Reaching the missing men: New TB interventions show promise in Uganda

A quiet but critical shift is taking place in the fight against tuberculosis (TB), as researchers turn their attention to a long-overlooked reality: men are less likely to seek care, yet more likely to suffer from the disease.

According to Dr Winters Mutamba, a research scientist at the Makerere University Lung Institute and programme manager for the LIGHT TB programme, the gap in TB care for men has long been recognised but not adequately addressed.

Through the LIGHT TB programme, researchers set out to design practical, gender-responsive solutions. Central to this effort was the IGNITE study, which brought together healthcare providers, communities, and men themselves to identify barriers to care.

“Some of the things men asked for were, small things,” Mutamba said. “For example, extending healthcare working hours.”

For many men, earning a living takes priority over their health. By the time they are free to visit a health facility, it is often closed. Others reported that health centres feel more welcoming to women than men, discouraging them from seeking care.

Armed with these insights, researchers co-designed interventions with communities and rolled them out in selected facilities, including Mityana and Gombe hospitals.

Speaking on March 18, 2026, during the LIGHT TB programme dissemination, Dr Jasper Nidoi, a researcher, said the results were significant. In Gombe, TB notifications rose from 82 to 120 cases within six months. Among men, the numbers nearly doubled from 43 to 81.

In Mityana, notifications increased from 132 to 180, with male cases rising from 71 to 103.

“These were people who were previously missed by the healthcare system,” Nidoi notes. “Once someone is notified, it means they have been diagnosed and started on treatment.”
Encouragingly, between 95 to 100% of those diagnosed began treatment, an essential step in preventing further spread within communities.

Overall, the intervention led to a 51% increase in TB case notifications between July and December 2023, compared to the first half of the year.

The interventions went beyond TB alone. Health facilities expanded screening services so that patients could also be checked for conditions such as hypertension, diabetes, and HIV during the same visit.

“This was not only for men,” Nidoi emphasises. “It improved care for everyone.”

According to the chief research scientist and founding director of the Makerere University Lung Institute, Prof. Bruce Kirenga, a TB prevalence survey conducted in 2014 revealed that 60% of TB patients in Uganda were men.

Meanwhile, the Lung Institute has reported a sharp rise in patients with lung-related conditions. While this could reflect improved health-seeking behaviour, experts caution that it does not necessarily mean the disease burden itself is increasing.

“We are seeing more people,” Kirenga explains, “but that may not mean there is more disease in the community.”

Robinah Kaitiritimba, executive director of the Uganda National Health Consumers Organisation and also part of the LIGHT programme, emphasised that prevention should remain the country’s priority, adding that TB is 100% preventable.

"Taking care of patients and detecting who has TB in the community is very important," she said.