Impact of Siliconis on Tuberculosis Treatment Outcomes in Kwekwe City, Midlands Province, Zimbabwe, 2022- 2024

Abstract

The co-existence of tuberculosis and silicosis may exacerbate treatment outcomes. Silicosis and tuberculosis are the diseases that have been targeted for elimination by 2030 globally. The study was aimed at determining the association of silicosis and unfavorable TB treatment outcomes in Kwekwe City. The study also aimed at exploring ways of improving treatment outcomes among silico-tuberculosis patients. A retrospective cohort was conducted among 165 male TB patients and 45 male silico TB patients admitted at Kwekwe General Hospital between 2022 and 2024 as well as 819 TB Patients and 11 silico -TB patients enrolled in Kwekwe City TB Registers between 2022 and 2024. The chi square test analysis was used to assess whether there is a statistically significant association between patients with silico-TB and having unfavorable treatment outcomes. This association was also assessed on TB patients without silicosis at 5% level of significance. In addition, Pearson’s Chi Square test statistic was also analyzed to assess if there is an association between silicosis and death, treatment failure and loss to follow-up. The statistical analysis was performed using SPSS and Epi info. The study therefore showed a 72.1% treatment success rate among TB patients admitted at Kwekwe Hospital and 27.9% death rate. Silico-TB had a 48.9% treatment success rate and a 51.1% death rate. For the Kwekwe City Clinics TB registers, TB treatment success rate was 84.9%, 0.8% death rate and 5.9% lost to follow up. Silico-TB treatment success rate was 54.5%, death rate 185 and loss to follow up rate was 27.2%. Controlling silicosis might decrease TB mortality and treatment failure in Kwekwe. Silicosis has a negative impact on TB treatment outcomes and it should be acknowledged as a co-morbidity of TB that should be included as a key risk factor in differentiated TB care approach. All TB patients need to be screened for silicosis regularly and all Silicosis patients need to be screened for TB regularly and initiated on TB preventive medicines. There is need to intensify health education on TB and Silicosis prevention and control including the occupation exposures that affect artisanal mining community of Kwekwe. Outreach programs for diagnosis, treatment and care for artisanal miners at their work areas need to be intensified so as to diagnose and treat these conditions early before they are complicated.