Addressing tuberculosis in artisanal and small-scale mining activities in sub-Saharan Africa: meta-analysis and a call for actions

Background Tuberculosis (TB) is a significant health issue in sub-Saharan African (SSA) countries, and artisanal mining (AM) may be a contributing factor. However, no systematic review has investigated the association between AM and TB in SSA. Therefore, this study aims to assess the burden of TB among artisanal miners in SSA. Methods We conducted a comprehensive search of PubMed, Medline-OVID, EMBASE, and Scopus databases for studies on AM and TB published up to January 25, 2022. We presented the findings of seven studies that met our inclusion criteria narratively and through figure synthesis, and used inverse-variance weighted random-effects models to combine effect estimates for meta-analysis. Results The overall prevalence of TB among artisanal workers was estimated to be 15% (95%CI: 8, 23), with higher rates in high TB burden countries (19%, 95%CI: 11, 28) compared to upper-moderate burden countries (8%, 95%CI: 3, 19. Further, exposure to silica dust, a common byproduct of AM, significantly increased the incidence of TB, with a pooled relative risk of 2.19 (95% CI: 1.77, 2.71). Additionally, we found that a higher number of artisanal miners in Ghana was associated with a reduction in TB incidence. Conclusion Our findings suggest that exposure to silica dust in AM is a neglected but a significant risk factor for TB in SSA. More studies and efforts are needed to address this threat to TB control.