Case Study

Malawi – TB Services to mining and construction workers through Mobile Clinics

Patients are waiting in line to get the X-ray screening for TB in a Mobile Clinic in Malawi

Malawi faces a significant burden of TB, particularly among miners, who account for 14% of the TB prevalence. Despite this, efforts to address TB among key populations have been limited. In 2023, the National TB and Leprosy Elimination Program collaborated with mining and construction companies to conduct targeted TB screening in 48 companies.

Mobile TB screening deployment

Delft Mobile Clinics equipped with EasyDR digital X-ray, CAD4TB, and GeneXpert were deployed to screen workers and host communities.

Parallel screening approach

TB screening combined symptom assessment and digital chest X-ray with CAD4TB.

Presumptive TB identification

Individuals identified as presumptive TB were referred for further evaluation.

Molecular confirmation

Presumptive TB cases were evaluated using Xpert testing.

Result

In 2023,

5 ,461 individuals
were screened
34 1 people
showed presumptive TB
  • 51 (14.9%) were diagnosed with active TB: 31 (60.8%) were bacteriologically confirmed, and 20 (39.2%) were clinically diagnosed.
  • The data highlighted a significant occupational risk, with a substantial number of TB cases among mine workers.
Patients are waiting in line to get the X-ray screening for TB in a Mobile Clinic in Malawi
Conclusion
  • Targeted TB screening yielded a high number of TB cases, underscoring the urgent need for expanded efforts among key populations.
  • The program needs to conduct regular TB screening in mining and construction companies and include more sites across the country.

REFERENCE: Mbendera, K. et al (2024, November 12-15). Scaling up targeted TB screening among miners and construction workers in Malawi: A collaborative approach towards TB elimination [Presentation]. The Union World Conference on Lung Health, Bali, Indonesia.