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DOTS for temporary workers in the agricultural sector. An exploratory study in tuberculosis case detection
M Clarke1, J Dick, M Zwarenstein
1Department of Public Health Sciences, Division of International Health (IHCAR), Karilinska Institutet, Stockholm, Sweden.
Curationis
|March 19, 2004
Summary
Tuberculosis is a significant health issue among temporary farm workers in South Africa, with a high prevalence rate found in this study. Access to anti-tuberculosis treatment for diagnosed individuals requires further investigation.
Area of Science:
- Public Health
- Epidemiology
- Infectious Diseases
Background:
- South Africa's Boland health district faces high tuberculosis (TB) incidence and prevalence.
- A 1998 survey revealed 65% of farm workers were temporarily employed, commuting daily from surrounding communities.
Purpose of the Study:
- To estimate the point prevalence of sputum smear-positive tuberculosis among temporary farm workers.
- To assess access to anti-tuberculosis treatment for diagnosed farm workers.
Main Methods:
- A cross-sectional, active case-finding survey was conducted.
- The study focused on adult temporary farm workers not residing on farms in the Boland health district.
Main Results:
- The total point prevalence of tuberculosis was 10 cases per 100,000 temporary farm workers (2,809 per 100,000).
- Six new sputum smear-positive tuberculosis cases were detected, yielding a prevalence rate of 1,685 per 100,000.
- Among self-reported cases, treatment access varied, with one worker having depleted medication.
Conclusions:
- Tuberculosis poses a major and potentially increasing health threat in the region, exacerbated by HIV/AIDS.
- The shift towards a temporary agricultural workforce may hinder healthcare access for farm workers.
- Effective early detection and management of tuberculosis in this high-risk group present a challenge for the South African health system.