Client showing TB prevention- cough etiquette.
Though TB Prevalence rates in Copper belt province in Zambia, is mainly attributed to the occupational risks associated with the mines, the burden of TB among mine workers and mining communities is not entirely known. The Workmen’s Compensation Act and the Occupational Health and Safety Act stipulates that any mine worker diagnosed with either TB or silicosis should not work in a scheduled area of the mine.
This has proved to be a barrier to seeking care for TB within the mine health institutions. Furthermore, the potential for loss of employment and income due to TB diagnosis prevents care seeking by this population-high risk for spread of TB. Miners also offer false addresses, hence lost to followup.
Open pit mine and dust emission- silica exposure In 2017, through a situation analysis of TB in the mines as well as the review of TB diagnosis through mandatory annual screening of mine employees showed that the prevalence of TB was not much different from that in the districts where the mines are located.
Therefore, training for health workers including a component of TB treatment supporter supervision is being conducted and this has solidified the community sensitisation. The districts helped the community volunteers who include former miners to recognize that the undiagnosed and untreated TB patient is the main source of infection in the communities.
All volunteers were trained as well as other care providers operating outside the TB networks. Volunteers conduct door to door sensitization and sputum collection from Ex-Miners and their families using trained field officers in order to increase case detection. Sensitization is also conducted in schools through drama performances and debate.
Other initiates include active screening of all clients and patients seeking health care to find the missing TB patients. One facility in Luanshya district reported an increase in detection of presumptive TB cases within four months (9 to 59). Increased case detection facilitates reduction in TB cases in the community once the identified cases are successfully treated.
Luanshya district TB coordinator has appreciated the implementation of the TB in the mines iniative which has helped improve case detection through community sensitization and sputum collection from presumptive TB cases.