Introduction: Workers with occupational exposure to respirable silica dust like casual labourers at road construction sites (RCSs) are known to be at a high risk of developing pulmonary tuberculosis (TB). There is limited literature about the burden of PTB among this sub-population with high occupational exposures to silica dust at road construction sites. We aimed to determine the prevalence of PTB among casual labourers working at road construction sites in Central Uganda. Methods: We enrolled 297 participants by consecutive sampling into a cross-sectional study in September 2022 at four road construction sites in four districts in Central Uganda. A structured questionnaire was administered and the PTB cases were identified using a Gene Xpert and/or Computer Aided Detection for TB (CAD4TB). Data were analyzed in STATA version 17.0. Descriptive statistics adjusted for clustering were used to summarize the data and the relationship between PTB and independent variables were assessed using a mixed effects modified Poisson regression model to estimate the adjusted prevalence ratios. Results: Most participants were males (95.6% (284/297)), median age was 29 years [Interquartile range (IQR); 25, 33]. The prevalence of PTB among casual labourers was 2.4% (95% CI: 1.9, 2.8). Being vaccinated with BCG (3.45, 95% CI (1.02, 11.61)), alcohol use (2.70, 95% CI (1.52, 4.80)) and staying in overcrowded house (8.13, 95% CI (4.37, 15.12)) were positively associated with having PTB.s Conclusion: There is a high prevalence of PTB among casual labourers working at road construction sites in Central Uganda. Individuals who had never been vaccinated with BCG, alcohol users and those staying in overcrowded houses were at an increased risk of having PTB. We recommend routine screening of casual labourers at road construction sites to optimize active TB case finding.

Silicosis, Uganda,, Medical and health sciences, CAD4TB, Casual labourers, Chest X-ray, Gene Xpert, road construction, tuberculosis (TB)