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Moyo D, Ncube R, Kavenga F, Chikwava L, Mapuranga T, Chiboyiwa N, Chimunhu C, Mudzingwa F, Muzvidziwa O, Ncube P, Mando TC, Moyo F, Chigaraza B, Masvingo H, Timire C. The Triple Burden of Tuberculosis, Human Immunodeficiency Virus and Silicosis among Artisanal and Small-Scale Miners in Zimbabwe. Int J Environ Res Public Health 2022; 19:ijerph192113822. [PMID: 36360701 PMCID: PMC9657277 DOI: 10.3390/ijerph192113822] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/09/2022] [Accepted: 10/17/2022] [Indexed: 05/31/2023]
Abstract
Artisanal and small-scale mining is characterized by an excessive exposure to silica-containing dust, overcrowding, poor living conditions and limited access to primary health services. This poses a risk to tuberculosis, HIV infection and silicosis. The main purpose of the study is to evaluate the burden of tuberculosis, HIV and silicosis among artisanal and small-scale miners. We conducted a cross sectional study on 3821 artisanal and small-scale miners. We found a high burden of silicosis (19%), tuberculosis (6.8%) and HIV (18%) in a relatively young population, with the mean age of 35.5 years. Men were 1.8 times more likely to be diagnosed with silicosis compared to women, adjusted prevalence ratio [aPR = 1.75 (95% CI: 1.02-2.74)]. Artisanal and small-scale miners who were living with HIV were 1.25 times more likely to be diagnosed with silicosis compared to those who were negative, [aPR = 1.25 (1.00-1.57)]. The risk of silicosis increased with both duration as a miner and severity of exposure to silica dust. The risk of tuberculosis increased with the duration as a miner. Zimbabwe is currently experiencing a high burden of TB, silicosis and HIV among artisanal and small-scale miners. Multi-sectoral and innovative interventions are required to stem this triple epidemic in Zimbabwe.
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Affiliation(s)
- Dingani Moyo
- Baines Occupational Health Services, Harare 024, Zimbabwe
- Occupational Health Division, School of Public Health, University of the Witwatersrand, Johannesburg 2000, South Africa
- Faculty of Medicine and Health Sciences, The National University of Science and Technology, Bulawayo 029, Zimbabwe
- Faculty of Medicine and Health Sciences, Midlands State University, P Bag 9005, Gweru 054, Zimbabwe
| | | | | | | | | | - Nathan Chiboyiwa
- Ministry of Health and Child Care, Harare 024, Zimbabwe
- Family Medicine, Global and Public Health Unit, Department of Primary Health Care Sciences, University of Zimbabwe, Harare 024, Zimbabwe
| | | | - Frank Mudzingwa
- Hospice and Palliative Care Association of Zimbabwe, Harare 054, Zimbabwe
| | | | | | - Tariro Christwish Mando
- Ministry of Health and Child Care, Harare 024, Zimbabwe
- Family Medicine, Global and Public Health Unit, Department of Primary Health Care Sciences, University of Zimbabwe, Harare 024, Zimbabwe
| | - Florence Moyo
- Baines Occupational Health Services, Harare 024, Zimbabwe
- Department of Health Sciences, Faculty of Sciences, Zimbabwe Open University, Harare 024, Zimbabwe
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Moyo D, Zishiri C, Ncube R, Madziva G, Sandy C, Mhene R, Siziba N, Kavenga F, Moyo F, Muzvidziwa O, Ncube P, Chigaraza B, Nyambo A, Timire C. Tuberculosis and Silicosis Burden in Artisanal and Small-Scale Gold Miners in a Large Occupational Health Outreach Programme in Zimbabwe. Int J Environ Res Public Health 2021; 18:ijerph182111031. [PMID: 34769551 PMCID: PMC8583466 DOI: 10.3390/ijerph182111031] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/04/2021] [Accepted: 09/07/2021] [Indexed: 12/24/2022]
Abstract
Artisanal and small-scale miners (ASMs) labour under archaic working conditions and are exposed to high levels of silica dust. Exposure to silica dust has been associated with an increased risk of tuberculosis and silicosis. ASMs are highly mobile and operate in remote areas with near absent access to health services. The main purpose of this study was to evaluate the prevalence of tuberculosis, silicosis and silico-tuberculosis among ASMs in Zimbabwe. A cross-sectional study was conducted from 1 October to 31 January 2021 on a convenient sample of 514 self-selected ASMs. We report the results from among those ASMs who attended an outreach medical facility and an occupational health clinic. Data were collected from clinical records using a precoded data proforma. Data variables included demographic (age, sex), clinical details (HIV status, GeneXpert results, outcomes of chest radiographs, history of tuberculosis) and perceived exposure to mine dust. Of the 464 miners screened for silicosis, 52 (11.2%) were diagnosed with silicosis, while 17 (4.0%) of 422 ASMs were diagnosed with tuberculosis (TB). Of the 373 ASMs tested for HIV, 90 (23.5%) were sero-positive. An HIV infection was associated with a diagnosis of silicosis. There is need for a comprehensive occupational health service package, including TB and silicosis surveillance, for ASMs in Zimbabwe. These are preliminary and limited findings, needing confirmation by more comprehensive studies.
