB case notification were: regular engagements between the NTLP and private health providers and, provision of materials and support to conduct case finding, while the main barriers included TB stigma, lack of resources such as TB diagnostic facilities.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>PHFs in Kampala Capital City are receptive to programmatic TB case notification. However, they need regular supervision and engagement activities to ensure that they have updated knowledge, equipment and funding support to carry out TB case notification according to policy.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0315402","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T18:35:16Z","timestamp":1734633316000},"page":"e0315402","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Facilitators and barriers to Tuberculosis case notification among private health facilities in Kampala Capital City, Uganda"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4438-1406","authenticated-orcid":true,"given":"Veronica","family":"Kembabazi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius","family":"Ssentongo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizeus","family":"Rutebemberwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,12,19]]},"reference":[{"key":"pone.0315402.ref001","volume-title":"Fact sheet","author":"WHO","year":"2020"},{"key":"pone.0315402.ref002","volume-title":"Fact sheet","author":"WHO","year":"2024"},{"key":"pone.0315402.ref003","volume-title":"Global tuberculosis report 2019","author":"WHO","year":"2019"},{"key":"pone.0315402.ref004","volume-title":"Fact Sheet","author":"WHO","year":"2021"},{"key":"pone.0315402.ref005","unstructured":"WHO conducts mid-term review of Uganda\u2019s response to TB [press release]. June 7th, 2023 2023."},{"key":"pone.0315402.ref006","volume-title":"National tuberculosis prevalence surveys 2007\u20132016","author":"WHO","year":"2021"},{"key":"pone.0315402.ref007","volume-title":"National Strategic Plan for Tuberculosis and Leprosy Control 2020\/21-2024\/25","author":"NTLP","year":"2020"},{"key":"pone.0315402.ref008","volume-title":"National TB and Leprosy Control Programme Performance review presentation(Unpublished)Presentation","author":"NTLP","year":"2021"},{"issue":"1","key":"pone.0315402.ref009","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1186\/s40249-017-0337-8","article-title":"Engagement of public and private medical facilities in tuberculosis care in Myanmar: contributions and trends over an eight-year period","volume":"6","author":"TT Nwe","year":"2017","journal-title":"Infectious Diseases of Poverty"},{"issue":"1","key":"pone.0315402.ref010","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1186\/s12913-018-3077-y","article-title":"High use of private providers for first healthcare seeking by drug-resistant tuberculosis patients: a cross-sectional study in Yangon, Myanmar","volume":"18","author":"SD Sidharta","year":"2018","journal-title":"BMC Health Services Research"},{"issue":"4","key":"pone.0315402.ref011","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.jegh.2017.08.001","article-title":"Pulmonary tuberculosis in Patna, India: Durations, delays, and health care seeking behaviour among patients identified through household surveys","volume":"7","author":"N Mistry","year":"2017","journal-title":"Journal of epidemiology and global health"},{"key":"pone.0315402.ref012","volume-title":"The WHO\/IUATLD Global Project on Anti-Tuberculosis Drug Resistance Surveillance, 2002\u20132007","author":"WHO","year":"2008"},{"key":"pone.0315402.ref013","doi-asserted-by":"crossref","first-page":"5120841","DOI":"10.1155\/2017\/5120841","article-title":"Factors Associated with Treatment Delay among Pulmonary Tuberculosis Patients in Public and Private Health Facilities in Addis Ababa, Ethiopia","volume":"2017","author":"GS Adenager","year":"2017","journal-title":"Tuberculosis Research and Treatment"},{"issue":"1","key":"pone.0315402.ref014","first-page":"3","article-title":"Scale and Ambition in the Engagement of Private Providers for Tuberculosis Care and Prevention. 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Fund","year":"2022","journal-title":"The Global Fund, Tuberculosis"},{"issue":"1","key":"pone.0315402.ref031","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.ijtb.2020.01.004","article-title":"Awareness & utilization of NIKSHAY and perceived barriers for tuberculosis case notification among the private practitioners in Udupi district, Karnataka","volume":"67","author":"S Dey","year":"2020","journal-title":"Indian Journal of Tuberculosis"},{"issue":"3","key":"pone.0315402.ref032","doi-asserted-by":"crossref","first-page":"84","DOI":"10.5588\/pha.19.0001","article-title":"Private primary health care provider delay in tuberculosis diagnosis and treatment in Georgia","volume":"9","author":"M Djibuti","year":"2019","journal-title":"Public Health Action"},{"issue":"1","key":"pone.0315402.ref033","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1186\/s13104-019-4581-9","article-title":"Acceptability of mandatory tuberculosis notification among private practitioners in Yogyakarta, Indonesia","volume":"12","author":"A Kurniawati","year":"2019","journal-title":"BMC Res Notes"},{"issue":"1","key":"pone.0315402.ref034","doi-asserted-by":"crossref","first-page":"e0147579","DOI":"10.1371\/journal.pone.0147579","article-title":"Perceptions of Private Medical Practitioners on Tuberculosis Notification: A Study from Chennai, South India","volume":"11","author":"BE Thomas","year":"2016","journal-title":"PLoS One"},{"issue":"8","key":"pone.0315402.ref035","doi-asserted-by":"crossref","first-page":"e71119","DOI":"10.1371\/journal.pone.0071119","article-title":"Tuberculosis management practices by private practitioners in Andhra Pradesh, India","volume":"8","author":"S Achanta","year":"2013","journal-title":"PLoS One"},{"issue":"2","key":"pone.0315402.ref036","doi-asserted-by":"crossref","first-page":"e023910","DOI":"10.1136\/bmjopen-2018-023910","article-title":"Tuberculosis notification in a private tertiary care teaching hospital in South India: a mixed-methods study","volume":"9","author":"A Siddaiah","year":"2019","journal-title":"BMJ Open"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0315402","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T18:35:26Z","timestamp":1734633326000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0315402"}},"subtitle":[],"editor":[{"given":"Hamufare Dumisani","family":"Mugauri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,12,19]]},"references-count":36,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,19]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0315402","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,19]]}}}