{
  "abstract": "Introduction High tuberculosis (TB) disease prevalences are reported among 50 million small-scale miners globally. We describe TB risk factors and TB treatment outcomes among small-scale miners, ex-miners and community members attending a screening program.Methods Between 11th-24th March 2024, miners and community members completed a questionnaire, chest Xray and were offered HIV testing. All miners and ex-miners were offered sputum Xpert MTB/RIF Ultra (Xpert) tests and, in a nested cohort of 280 miners, Mycobacterium Growth Indicator Tube culture. Community members were offered Xpert if symptomatic. Follow up Xpert was performed if CXRs were abnormal. WHO tuberculosis outcomes were recorded 9-months following screening. Modelling of risk factors for TB and TB-associated mortality is ongoing.Results Among 1341 participants, 59 (4.4%) had microbiological TB; these included 43/1122 (3.8%) current miners, 14/93 (15%) ex-miners, and 2/127 (1.6%) community members. Silicosis prevalence in current and ex-miners was 11% and 36%, respectively. No rifampicin resistant cases were identified. Microbiological TB prevalence in mines with >75% attendance was 15/277 (5.4%). Median work duration was higher among those with TB (13 years, IQR 8.5, 20 years) compared to those without TB (7.5 years, IQR 3, 15 years) and HIV was more common (10% vs 4%). Silicosis, TB and self-reported previous TB diagnoses clustered together ( figure 1). At 9 months following treatment, 10/66 (15%) of participants diagnosed with TB had died. Of these, three refused to start treatment and subsequently died, five died within 6 weeks of starting treatment and two over 6 months after starting treatment. Two participants, both of whom died over 6 months after starting treatment, were HIV positive. Those who died on treatment were more likely to report weight loss at presentation, compared to those who did not die (86% vs 21%) but did not appear more likely to have silicosis (29% vs 44%).Abstract M37 Figure 1A Euler Venn diagram of miner and ex-miner participants with silicosis, previous tuberculosis and active tuberculosis (n = 1145; complete cases)Conclusion As expected from our previous systematic review, TB prevalence was very high and associated with work exposures and silicosis. More concerningly, and despite a largely active workforce sample with relatively low HIV prevalence, mortality was high. Limitations include possible selection bias and underdiagnosis of clinical TB.",
  "authors": [
    {
      "affiliations": [
        "Imperial College London, London, UK"
      ],
      "name": "P Howlett"
    },
    {
      "affiliations": [
        "Kibongoto Infectious Diseases Hospital, Kilimanjaro, Tanzania"
      ],
      "name": "B Said"
    },
    {
      "affiliations": [
        "Kibongoto Infectious Diseases Hospital, Kilimanjaro, Tanzania"
      ],
      "name": "E Mwanga"
    },
    {
      "affiliations": [
        "Imperial College London, London, UK"
      ],
      "name": "A Amaral"
    },
    {
      "affiliations": [
        "Imperial College London, London, UK"
      ],
      "name": "OM Kon"
    },
    {
      "affiliations": [
        "Imperial College London, London, UK"
      ],
      "name": "J Feary"
    },
    {
      "affiliations": [
        "Kibongoto Infectious Diseases Hospital, Kilimanjaro, Tanzania"
      ],
      "name": "S Mpagama"
    }
  ],
  "title": "M37 The burden and determinants of tuberculosis among small-scale miners and community members in Northern Tanzania",
  "uid": "54f8fce9-bbac-5369-8623-17d7cbe06a86"
}