Title : Prevalence of Mycobacterium tuberculosis and risk factors among internally and externally displaced populations in Northwest Ethiopia: The case of Dabat and Metema
Abstract:
Background: Tuberculosis is a major global health crisis, with conflicts and displacement dramatically increasing its risk and spread. Conflicts disrupt healthcare, leading to overcrowded, unsanitary conditions, accelerating tuberculosis spread, particularly among displaced populations who face increased vulnerability due to limited healthcare access. This study investigated active pulmonary tuberculosis epidemiology in Northwest Ethiopia, focusing on refugees, internally displaced persons, and their host communities.
Methods: A multicenter cross-sectional study was conducted in April–May 2024 across Dabat and Metema refugee sites in Northwest Ethiopia including 1,350 participants. Sputum samples were tested using the GeneXpert MTB/RIF assay, with positive samples cultured on Lowenstein-Jensen media. Data analysis was performed using SPSS v27. Descriptive statistics and logistic regression identified TB-associated factors, reporting odds ratios with 95% confidence intervals at p < 0.05. Model fitness was evaluated through multicollinearity (VIF) and goodness-of-fit tests to ensure reliability of the findings.
Results: Among 1,350 study participants in Northwestern Ethiopia, 56% were male, with a mean age of 35.29 years. The prevalence of Xpert MTB/RIF-confirmed tuberculosis was 7.56%, while culture-confirmed cases were 5.9%. Multivariable logistic regression identified significant associations between TB infection and factors such as weight loss, shortness of breath, smoking, recent TB contact, occupational exposure, diabetes, alcohol use, biomass smoke exposure, prolonged camp stay, and limited healthcare access. Interestingly, sputum containing blood was negatively associated with TB. These findings underscore the multifactorial nature of TB risk in displaced populations and highlight the need for targeted public health interventions.
Conclusion: Data of the present study showed that the prevalence of Mycobacterium tuberculosis among TB suspects living in conflict-driven displaced settings of the Northwest Ethiopia was high. Key risk factors identified were diabetes mellitus, smoking, recent TB contact, alcohol use, biomass smoke exposure, prolonged camp residence, and poor healthcare access. These findings underline the critical need for targeted TB screening and control interventions among vulnerable groups and their specific risk profiles.
