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Tytuł:
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Zambia Assessment of Tuberculosis (TB) and HIV in the Mines (ZATHIM): implications for programs and policies.
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Autorzy:
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Podewils LJ; Centers for Disease Control and Prevention, Atlanta, GA, USA. .; Emory University Rollins School of Public Health, Atlanta, GA, USA. .
Long EF; Centers for Disease Control and Prevention, Atlanta, GA, USA.; Emory University Rollins School of Public Health, Atlanta, GA, USA.
Fuller TJ; Centers for Disease Control and Prevention, Atlanta, GA, USA.; Emory University Rollins School of Public Health, Atlanta, GA, USA.
Mwakazanga D; Tropical Diseases Research Centre, Ndola, Zambia.
Kapungu K; Tropical Diseases Research Centre, Ndola, Zambia.
Tembo M; Tropical Diseases Research Centre, Ndola, Zambia.
Mwanza S; Tropical Diseases Research Centre, Ndola, Zambia.
Curran KG; Centers for Disease Control and Prevention, Atlanta, GA, USA.
Smith JP; School of Public Health, Yale University, New Haven, CT, USA.; Peraton, Atlanta, GA, USA.
Tobias JL; Centers for Disease Control and Prevention, Atlanta, GA, USA.; Peraton, Atlanta, GA, USA.
Kasongo W; Tropical Diseases Research Centre, Ndola, Zambia.
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Źródło:
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BMC public health [BMC Public Health] 2022 Apr 20; Vol. 22 (1), pp. 791. Date of Electronic Publication: 2022 Apr 20.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: London : BioMed Central, [2001-
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MeSH Terms:
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Health Knowledge, Attitudes, Practice*
Mining*/organization & administration
HIV Infections/*epidemiology
Health Services Accessibility/*statistics & numerical data
Tuberculosis/*epidemiology
Cough ; HIV Infections/diagnosis ; Health Personnel/psychology ; Health Services Accessibility/economics ; Health Services Accessibility/trends ; Humans ; Policy ; Social Determinants of Health/economics ; Social Determinants of Health/trends ; Tuberculosis/diagnosis ; Tuberculosis/prevention & control ; Zambia/epidemiology
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References:
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Int J Health Serv. 2013;43(4):639-49. (PMID: 24397231)
Int J Tuberc Lung Dis. 2017 May 1;21(5):571-578. (PMID: 28399973)
Am J Ind Med. 2009 Dec;52(12):901-8. (PMID: 19882740)
Am J Ind Med. 2010 Apr;53(4):398-404. (PMID: 19565628)
Biomed Res Int. 2016;2016:5928572. (PMID: 27274987)
PLoS One. 2012;7(6):e38598. (PMID: 22761688)
BMC Public Health. 2016 Aug 23;16(1):855. (PMID: 27552992)
Int J Health Serv. 2013;43(4):651-64. (PMID: 24397232)
PLoS One. 2016 Jan 15;11(1):e0146392. (PMID: 26771588)
Am J Public Health. 2011 Mar;101(3):524-30. (PMID: 20516372)
Health Commun. 2010 Dec;25(8):661-9. (PMID: 21153982)
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Contributed Indexing:
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Keywords: Africa; HIV; Healthcare; KAPs; Miners; Mining; Policy; TB
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Entry Date(s):
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Date Created: 20220420 Date Completed: 20220421 Latest Revision: 20220716
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Update Code:
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20240104
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PubMed Central ID:
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PMC9018205
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DOI:
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10.1186/s12889-022-13053-8
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PMID:
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35439984
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Background: Mineworkers in Southern Africa have the highest rates of tuberculosis (TB) among working populations in the world (The World Bank, Benefits and costs associated with reducing tuberculosis among Southern Africa's mineworkers, 2014), making mineworkers a key population for TB program efforts. The current evaluation aimed to characterize mineworkers and former (ex-) mineworkers, and assess knowledge, attitudes and practices related to TB and HIV care among mineworkers and healthcare workers (HCWs) in Zambia.
Methods: A mixed-methods evaluation of current and former (ex-) mineworkers and HCWs was conducted in the Copperbelt and North-Western provinces, Zambia. Knowledge, attitudes and practices (KAPs) related to TB care and policies were assessed using a structured survey. Focus Group Discussions (FGDs) were conducted with current and ex-mineworkers to understand perceptions, practices, and barriers related to accessing healthcare for TB.
Results: Overall, 2,792 mineworkers and 94 HCWs completed the KAP survey, and 206 (171 current, 71 ex-) mineworkers participated in FGDs. Mineworkers and ex-mineworkers were knowledgeable about TB symptoms (cough; 94%), transmission (81.7%) and treatment (99.2%). Yet, barriers to seeking care were evident with 30% of mineworkers experiencing cough, and 19% reporting 2 or more TB symptoms at the time of the survey. The majority of mineworkers (70.9%) were aware of policies barring persons from working after a diagnosis of TB, and themes from FGDs and HCW comments (n = 32/62; 51.6%) recognized fear of job loss as a critical barrier to providing timely screening and appropriate care for TB among mineworkers. The majority (76.9%) of mineworkers indicated they would not disclose their TB status to their supervisor, but would be willing to share their diagnosis with their spouse (73.8%).
Conclusion: Fear of job loss, driven by governmental policy and mistrust in mining companies, is a major barrier to healthcare access for TB among mineworkers in Zambia. As a result of these findings, the government policy prohibiting persons from working in the mines following TB disease is being repealed. However, major reforms are urgently needed to mitigate TB among mineworkers, including ensuring the rights of mineworkers and their communities to healthy living and working environments, improved social responsibility of mining companies, and facilitating choice and access to affordable, timely, and high-quality healthcare services.
(© 2022. The Author(s).)
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