ABSTRACT
Zambia is among the sub-Saharan countries highly burdened with tuberculosis (TB) and has an estimated prevalence rate of 638 per 100 000 population in those aged 15 years and above. The mining industry is the main contributor to the country's gross national product, although it is associated with public health challenges, with TB in the mines being among the occupational health diseases having a negative economic impact and threatening to delay the control of TB in the country. We reviewed available evidence on the extent of the burden of TB in the mines so as to inform the development of targeted interventions for the post-2015 End TB Strategy. This was a review of published data from Medline/Pubmed, Cochrane Library and Embase, including unpublished “grey” literature on the burden of TB and the risk factors of TB in the mines of Zambia. There is limited research in Zambia to fully understand the burden of TB and risk factors associated with TB in the mines. However, the few studies and data available have shown that TB is a significant health problem requiring interventions to improve the quality of life of miners, ex-miners and surrounding communities. TB is a potential problem in the mines of Zambia and the actual burden needs to be determined. Exposure to silica as a risk factor needs further investigation.
ABSTRACT
Objective: To assess the prevalence of HIV infection, to highlight HIV-testing refusal rates among participants in a population-based tuberculosis survey and to assess the implication for programme implementation. Methods: This cross-sectional study on the characteristics of participants who refused HIV testing was conducted in a national survey in Zambia. All eligible participants were aged above 15 years and included in the analysis. Results: Out of the 44 791 tuberculosis survey participants, 14 164 (31.6%) refused to participate in HIV testing. The unemployed, rural dwellers, married, and those aged 15- 24 years were associated with higher refusal rates. Conclusions: Strategies to improve HIV testing acceptance are necessary. Qualitative research is recommended to understand the reasons for testing refusals so that remedial interventions can be implemented.