PT  - JOURNAL ARTICLE
AU  - Tumusime, Robert
AU  - Miller, Michael S.
AU  - Niyigena, Anne
AU  - Dusabeyezu, Symaque
AU  - Uwitonze, Pierrot
AU  - Harerimana, Emmanuel
AU  - Umugiraneza, Grace
AU  - Dusingizimana, Wellars
AU  - Hatfield, Samuel
AU  - Savarimuthu, Stella
AU  - Lawrence, Juliana
AU  - Hagenimana, Pacifique
AU  - Ngenzi, Jean Marie Vianney
AU  - Murara, Aristarque
AU  - Mwiseneza, Phoebe
AU  - Sonenthal, Paul
AU  - Cubaka, Vincent K.
AU  - Kateera, Fredrick
AU  - Kamali, Innocent
TI  - Implementation and Cost Analysis of a Novel Silicosis Case-Finding Program For Mine Workers in Rural Rwanda
AID  - 10.9745/GHSP-D-23-00290
DP  - 2024 Apr 29
TA  - Global Health: Science and Practice
PG  - e2300290
VI  - 12
IP  - 2
4099  - http://www.ghspjournal.org/content/12/2/e2300290.short
4100  - http://www.ghspjournal.org/content/12/2/e2300290.full
SO  - GLOB HEALTH SCI PRACT2024 Apr 29; 12
AB  - Key FindingsA novel case-finding program for silicosis was developed and implemented for mine workers working in semi-industrial mines that included education about causes and protection, symptom screening for silicosis and TB, chest X-ray, spirometry, and screening for hypertension and diabetes.Of the 1,032 mine workers enrolled in the program, 95 (9.2%) had radiographic evidence of silicosis, 221 (21.6%) screened positive for hypertension, and 12 (1.1%) had elevated glucose readings.Partnership between private employers, the Ministry of Health, and nongovernmental organizations is essential for occupational lung disease case-finding and linkage to care.Key ImplicationOccupational lung disease case-finding can be integrated with routine noncommunicable disease case-finding to reduce costs and improve comprehensive linkage to care.Little is known about the burden of silicosis in Africa, despite extensive mining and construction operations in the region putting numerous people at risk. The implementation experience and costs of case-finding for occupational lung disease in resource-limited settings are also currently unknown. We describe the first-ever silicosis case-finding project in rural Rwanda using chest X-ray, symptom questionnaires, and spirometry. This was coupled with routine noncommunicable disease case-finding for diabetes and hypertension. We performed an ingredient-based analysis of the costs of all case-finding activities. In 2022, over 25 days, 1,032 mine workers were included in the program, of which 1,014 (98.3%) completed silicosis case-finding activities. The total cost of the program was estimated to be US$38,656, representing a cost of US$37.49 per person. We conclude that conducting large-scale occupational lung disease case-finding is clinically and economically feasible in resource-limited settings and can be effectively integrated with routine noncommunicable disease case-finding.