Prevalence and Associated Factors of Tuberculosis Among Tea Estate Workers in Thyolo and Mulanje Districts, Malawi: A cross-sectional study
Benson Isake Chiwaka*, Emmanuel Francisco, Thomas Mwale, James Mpunga, Arnold Jumbe, Prisca Ngoma, Tisungane Mwenyenkulu, Balwani Mbakaya, Billy W Nyambalo, Master RO Chisale, Saul Eric Mwale, Frank Sinyiza, Kuzani Mbendera, Henry Kanyerere, Samuel Chirwa and Levi Luwanda
ABSTRACT
Background: Tuberculosis remains one of the major health problems in the tea gardens of tea growing countries worldwide. International Labour Organization recognizes TB as an occupational disease. Early diagnosis of people with TB helps to cut transmission of the disease and also lead to improved treatment outcomes. The World health organization launched the End TB strategy which aims at identifying all TB patients and putting them on treatment. Thyolo and Mulanje are the tea growing districts which has a high burden of TB and HIV in Malawi. There is paucity of data of TB burden among tea estate worker in Malawi. Therefore, this study was conducted to determine the prevalence and associated factors of TB among tea estate workers in Thyolo and Mulanje districts in Malawi.
Methods: A cross-section study was conducted in the tea estates of Thyolo and Mulanje targeting 1,068 estate tea workers. Multi stage random sampling was used to obtain a sample size of 1,068 study participants. Socio-demographic, employment and clinical data was collected using a structured questionnaire. Chest x-ray and gene x-pert machine were used to test the participants for TB. Ethical clearance was obtained from National Health Sciences Research Committee, letter of authorization was obtained from Tea Association of Malawi, and district councils of Thyolo and Mulanje and data analysis was
conducted using SPSS version 25.
Results: A total of 976 participants were included in the study representing 91.4% response rate. The prevalence of TB was found to be 1.84% which translates to 1840 TB cases per 100,000 population of the tea estate workers. Level of education (P=0.012), type of employment (p=0.019), HIV status (p=0.046) and history of TB among household contact (p=<0.001) were factors associated with TB infection.
Conclusion: Prevalence of TB among tea estate workers is high yet not included among high-risk group to be targeted for TB interventions in Malawi. Therefore, this calls for policy makers to strengthen prevention and control strategies among tea estate workers so to contribute to global agenda of ending TB by 2030.
