Improving TB care services among coal mine workers and their associated communities in Pakistan.

SETTING: Five major coal mining districts in Balochistan, Pakistan.

OBJECTIVES: To assess burden of TB among coal miners and their associated communities and establish linkages with TB care services.

DESIGN: A cross-sectional study was conducted to find TB cases through active case finding. The target population included people working at coal mining sites and surrounding communities residing within 10 km, including coal miners' families and other individuals. Verbal symptom screening was carried out via mobile camps and community outreach. Sputum was collected from screened positive individuals and tested for TB on GeneXpert. TB cases diagnosed were linked with TB care services.

RESULTS: A total of 14,541 individuals including 8,149 (56%) coal miners were screened. Of the people screened, 81% were male, median age was 31 years, 2,274 (15.6%) had TB symptoms, and 34 confirmed TB cases were diagnosed. All 34 TB patients were linked to care and 32 completed treatments successfully. The estimated TB prevalence was 234 cases per 100,000 population (95% confidence interval: 150.6-316.5), with no significant difference between coal miners and associated communities.

CONCLUSION: Similar TB prevalence among coal miners and associated communities reflects shared vulnerability. Use of more sensitive screening tools is recommended to validate prevalence estimates in future studies.