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MINE-TB

Challenge

The mining industry working conditions are a ripe environment for the transmission of TB and other infectious diseases.

The incidence of TB within the mining workforce is 10 times the WHO threshold for a health emergency, and is nearly three times the incidence rate in the general population.

An estimated 70% of cases go undetected, many of whom have no incentive to reveal any diagnosed conditions at the cost of rendering themselves unemployable and exposed to stigma among their families and communities.

Over 500,000 people employed in the mining industry in South Africa, many are highly susceptible to contracting TB due to prolonged exposure to silica dust, poor living conditions, and high HIV prevalence in mining communities. In addition, the circular movement of mine workers across provincial and national borders and a poor cross border health referral system fuels infection rates. There is a need to build an ecosystem of care cross cutting infectious diseases and other pertinent health challenges.

Our Approach

In 2014, IRD South Africa and Aurum institute partnered with the Provincial Department of Health (PDOH) to implement the MINE TB Project to increase TB and HIV case detection and treatment initiation in Ugu and eThekwini Districts in KwaZulu-Natal province.

By employing intensified case finding strategies, the MINE TB Project is aimed at combatting the high incidence of TB through a combination of facility and community-based screenings. A customized mHealth application has been designed to screen patients for TB and HIV. With better data quality, real time data collection, and improved supervision and monitoring of health workers, MINE TB offers a sustainable, scalable solution for optimizing the number of patients screened.

Using an integrated approach, the program invests in resources to effectively respond to this burgeoning epidemic. Quality sputum collection is promoted through the use of an adapted instructional video that is available in 5 local languages. Furthermore, health workers are incentivized, through conditional cash transfers, that are contingent on their productively levels around specific tasks, positive sputum submission samples and treatment initiation.

Impact

The MINE TB Program is a cost-effective, multi-site solution that has been deployed at 32 facilities in South Africa. Over 90,000 patients have been screened to date, of which more than 1,550 MTB+ cases have been identified and linked to the National TB program for counseling and treatment initiation.

 

References

“Tackling Tuberculosis in Southern Africa's Mineworkers with an Innovative Approach.” World Bank, 23 Mar. 2017, www.worldbank.org/en/news/feature/2017/03/23/tackling-tuberculosis-in-southern-africas-mineworkeres-with-an-innovative-approach. Accessed 29 Aug. 2017.

“TB in South Africa’s mines: A Peek into the Life of a Southern African Mineworker.” World Bank, 13 Feb. 2017, www.worldbank.org/en/news/feature/2017/02/13/tb-in-south-africas-mines-a-peek-into-the-life-of-a-southern-african-mineworker. Accessed 29 Aug. 2017.