Tuberculosis and HIV Infections in Mining Fields: A Case of Osiri-Matanda Gold Mines in Nyatike Sub-County, Migori County, Kenya

Abstract

Most interventions towards tuberculosis (TB) infections in Kenya occur within the health facilities, including TB screening, laboratory-based and radiological testing, and treatment initiation for anyone found to be infected. Little is however done towards those not visiting the health facilities, yet may harbor TB disease and continue its spread in the community. This cross-sectional study sought to find out if such infections exist among miners at Osiri-Matanda gold mines in Nyatike Sub-County, Migori County, and to determine TB drug resistance (DR-TB) as well as TB-HIV co-infection among them. A TB risk assessment tool was used to capture the demographic information of participants consenting to the study. HIV testing was done via a finger-prick blood sample. Sputum was collected and tested for TB infection by the Ziehl-Neelsen (ZN) staining method. GeneXpert testing was used to confirm the positive microscopy results and to determine rifampicin (RIF) resistance. The resulting data was analysed alongside key demographic characteristics captured such as age, sex, gender, weight, height and BMI. A total of 297 participants took part in the study of which 49.5% (147) were males and 50.5% (150) were females. The age range was 63 (15-78) and median age 40. A TB positivity of 15.5% (46/297) was obtained. Overall positivity was highest at age 35-44 (39%) and lowest in those above 64 years (<5%). Males accounted for 71.7% (33/46) of infections while females were 28.3% (13). HIV infections among TB positive participants was 37%, with the highest co-infection rate being in males at 76.5% (13) compared to 23.5% (4) in females. There was no RIF-resistant TB identified. Fever, cough, weight loss, chest pain, and night sweats (p<0.0001) were found to be determining factors for TB infections. Tuberculosis infection occurs undetected in this community with infections being higher in males than in females. The age group to focus on is ages 25-44 where there's a steady rise in TB infections. Considerable intervention towards TB and HIV eradication including active case finding must target populations living a collegiate lifestyles like miners, students and fisher folk.