Type and physical intensity of occupations at pulmonary TB diagnosis

BACKGROUND: Pulmonary TB (PTB) predominantly affects individuals of working age. We sought to characterise the occupations of people newly diagnosed with PTB in Karachi, Pakistan, by type and physical intensity. DESIGN/METHODS: We did a secondary analysis of data from a study evaluating the diagnostic accuracy of artificial intelligence-based chest X-ray (CXR) analysis software, where individuals had been evaluated for active PTB using sputum cultures and had provided information on occupation. We used an accelerometer-validated US National Health and Nutrition Examination Survey-based job categorisation to assign physical activity levels to participant-reported occupations as High, Intermediate, or Low. RESULTS: Among 272 participants with microbiologically confirmed PTB (women: 130/272, 48%; median age: 29 years, IQR 22–45), 78% (211/272) had smear-positive disease, and 96% (260/272) had data on occupation. Unemployment was common (women: 70/122, 57%; men: 23/138, 17%). Most women reporting an occupation were homemakers (21/52, 40%), and 54% (28/52) had an intermediate- or a high physical activity occupation. Among men reporting an occupation, 35% (40/115) were labourers, and 79% (91/115) had an intermediate- or high-physical activity occupation. CONCLUSION: The majority of individuals with PTB were in their working age, had extensive disease, and had intermediate or high physical activity occupations, suggesting economic vulnerability due to physical impairment.