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Factors associated with TB screening among agricultural workers in Limpopo Province, South Africa
BACKGROUND : Tuberculosis (TB) continues to be a public health issue of concern in South
Africa. Workers in the agricultural sector are generally at increased risk of TB due to multiple
interacting factors such as exposure to silica dust, co-worker infection, and occupations falling
within the lower socio-economic sectors.
OBJECTIVE : This study investigates factors associated with TB screening uptake for agricultural
workers in Limpopo Province, South Africa.
METHOD : This cross-sectional study targeted a study population of 16,787 agricultural workers
across 96 agricultural worksites in South Africa. A two-stage cluster random sampling design
identified 24 agricultural worksites and a potential 2500 participants. The outcome variable
was self-reported TB screening. Descriptive statistics and unadjusted and adjusted logistic
regression analyses were performed to determine factors associated with TB screening.
A literature review informed the selection of covariates as possible confounders.
RESULTS : The final study sample comprised 2144 workers across 24 sites, with 55% being
women. TB screening uptake was 1155 (56.3%). Factors such as living with human immunodeficiency
virus (HIV) (AOR 3.16, 95% CI: 2.44–4.09), accessing health services in the workplace
(AOR 1.94, 95% CI: 1.09–3.46), and having prior TB knowledge (AOR 18.45, 95% CI: 9.8–34.74)
were positively associated with TB screening. Participants in the age group 36–49 years had
significantly higher odds of self-reporting TB screening, compared with those aged 18–25
years (AOR 1.37, 95% CI 1.07–1.77). Migrant workers from Mozambique (OR 0.52, 95% CI:
0.34–0.79) and Zimbabwe (OR 0.71, 95% CI 0.57–0.89) were significantly less likely to selfreport
TB screening compared to their South African counterparts.
CONCLUSION : The findings underscore the importance of workplace health services in achieving
end-TB targets. We recommend programs and interventions for preventing TB in South
Africa that target the agricultural sector in general, and in particular migrant workers.