Baseline knowledge on chronic pulmonary aspergillosis and tuberculosis among health care workers involved in tuberculosis care in Uganda.

OBJECTIVES

Chronic pulmonary aspergillosis (CPA) often mimics pulmonary tuberculosis (PTB), leading to misdiagnosis and inappropriate management. We aimed to determine the baseline knowledge, practices, and self-rated confidence of health care workers (HCWs) regarding CPA in Uganda.

METHODS

Between January and April 2024, we conducted a cross-sectional survey involving HCWs at four public health facilities in Uganda currently enrolling patients with current or previously treated for PTB into a cohort study aimed at establishing the incidence of CPA. Data on sociodemographic characteristics, awareness, knowledge, practices regarding CPA, PTB, and finger-prick tests for point of care testing were collected using semi-structured questionnaires. Adequate knowledge was defined as a score of ≥80%.

RESULTS

A total of 110 HCWs participated, predominantly males (61, 57.5%), with a mean age of 38.8 years. Although most HCWs had heard of aspergillosis (78, 82.1%), only 23 (21.7%) demonstrated adequate knowledge about CPA. In addition, 25 (28.7%) reported encountering a patient with CPA in the past year, with 41 (47.1%) never routinely screening for CPA. Confidence in managing CPA was low among HCWs, with 29 (29.8%) expressing no confidence. Furthermore, only 22 (20.8%) had adequate knowledge about PTB. Referral hospital practice was significantly associated with higher odds of adequate CPA knowledge (adjusted odds ratio: 6.69, 95% confidence interval: 1.67-26.82, P = 0.007).

CONCLUSIONS

There are significant gaps in awareness, knowledge, and practices of HCWs in Uganda related to CPA and PTB. Strategies to enhance training, guideline dissemination, and diagnostic capacity are essential to improve the management of these respiratory conditions and reduce misdiagnosis.