Tuberculosis in the workplace: developing partnerships with the garment industries in Bangladesh

Abstract

OBJECTIVES: To implement and evaluate a public-private partnership model involving garment factories to reduce the tuberculosis (TB) burden in this workforce. DESIGN: We used operational research to develop and evaluate a mechanism for effective and sustainable TB control in workplaces in three areas of Dhaka, Bangladesh. Strategies, protocols, guides and tools were developed with stakeholders. We assessed the impact of the project using quantitative and qualitative measures: changes in TB outcomes were calculated using standard indicators based on factory and DOTS centre records; changes in TB care-seeking behaviour were assessed using qualitative in-depth interviews with factory managers and medical personnel, and focus group discussions with factory workers, including TB patients. FINDINGS: The project brought positive changes in knowledge, attitudes and practices of managers, workers and health care providers on TB care and control. During 2008–2010, a total of 3372 workers from a workforce of 69 000 were referred for sputum microscopy and 598 were diagnosed with smear-positive TB, 145 of whom received care at their workplace. The overall treatment success rate was 100%. CONCLUSION: It is feasible to engage factories in TB control activities in Bangladesh, and thereby increase case notifications and improve treatment outcomes. There is a brief based on this research This research is supported by the Department for International Development’s COMDIS-HSD Programme