Tobacco use and presumptive tuberculosis in Uganda: findings from the Uganda National TB Prevalence Survey 2014 - 2016

Background Tuberculosis (TB) patients who smoke tobacco are at an increased risk for adverse TB treatment outcomes. The association between smoking and TB is well known but has not yet received sufficient attention in terms of TB care standards in Uganda. This study describes prevalence of smoking among presumptive TB patients and risk factors associated with presumptive TB among tobacco smokers in Uganda. Methods This was a national cross-sectional population-based study among respondents aged 15 years and above. We defined a presumptive TB patient as any person with cough (≥14 days) and abnormal chest x-ray.We collected information on current and past tobacco use, socio-economic and demographic status using structured interviewer-administered questionnaires. Data analysis entailed descriptive statistics, followed by multivariate logistic regression with backward elimination, adjusted for clustering by facility. Results Detailed interviews were conducted for 45294 individuals; prevalence of presumptive TB was 11.8% (95% CI =11.5-12.1), 12.7% (95% CI=12.4-13.0) had a history of tobacco smoking (both previous and current tobacco smokers). Prevalence of current tobacco smoking was 7.3% (95% CI=7.1-7.6) and prevalence of past tobacco smoking was 7.1% (CI= 6.9-7.4). History of tobacco smoking among presumptive TB patients was 26.7% (95% CI=25.5-27.9), presumptive TB among current tobacco smokers was 13.7% (95% CI=12.8-14.7) while for past tobacco smokers was 15.0% (95% CI=14.0-16.0). Not having any education AOR (Adjusted odds ratio) 2.90 (95% CI=2.34-3.6), primary education OR 1.47 (95% CI=1.22-1.76) and being male AOR 8.6 (95% CI=7.3-10.2) were the key risk factors for history of smoking among TB patients. Conclusions Tobacco smoking was associated with presumptive TB in Ugandans. Smoking cessation interventions should be included in the current TB care standards at various levels of the TB health care system In Uganda