Abstract
OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.