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Affiliation(s)
- Dingani Moyo
- Baines Occupational Health Services, Harare 024, Zimbabwe; (G.M.); (F.M.); (O.M.); (P.N.); (B.C.)
- Occupational Health Division, School of Public Health, University of the Witwatersrand, Johannesburg 2193, South Africa
- Department of Community Medicine, Faculty of Medicine, Midlands State University, Gweru 054, Zimbabwe
- Department of Community Medicine, Faculty of Medicine, National University of Science and Technology, Bulawayo 029, Zimbabwe
- Correspondence: ; Tel.: +26-(37)-7215-0115
| | | | | | - Godknows Madziva
- Baines Occupational Health Services, Harare 024, Zimbabwe; (G.M.); (F.M.); (O.M.); (P.N.); (B.C.)
| | - Charles Sandy
- Ministry of Health and Child Care, Harare 024, Zimbabwe; (C.S.); (R.M.); (N.S.); (F.K.); (A.N.); (C.T.)
| | - Reginald Mhene
- Ministry of Health and Child Care, Harare 024, Zimbabwe; (C.S.); (R.M.); (N.S.); (F.K.); (A.N.); (C.T.)
| | - Nicholas Siziba
- Ministry of Health and Child Care, Harare 024, Zimbabwe; (C.S.); (R.M.); (N.S.); (F.K.); (A.N.); (C.T.)
| | - Fungai Kavenga
- Ministry of Health and Child Care, Harare 024, Zimbabwe; (C.S.); (R.M.); (N.S.); (F.K.); (A.N.); (C.T.)
| | - Florence Moyo
- Baines Occupational Health Services, Harare 024, Zimbabwe; (G.M.); (F.M.); (O.M.); (P.N.); (B.C.)
| | - Orippa Muzvidziwa
- Baines Occupational Health Services, Harare 024, Zimbabwe; (G.M.); (F.M.); (O.M.); (P.N.); (B.C.)
| | - Petronella Ncube
- Baines Occupational Health Services, Harare 024, Zimbabwe; (G.M.); (F.M.); (O.M.); (P.N.); (B.C.)
| | - Blessings Chigaraza
- Baines Occupational Health Services, Harare 024, Zimbabwe; (G.M.); (F.M.); (O.M.); (P.N.); (B.C.)
| | - Andrew Nyambo
- Ministry of Health and Child Care, Harare 024, Zimbabwe; (C.S.); (R.M.); (N.S.); (F.K.); (A.N.); (C.T.)
| | - Collins Timire
- Ministry of Health and Child Care, Harare 024, Zimbabwe; (C.S.); (R.M.); (N.S.); (F.K.); (A.N.); (C.T.)
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Khaji RA, Kabwebwe VM, Mringo AG, Nkwabi TF, Bigio J, Mergenthaler C, Aguilera Vasquez N, Pande T, Rahman MT, Haraka F. Factors Affecting Motivation among Key Populations to Engage with Tuberculosis Screening and Testing Services in Northwest Tanzania: A Mixed-Methods Analysis. Int J Environ Res Public Health 2021; 18:9654. [PMID: 34574579 DOI: 10.3390/ijerph18189654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/04/2021] [Accepted: 09/09/2021] [Indexed: 12/02/2022]
Abstract
In northwest Tanzania, many artisanal small-scale miners (ASMs) and female sex workers (FSWs) live in informal communities surrounding mines where tuberculosis (TB) is highly prevalent. An active case finding (ACF) intervention to increase TB case notification was undertaken in two districts. Alongside this, a study was implemented to understand engagement with the intervention through: (1) quantitative questionnaires to 128 ASMs and FSWs, who either engaged or did not engage in the ACF intervention, to assess their views on TB; (2) qualitative interviews with 41 ASMs and FSWs, 36 community health workers (CHWs) and 30 community stakeholders. The mean perceived severity of TB score was higher in the engaged than in the non-engaged group (p = 0.01). Thematic analysis showed that health-seeking behaviour was similar across both groups but that individuals in the non-engaged group were more reluctant to give sputum samples, often because they did not understand the purpose. CHWs feared contracting TB on the job, and many noted that mining areas were difficult to access without transportation. Community stakeholders provided various recommendations to increase engagement. This study highlights reasons for engagement with a large-scale ACF intervention targeting key populations and presents insights from implementers and stakeholders on the implementation of the intervention.
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