Evaluating the Impact of Cash Transfers Plus on Tuberculosis Outcomes in Uganda: the ExaCT TB Study | Social medicine, infectious diseases and migration (SIM)

Poor case detection is a critical gap in TB care, where 40% of the world’s 10 million cases are not detected (WHO 2017). Many of these patients are lost in the pre-treatment period; up to 83% in Uganda. A major reason for this is the social and economic barriers that impede access to care. Accordingly, WHO’s End TB Strategy proposes the use of social protection interventions as part of TB care. How best to implement and scale-up these interventions is still unknown.

The purpose of our research was to develop an evidence base for the effectiveness of social protection interventions in enabling completion of diagnostic evaluation and treatment initiation for TB patients in Uganda. We used formative mixed-methods research to identify social and economic barriers that impede access and adherence to care. We designed and evaluated a context specific, multi-faceted social protection intervention to overcome these barriers. Our outcomes was the proportion of: (1) diagnosed patients who initiate TB treatment; (2) TB affected households who suffered catastrophic costs.

This work was coordinated and led by University of California San Francisco (UCSF) Principal Investigator Dr. Priya Shete and co-investigator Professor Adithya Cattamanchi. Other project partners included: Uganda Tuberculosis Implementation Research  and Makerere University with co-investigator Dr Achilles Katamba. Karolinska Institutet with co-investigators Professor Knut Lönnroth and Dr. Kristi Sidney Annerstedt.

This project received funding from Swedish Research Council (VR) under grant agreement No 2018-04860.