Prevalence and factors associated with TB among presumptive TB patients in war-affected areas of North Wollo, Ethiopia.

Background: TB is a leading infectious disease globally, with war and displacement significantly increasing its burden. In Ethiopia, ongoing conflict and displacement have worsened health conditions, yet data on TB prevalence and resistance remain scarce. This study aimed to determine the prevalence of TB, rifampicin-resistant TB (RR-TB), and associated factors among presumptive TB patients in hospitals during the ongoing crisis.

Methods: A cross-sectional study was conducted with 273 presumptive TB participants, recruited via convenience sampling. Data on socio-demographic and behavioural factors were collected through interviews using a pre-tested structured questionnaire. Sputum samples were examined using the Xpert MTB/RIF molecular assay. Binary logistic regression was used to analyse the association between independent variables and TB. Variables with a P value  ≤0.25 in the univariate analysis were included in the multivariable regression to identify independent predictors, with a P value ≤0.05 considered statistically significant.

Results: Among the 273 study participants, 47 were confirmed to have Mycobacterium tuberculosis, resulting in a prevalence of 17.2%. Of the 47 patients diagnosed with M. tuberculosis, 17 (36.2%) were found to have rifampicin-resistant strains. Previous contact with displaced persons [adjusted odds ratio (AOR): 4.237; 95% CI: 1.67-10.762; P value: 0.002), contact with TB-infected individuals (AOR: 5.644; 95% CI: 2.46-12.96; P value: <0.01) and being HIV positive (AOR: 3.074; 95% CI: 1.26-7.50; P value: 0.014) were the significant predictors for TB.

Conclusions: Our study revealed a troubling prevalence of RR-TB, underscoring the adverse effects of war and displacement on healthcare services. Significant associations with predictors like HIV infection and close contact with TB-infected individuals necessitate targeted interventions.