Stop TB Partnership

Five-cent-a-day preventive treatment can reduce TB cases among miners by 63%


9 March 2012 - Johannesburg - Preliminary results from a research project carried out in South Africa show that gold miners who took a daily dose of isoniazid preventive treatment (IPT) on a daily basis for 9 months had 63% fewer cases of tuberculosis (TB) than a control group of miners who had no preventive treatment.

The Thibela Study, which was led by the Aurum Institute as part of the CREATE consortium, offered IPT treatment to eight mine shaft clusters of gold miners at three mining companies in South Africa over a five year period. A further seven clusters were enrolled as control groups.

The estimated half a million mine workers in South Africa have the highest TB incidence in the world, with an estimated rate of 3000 to 7000 cases per 100,000 population.

In addition to the evidence on the effectiveness of IPT, previously published findings from Aurum show that it was feasible and safe for mine workers to take the daily treatment for the nine month period of the study. Each daily dose of IPT - which comes in a single pill - costs around US five cents, equivalent to $20 for a year of preventive treatment.

The preliminary results did not show that offering IPT on a broad basis to the whole mining cluster results in a statistically significant effect in the number of incident TB cases. However, as the study was conducted on a voluntary basis, not all miners in the community agreed to take IPT and, of those that did, not all miners took their daily treatment for the full nine months.

Reacting to the study results, Dr Lucica Ditiu, Executive Secretary of the Stop TB Partnership, said "The study appears to show that, for people who are at a high-risk of developing active TB, taking IPT on a daily basis can have significant benefits. The promise of a cheap, effective and well targeted solution in a sector which is considered the tip of the spear in terms of TB in Africa is very exciting.

"It seems that Africa is not on track to reach the Millennium Development Goal of reducing TB deaths by 50% by 2015. But there is strong leadership and a huge amount of energy in the region. I think that we can draw on this energy to make a breakthrough in Africa that can inspire the rest of the world."

The mining industry is heavily dependent on migratory workers from rural areas and from surrounding countries, particularly Lesotho, Swaziland, Mozambique and Zimbabwe, making TB and mining a regional problem.

Three members of the Stop TB Partnership Coordinating Board, South African Health Minister Aaron Motsoaledi, Swaziland Health Minister Benedict Xaba and Lesotho Health Minister Dr Mphu Ramatlapeng raised this issue to the Southern African Development Community (SADC) agenda in November 2011.

Supported by the Stop TB Partnership, The World Bank and the International Organization for Migration and other partners, SADC met in Johannesburg on 7 to 8 March to draft a declaration on TB and mining which aims to which aims to set out the steps needed to free mine workers, their families and communities from TB.

The declaration is due to be signed by SADC heads of State in August in Maputo, Mozambique.