Implementation and Cost Analysis of a Novel Silicosis Case-Finding Program For Mine Workers in Rural Rwanda.

Area of Science:

• Public Health
• Occupational Medicine
• Epidemiology

Background:

• Silicosis burden in Africa is largely unknown, despite significant mining and construction risks.
• Implementation and costs of occupational lung disease case-finding in resource-limited settings are poorly understood.

Purpose of the Study:

• To describe the first silicosis case-finding project in rural Rwanda.
• To assess the feasibility and cost of integrating occupational lung disease screening with noncommunicable disease screening.

Main Methods:

• Utilized chest X-ray, symptom questionnaires, and spirometry for silicosis case-finding.
• Integrated screening with routine noncommunicable disease case-finding for diabetes and hypertension.
• Conducted an ingredient-based cost analysis of all case-finding activities.

Main Results:

• 1,032 mine workers were enrolled, with 98.3% completing silicosis case-finding activities.
• The total program cost was US$38,656, averaging US$37.49 per person.
• Demonstrated successful integration of occupational and noncommunicable disease screening.

Conclusions:

• Large-scale occupational lung disease case-finding is clinically and economically viable in resource-limited environments.
• Integrating occupational lung disease screening with existing noncommunicable disease programs is effective.