Preventing Workplace Transmission of Tuberculosis in a High Tuberculosis Endemic Country

摘要

Objective Scope: Papua New Guinea is a developing country with a high incidence rate of tuberculosis (TB) and drug resistance TB. For 2015, the World Health Organization (WHO) reported an incidence rate of 432 / 100,000 population with an estimated 3.4% of cases being multi drug resistance TB. In order to protect our workers, ExxonMobil PNG Limited (EMPNG), as the operator of the PNG LNG Project, implemented a TB Control Plan at our work sites to detect and prevent the spread of TB among our workforce. An outbreak of TB at the work place would result in significant disruption in operations resulting in a drop of productivity. Methods, Procedures, Process: The TB control plan is implemented at all work sites where workers work and live together i.e. where there are camps or dormitories. The program covers all workers including short- term visitors who spend more than 30 days per year at a camp. The components of the TB Control plan are i) awareness of TB where every worker at the camp is given an educational talk on the signs and symptoms of TB, preventive measures and when to seek medical attention and ii) screening of all workers at the workplace by a TB questionnaire and Quantiferon Gold blood tests annually. Those identified with latent TB will undergo further tests to determine if they have active TB or not. During the construction phase of the PNG LNG Project in 2010, TB screening was done by a questionnaire and subsequently in 2012, Quantiferon Gold testing was introduced to enhance the TB screening process. This was in response to the increase number of TB cases detected at the Project areas. Results, Observations, Conclusions: Since 2012 when screening using the Quantiferon method was implemented, 14,704 workers had undergone TB screening at our worksites. Out of this, a total of 3802 workers were found to have latent TB and were subjected to testing for active TB. With close monitoring of workers with latent TB, we detected 28 workers who converted from latent to active TB over a period of time while working at our sites. Assuming that one person with active TB can infect up to 10 people, the screening and monitoring program helped prevent at least 280 active TB cases which would have resulted in significant operational disruption of the PNG LNG Project. Novel/additive information: The ExxonMobil PNG Ltd TB Control Plan has succeeded in detecting and preventing the spread of TB at the workplace. As more companies operate in TB endemic countries, implementing a robust control plan will help ensure a safe, healthy and productive workforce