Evaluation of the diagnostic capacity for neglected tropical diseases in a refugee settlement in Uganda: a cross-sectional study.

Abstract

BACKGROUND: Neglected tropical diseases (NTDs) pose a substantial global public health challenge, particularly in vulnerable refugee populations. In Uganda, approximately 1.8 million refugees residing in settlements nationwide, including over 145,000 in Nakivale alone, are at risk, yet primary healthcare (PHC) facility capacity within refugee settlements to effectively manage these diseases remains underexplored. This study assessed infrastructure, diagnostic capabilities, and resource availability for NTD management in health facilities across Nakivale Refugee Settlement, Uganda. METHODS: A quantitative assessment was conducted across 8 health facilities (6 Health Centre III, 2 Health Centre IV) in Nakivale Refugee Settlement. Data collection included facility type, bed capacity, dedicated laboratory services and personnel, availability of diagnostic tests and guiding tools, status of reporting systems, and essential medicines and laboratory supplies for soil-transmitted helminths (STH) and schistosomiasis. Descriptive statistics summarized findings. RESULTS: The 8 assessed facilities (6 HCIII, 2 HCIV) averaged 23 and 50 beds, respectively. All facilities reported dedicated laboratories with technicians and microscopes. Diagnostic tests (microscopes, dyes, assay strips) and guiding tools (clinical guidelines, laboratory protocols, bench aids) were consistently available, though specific test types varied. Five out of eight (62.5%) facilities had Health Management Information System reporting forms. Essential medicines, albendazole and mebendazole, were available in most facilities (7 had both, 1 had albendazole only). Common laboratory supplies (e.g., centrifuge tubes, syringes) were universal, but critical items like cellophane and Kato-Katz templates were absent in all facilities. Most facilities were over 10 km from the town council, the service hub. CONCLUSION: Health facilities in Nakivale Refugee Settlement possess foundational infrastructure for NTD management, including laboratories, microscopes, and essential medicines. However, significant gaps exist in specific diagnostic supplies (e.g., Kato-Katz templates, cellophane) and reporting system completeness. Their predominantly remote location also highlights potential access challenges. Addressing these gaps through targeted provision of laboratory consumables, strengthening reporting, and considering geographical accessibility is crucial for enhancing PHC capacity to manage NTDs in this refugee setting.