Ethel Rambiki, Andrew Dimba, Pilirani Banda, Wingston Ng'ambi, Knox Banda, Belaineh Girma, Birru Shight, Levi Lwanda, Isaias Dambe, Jaya Prasad Tripathy, Mumbi Chola, Pascalina Chanda-Kapata, James Mpunga, Damson Kathyola
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引用次数: 11
Abstract
Introduction: Miners in sub-Saharan Africa have a greater risk of tuberculosis (TB) than any other working population in the world. In spite of the presence of large and vulnerable population of miners in Malawi, no previous study has aimed to assess the burden of TB among these miners. This study aimed to determine the prevalence of pulmonary tuberculosis (PTB) and health-seeking behaviour (HSB) in a population of miners in Malawi, and a range of associated factors. Our goal was to develop a method to identify missing cases of TB.
Methods: We conducted a cross-sectional study in the Karonga, Rumphi, Kasungu and Lilongwe districts of Malawi in 2019. We calculated frequencies, proportions, odds ratios (ORs) and their 95% confidence intervals (95% CIs), and used the chi-square test in STATA version15.1 to investigate the burden and magnitude of PTB in the mining sector. Bivariate and multivariate logistic regression models were also fitted for PTB and HSB.
Results: Of the 2400 miners approached, we were able to interview 2013 (84%). Of these, 1435 (71%) were males, 1438 (71%) had known HIV status and 272 (14%) had PTB. Multivariate analysis showed that the miners performing informal mining were 50% more likely to develop PTB compared with those in formal mining (adjusted odds ratio [AOR]=1.50, 95% CI: 1.10-2.05, P=0.01). A total of 459 (23% of 2013) miners had presumptive TB. Of these, 120 (26%) sought health care; 80% sought health care at health facilities. Multivariate analysis also showed that miners who experienced night sweats were less likely to seek health care compared with those without night sweats (AOR=0.52, 95% CI: 0.30-0.90, P=0.02).
Conclusion: The prevalence of PTB was higher among miners than in the general population. Consequently, targeted TB screening programmes for miners may represent a suitable strategy to adopt if we are to end TB by 2030. Poor health-seeking behaviours among miners is worrisome and further qualitative research is necessary to understand the barriers to accessing health care in these settings.
期刊介绍:
Driven and guided by the priorities articulated in the Malawi National Health Research Agenda, the Malawi Medical Journal publishes original research, short reports, case reports, viewpoints, insightful editorials and commentaries that are of high quality, informative and applicable to the Malawian and sub-Saharan Africa regions. Our particular interest is to publish evidence-based research that impacts and informs national health policies and medical practice in Malawi and the broader region.
Topics covered in the journal include, but are not limited to:
- Communicable diseases (HIV and AIDS, Malaria, TB, etc.)
- Non-communicable diseases (Cardiovascular diseases, cancer, diabetes, etc.)
- Sexual and Reproductive Health (Adolescent health, education, pregnancy and abortion, STDs and HIV and AIDS, etc.)
- Mental health
- Environmental health
- Nutrition
- Health systems and health policy (Leadership, ethics, and governance)
- Community systems strengthening research
- Injury, trauma, and surgical disorders