Prevalence of Asymptomatic Mycobacterium tuberculosis Infection in Charcoal Producers: A Cross-Sectional Study in Kaase, Ghana

Hindawi Journal of Pathogens Volume 2018, Article ID 9094803, 4 pages https://doi.org/10.1155/2018/9094803 Research Article Prevalence of Asymptomatic Mycobacterium tuberculosis Infection in Charcoal Producers: A Cross-Sectional Study in Kaase, Ghana Benjamin Kwame Senya, Nketiah Bernard Anim, Bright Segu Kobena Domson, and Patrick Adu Department of Medical Laboratory Science, College of Health and Allied Health Sciences, University of Cape Coast, Ghana Correspondence should be addressed to Patrick Adu; Received 14 May 2018; Accepted 26 July 2018; Published 2 August 2018 Academic Editor: Giovanna Franciosa Copyright © 2018 Benjamin Kwame Senya et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Charcoal production is a significant economic activity in Ghana. However, there is scarcity of data on the risk of acquiring Mycobacterium tuberculosis infection among charcoal producers in Ghana, even though persistent smoke exposure is a known predisposition factor. Methods. This cross-sectional study recruited 40 charcoal producers: 6 males and 34 females. Two sets of early morning sputum samples were collected from each participant and examined for the presence of acid-fast bacilli (AFB) using fluorescent microscopy. Structured questionnaires were used to retrieve demographic data from each participant. Data were analyzed using SPSS version 21 and presented as frequencies and proportions. Categorical variables were compared using Chi-square test. Significant difference was identified as 𝑝 < 0.05 at 95% confidence interval. Results. Overall, 2/40 (5%) of the participants demonstrated AFB in their sputum. All participants with AFB positive sputum were females and had 6–10 years of experience in charcoal production. Whereas coughing was the most self-reported symptom by the charcoal producers, none complained of blood in sputum. Also, only 9/40 (22.5%) had knowledge about the Mycobacterium tuberculosis-infection risk associated with charcoal production. Moreover, 62.5% (25/40) of participants had no formal education. Conclusion. Education on personal protection equipment must be a public health priority in these charcoal producers in Ghana as sawdust and smoke exposure may predispose charcoal producers to acquisition of tuberculosis. 1. Introduction Tuberculosis (TB) is a global public health problem caused by Mycobacterium tuberculosis. One-third of the world’s population is thought to be infected with TB [1]. According to Patra et al. [2], about 8.6 million people developed active TB with at least 1.3 million mortalities mainly in resource-limited countries. In 2014, there were 9.6 million cases of active TB which resulted in 1.5 million deaths with more than 95% of the deaths occurring in developing countries [1]. Also, the number of cases of TB per 100,000 people was highest in sub-Saharan Africa in 2007 [3]. TB is among the commonest communicable diseases in Ghana with a reportedly over 250,000 more Ghanaians acquiring M. tuberculosis infection each year [4]. TB is transmitted by droplet inhalation produced by coughing, singing, and sneezing of an infected person. Certain lifestyle choices and occupations are known to predispose individuals to risk of contracting the bacterium and subsequently developing active infection. Previous findings have shown that exposure to particulate matter and smoke from carbonizing wood is a risk factor for developing TB in case-control studies conducted in India [5], Nepal [6], and Metropolitan Mexico City [7]. Another study also showed that exposure to wood smoke is associated with the development of TB in children aged ≤17 due to the immaturity of their respiratory and immune system [8]. Also, analysis of data from 200,000 Indian adults found an association between self-reported tuberculosis and exposure to wood smoke [9]. The global production of wood charcoal was estimated at 47 million metric tonnes in 2009 and increased by 9% since 2004 with Africa accounting for 63% of global production. Ghana is rated as the 9th producer of wood charcoal, producing 3% of the entire world wood charcoal [10]. Even 2 Journal of Pathogens Table 1: Age group of participants according to gender of participants. Characteristic Age Group 15-24 25-34 35-44 45-54 55-64 ≥65 Male (%) Female (%) Total (%) 2 (5.0) 1 (2.5) 2 (5.0) 1 (2.5) 0 (0.0) 0 (0.0) 3 (7.5) 7 (17.5) 9 (22.5) 7 (17.5) 3 (7.5) 5 (12.5) 5 (12.5) 8 (20.0) 11 (27.5) 8 (20.0) 3 (7.5) 5 (12.5) though charcoal production is a significant occupation in Ghana, studies assessing the incidence of asymptomatic TB infection among the charcoal producers are nonexistent. This study thus sought to provide such empirical data. Table 2: Knowledge of TB-infection risk associated with charcoal production. 2. Materials and Methods Gender Male Female Age Group 15-24 25-34 35-44 45-54 55-64 ≥65 Educational Level Primary JHS SHS None 2.1. Study Design/Population. This was a cross-sectional study based on convenience sampling that recruited charcoal production workers with a minimum of one-year work experience and at least 15 years old at Kaase, a suburb of Kumasi, the regional capital of the Ashanti Region, Ghana. A total of 40 participants (6 males and 34 females) who gave informed consent were recruited. 2.2. Data Collection. Two (2) sets of morning sputum specimens (3-5 ml each) at 30 minutes intervals were collected from each participant for the study since sputum is best collected in the morning soon after the patient wakes up and before any antiseptic mouth-wash use. 2.3. Ethical Consideration. The study had approval from the University of Cape Coast Institutional Review Board (UCCIRB/CHAS/2016/47) and the Kumasi South Hospital authorities. A written consent was sought from interested participants after the procedures were clearly explained to them. Results and records were strictly kept confidential. 2.4. Sputum AFB. Sputum specimen from each participant was identified with a unique numbering system followed by A or B indicating soon after the patient wakes up and before any antiseptic mouth-wash use, respectively. Florescence microscopy was done after fluorochrome staining following standard protocols and bacteria found graded according to the International Union against Tuberculosis and Lung Disease (IUATLD)/WHO for reporting the sputum smear microscopy results [11]. 2.5. Data Analysis. The data obtained was entered and stored in Microsoft Excel and analyzed using Statistical Package for Social Sciences (SPSS) software version 21.0 (IBM Inc., USA). Summary descriptive statistics were used to describe the study population and reported using frequency table, bar chart, and cross-tabulation. Pearson’s Chi-square model (𝜒2 ) was used where appropriate to compare categorical variables TB Knowledge Yes No 2 7 4 27 (...truncated)