RT Journal Article
SR Electronic
T1 Implementation and Cost Analysis of a Novel Silicosis Case-Finding Program For Mine Workers in Rural Rwanda
JF Global Health: Science and Practice
JO GLOB HEALTH SCI PRACT
FD Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs
SP e2300290
DO 10.9745/GHSP-D-23-00290
VO 12
IS 2
A1 Tumusime, Robert
A1 Miller, Michael S.
A1 Niyigena, Anne
A1 Dusabeyezu, Symaque
A1 Uwitonze, Pierrot
A1 Harerimana, Emmanuel
A1 Umugiraneza, Grace
A1 Dusingizimana, Wellars
A1 Hatfield, Samuel
A1 Savarimuthu, Stella
A1 Lawrence, Juliana
A1 Hagenimana, Pacifique
A1 Ngenzi, Jean Marie Vianney
A1 Murara, Aristarque
A1 Mwiseneza, Phoebe
A1 Sonenthal, Paul
A1 Cubaka, Vincent K.
A1 Kateera, Fredrick
A1 Kamali, Innocent
YR 2024
UL http://www.ghspjournal.org/content/12/2/e2300290.abstract
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.