Evolving Tuberculosis Patient Profiles and Predictors of Treatment Success: Insights from a Five-Year Real-World Cohort Study in Uganda

Background There is a need to evaluate evolving trends in tuberculosis (TB) patient profiles and treatment success determinants, which this study assessed over a five-year period (2019–2023). Methods We conducted a cohort study, retrospectively reviewing records of 1,051 TB patients. Descriptive statistics summarised demographics and clinical characteristics. Treatment success was defined as cured or completed treatment. Chi-square, Fisher’s exact and logistic regression identified factors associated with treatment outcomes, with significance set at p < 0.05. Results Most TB cases were, male 55.2%, aged 34–50 years 40.8%, HIV-positive72.1%, new cases (90.7%), and urban residents (Kampala Metropolitan Area) 84.9%. Pulmonary TB was predominant with bacteriologically confirmed at 58.2%. Patient profiles included 91% new cases, 0.6% failures, 7% relapses, and 1.4% defaulters. Relapses rose from 0.74% in 2019 to 14.6% in 2023 (p < 0.001). Unsuccessful outcomes were linked with, older age (≥ 50 years) (aOR = 3.66; 95% CI: 1.27–10.55; p = 0.016), being separated, divorced, or widowed (aOR = 1.86; 95% CI: 1.08–3.22; p = 0.027), unknown tuberculosis preventive therapy (TPT) status (aOR = 11.19; 95% CI: 2.70–46.29; p = 0.001), and prior TB treatment failure (aOR = 18.45; 95% CI: 3.36–101.40; p = 0.001). Conclusion This study highlights a shifting trend in TB patient profiles with an increase in relapses. Unsuccessful outcomes were linked with age ≥ 50, unknown TPT status, prior treatment failure, and being separated, divorced, or widowed. Post-treatment follow-up, adherence support, TPT awareness and prospective research on TB patient profiles and treatment outcomes are critical.