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ORIGINAL ARTICLE
Open Access

Implementation and Cost Analysis of a Novel Silicosis Case-Finding Program For Mine Workers in Rural Rwanda

Robert Tumusime, Michael S. Miller, Anne Niyigena, Symaque Dusabeyezu, Pierrot Uwitonze, Emmanuel Harerimana, Grace Umugiraneza, Wellars Dusingizimana, Samuel Hatfield, Stella Savarimuthu, Juliana Lawrence, Pacifique Hagenimana, Jean Marie Vianney Ngenzi, Aristarque Murara, Phoebe Mwiseneza, Paul Sonenthal, Vincent K. Cubaka, Fredrick Kateera and Innocent Kamali
Global Health: Science and Practice April 2024, 12(2):e2300290; https://doi.org/10.9745/GHSP-D-23-00290
Robert Tumusime
aPartners In Health-Rwanda/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
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Michael S. Miller
bDepartment of Medicine, Brigham and Women’s Hospital, Boston, MA, USA.
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  • For correspondence: mmiller2493@gmail.com
Anne Niyigena
aPartners In Health-Rwanda/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
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Symaque Dusabeyezu
aPartners In Health-Rwanda/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
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Pierrot Uwitonze
aPartners In Health-Rwanda/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
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Emmanuel Harerimana
aPartners In Health-Rwanda/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
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Grace Umugiraneza
aPartners In Health-Rwanda/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
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Wellars Dusingizimana
cMinistry of Health of Rwanda, Kigali, Rwanda.
dRwinkwavu District Hospital, Kayonza, Rwanda.
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Samuel Hatfield
eDepartment of Medicine, University of California at San Francisco, San Francisco, CA, USA.
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Stella Savarimuthu
fDepartment of Medicine, Yale New Haven Hospital, New Haven, CT, USA.
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Juliana Lawrence
bDepartment of Medicine, Brigham and Women’s Hospital, Boston, MA, USA.
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Pacifique Hagenimana
aPartners In Health-Rwanda/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
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Jean Marie Vianney Ngenzi
gWolfram Mining and Processing Ltd, Kigali, Rwanda.
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Aristarque Murara
gWolfram Mining and Processing Ltd, Kigali, Rwanda.
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Phoebe Mwiseneza
cMinistry of Health of Rwanda, Kigali, Rwanda.
dRwinkwavu District Hospital, Kayonza, Rwanda.
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Paul Sonenthal
hDivision of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, MA, USA.
iHarvard Medical School, Boston, MA, USA.
jPartners In Health, Boston, MA, USA.
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Vincent K. Cubaka
aPartners In Health-Rwanda/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
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Fredrick Kateera
aPartners In Health-Rwanda/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
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Innocent Kamali
aPartners In Health-Rwanda/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
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Figures & Tables

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  • FIGURE 1
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    FIGURE 1

    Flow of Silicosis Case-Finding Program Activities, Rwanda

  • FIGURE 2
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    FIGURE 2

    Linkage to Care Protocol for Individuals With Suspected Silicosis

    Abbreviation: PMF, progressive massive fibrosis.

  • FIGURE 3
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    FIGURE 3

    Linkage to Care Protocol for Individuals With Non-Silicosis Identified Illnesses

    Abbreviations: BP, blood pressure; COPD, chronic obstructive pulmonary disease; FEV1, forced expiratory volume in 1 second; NCD, noncommunicable disease clinic; RHC, Rwinkwavu Health Center.

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    TABLE.

    Ingredient-Based Cost Analysis of Silicosis Case-Finding Program Activities, Rwanda

    CategoryQuantity

    DaysUsed

    Lifespan,Years

    Total ProgramCost, US$

    Total Cost Per PersonTested, US$

    Screening staff    
     PIH/IMB permanent staff650N/A17,973.5917.42
     Hospital clinical staff730N/A2,631.772.55
     Radiologist consultant112N/A2,000.001.94
     Data collectors230N/A1,508.571.46
      Subtotal24,113.9323.37
    Training and meeting supplies   
     Conference room17N/A533.330.52
     Food and drinks156N/A678.570.66
     T-shirts100N/AN/A842.860.82
      Subtotal2,054.761.99
    Transport   
     Driver for on-site education17N/A114.910.11
     Car for the field visit1715136.750.13
     Fuel, L47N/A41.650.04
      Subtotal293.320.28
    Data collection materials   
     Tablets625358.970.06
     Printing costs8225N/A195.240.19
      Subtotal306.590.30
    Screening day refreshments   
     Drinks13625N/A2,104.762.04
     Snacks14025N/A500.000.48
      Subtotal2,604.762.52
    Medical supplies and materials   
     Glucometers22550.690.01
     Strips and lancets4125N/A241.120.23
     Blood pressure machine22532.980.00
     Chest X-ray tests4125N/A6,567.816.36
     Alcohol swabs4125N/A7.810.01
     Cotton rolls (500 mg)225N/A66.670.06
     Gloves4125N/A19.520.02
     Waste bags1025N/A142.860.14
     Dust bins52553.530.01
     Safety boxes225N/A133.330.13
     Spirobank II Basic6251075.870.07
     Disposable mouthpieces4125N/A2,050.001.99
      Subtotal  9,312.199.02
    Totals   38,685.5537.49
    • Abbreviations: N/A, not applicable; PIH/IMB, Partners In Health/Inshuti Mu Buzima.

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Global Health: Science and Practice: 12 (2)
Global Health: Science and Practice
Vol. 12, No. 2
April 29, 2024
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Implementation and Cost Analysis of a Novel Silicosis Case-Finding Program For Mine Workers in Rural Rwanda
Robert Tumusime, Michael S. Miller, Anne Niyigena, Symaque Dusabeyezu, Pierrot Uwitonze, Emmanuel Harerimana, Grace Umugiraneza, Wellars Dusingizimana, Samuel Hatfield, Stella Savarimuthu, Juliana Lawrence, Pacifique Hagenimana, Jean Marie Vianney Ngenzi, Aristarque Murara, Phoebe Mwiseneza, Paul Sonenthal, Vincent K. Cubaka, Fredrick Kateera, Innocent Kamali
Global Health: Science and Practice Apr 2024, 12 (2) e2300290; DOI: 10.9745/GHSP-D-23-00290

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Implementation and Cost Analysis of a Novel Silicosis Case-Finding Program For Mine Workers in Rural Rwanda
Robert Tumusime, Michael S. Miller, Anne Niyigena, Symaque Dusabeyezu, Pierrot Uwitonze, Emmanuel Harerimana, Grace Umugiraneza, Wellars Dusingizimana, Samuel Hatfield, Stella Savarimuthu, Juliana Lawrence, Pacifique Hagenimana, Jean Marie Vianney Ngenzi, Aristarque Murara, Phoebe Mwiseneza, Paul Sonenthal, Vincent K. Cubaka, Fredrick Kateera, Innocent Kamali
Global Health: Science and Practice Apr 2024, 12 (2) e2300290; DOI: 10.9745/GHSP-D-23-00290
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  • Article
    • ABSTRACT
    • INTRODUCTION
    • SILICOSIS CASE-FINDING PROGRAM DESCRIPTION
    • METHODS
    • KEY FINDINGS
    • DISCUSSION AND LESSONS LEARNED
    • CONCLUSION
    • Acknowledgments
    • Funding
    • Author contributions
    • Competing interests
    • Notes
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