# Prevalence of Mycobacterium tuberculosis and risk factors among internally and externally displaced populations in northwestern Ethiopia: The case of Dabat and Metema

## TL;DR

A high rate of tuberculosis was found among displaced people in northwestern Ethiopia, with risk factors including diabetes, smoking, and poor healthcare access.

## Contribution

This study identifies specific risk factors for TB in conflict-affected displaced populations in Ethiopia using a cross-sectional design.

## Key findings

- TB prevalence was 7.6% among displaced populations in northwestern Ethiopia.
- Smoking, diabetes, and poor healthcare access were strongly linked to increased TB risk.
- Prolonged camp residence and biomass smoke exposure also significantly increased TB odds.

## Abstract

•High tuberculosis (TB) prevalence (7.6%) was found among conflict-affected displaced people.•Prolonged camp residence and poor health care access elevate risk.•The classic symptom hemoptysis was paradoxically associated with lower TB odds.•Diabetes and smoking dramatically increase TB risk.

High tuberculosis (TB) prevalence (7.6%) was found among conflict-affected displaced people.

Prolonged camp residence and poor health care access elevate risk.

The classic symptom hemoptysis was paradoxically associated with lower TB odds.

Diabetes and smoking dramatically increase TB risk.

Tuberculosis (TB) is a major global health crisis exacerbated by conflict and displacement. These factors disrupt health care and create overcrowded, unsanitary conditions that accelerate TB spread. This study investigated pulmonary TB epidemiology among refugees, internally displaced persons, and host communities in northwestern Ethiopia.

A multicenter cross-sectional study was conducted from July 1 to September 30, 2024 at Dabat and Metema refugee sites in northwestern Ethiopia. In this study, 1350 sputum samples were tested using GeneXpert MTB/RIF, with culture performed on Löwenstein–Jensen medium. Data were analyzed in IBM SPSS Statistics, Version 27 using logistic regression, with model fitness assessed to ensure reliable findings.

Among 1350 study participants in northwestern Ethiopia, 56% were male, with a mean age of 35.29 years. The prevalence of Xpert MTB/RIF–confirmed TB was 102 cases (7.56%), of which 80 (78.4%) were culture-confirmed. Multivariable logistic regression identified several factors significantly associated with TB infection, such as cigarette smoking, recent TB contact, occupational exposure, diabetes, limited health care access, prolonged camp stay, alcohol consumption, biomass smoke exposure, weight loss, and shortness of breath.

This study demonstrated a high prevalence of Mycobacterium tuberculosis among conflict-affected displaced populations. Diabetes mellitus, smoking, recent TB contact, alcohol use, biomass smoke exposure, prolonged camp residence, and poor health care access were identified as significant risk factors.