Targeted Tuberculosis Case Finding Interventions in Six Mining Shafts in Remote Districts of Oromia Region in Ethiopia
Together with Borena and Guji zonal health department and the Oromia Regional Health Bureau (RHB), MSH, through the HEAL TB project (December 2015-June 2016) and now through Challenge TB (December 2016-present), identified six districts within the mining areas. Six woreda coordinators were trained and deployed to coordinate case finding and treatment observation. These are health care workers with TB program experience in the Borena and Guji zones in the mining areas.
A GeneXpert machine was also provided to one health center for use as a primary diagnostic tool for miners. Motorbikes were bought for sample transportation for all mining woredas in the zones. The project also provided technical support on the mentoring, supportive supervision and capacity building of health care workers engaged in TB case evaluation and diagnosis in the health facilities in the mining districts.
The project identified 55 active volunteers and 81 women developmental armies to support the health education and social mobilization with the coordinators. During the nine months of the intervention, health education and sensitization on TB and TB/HIV was provided to 22,525 miners, 23 catchment area meetings were conducted, and an estimated 42,678 workers were engaged in informal gold mining activities. In addition, 23 PHCU catchment area meetings were conducted.
The recruited coordinators provided health education for the mining workers at the mining shafts and screened the workers for TB using the symptomatic TB screening recommended by WHO. The presence of any one of the following signs or symptoms in an individual is diagnosed as a presumptive TB case:
- Two or more weeks of cough;
- Fever persisting for more than
- two weeks;
- Night sweating for at least two
- weeks; and
- Weight loss.
Among HIV infected individuals, the presence of the aforementioned symptoms of any duration is taken as a presumptive TB case. The coordinators referred presumptive TB cases to a nearby health center for TB evaluation and AFB or GeneXpert. They also served as TB treatment supporters for those who started anti-TB medications. In addition, the coordinators carried out contact investigation for individuals who had come into close contact with the presumptive cases.