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Tuberculosis (TB) is an important cause of morbidity and mortality among refugees and migrant populations. These groups are among the most vulnerable populations at increased risk of developing TB. However, there is no systematic review that attempts to summarize TB among refugees and migrant populations. This study aimed to summarize evidence on the magnitude of TB among refugees and migrant populations. The findings of this review will provide evidence to improve TB prevention and control policies in refugees and migrants in refugee camps and in migrant-hosting countries. A systematic search was done to retrieve the articles published from 2014 to 2021 in English language from electronic databases. Key searching terms were used in both free text and Medical Subject Heading (MeSH). Articles which had reported the magnitude of TB among refugees and migrant populations were included in the review. We assessed the risk of bias, and quality of the included studies with a modified version of the Newcastle–Ottawa Scale (NOS). Included studies which had reported incidence or prevalence data were eligible for data synthesis. The results were shown as summary tables. In the present review, more than 3 million refugees and migrants were screened for TB with the data collection period between 1991 and 2017 among the included studies. The incidence and prevalence of TB ranged from 19 to 754 cases per 100,000 population and 18.7 to 535 cases per 100,000 population respectively among the included studies. The current findings show that the most reported countries of origin in TB cases among refugees and migrants were from Asia and Africa; and the incidence and prevalence of TB among refugees and migrant populations is higher than in the host countries. This implies the need to implement and improve TB prevention and control in refugees and migrant populations globally. Trial registration : The protocol of this review was registered on PROSPERO (International prospective register of systematic reviews) with ID number, CRD42020157619 .

Latent tuberculosis infection (LTBI) is the major source of active TB and is an obstacle to the strategy of World Health Organization to end TB by 2035. In Ethiopia, there are hundreds of prisons and they are conducive settings for the transmission of TB and could serve as the sources of infection to the general public. However, there is little data on the epidemiology of TB in prisons in Ethiopia. The objective of the present study was to estimate the prevalence of LTBI and evaluate associated risk factors in prisons in East Wollega Zone in western Ethiopia. A cross-sectional design and systematic sampling technique were used to select 352 prisoners from a total of 2620 prisoners during the two months (May and June, 2019). The selected inmates were consented for their willingness to participate in the study. Thereafter, they were interviewed and 2ml of blood sample was collected from each prisoner and screened for LTBI using interferon-gamma release assay (IGRA). The data were analyzed using SPSS version 25 and logistic regression was used to model the likelihood of LTBI occurrence and to identify risk factors associated with LTBI. The prevalence of LTBI was 51.2% (95% CI: 46.45-57%) and higher prevalence was recorded in males (53%) than in females (43.5%) although the difference was not significant. Prisoners whose age ≥45 years (AOR = 2.48, 95%CI, 1.04-5.9), who chewed khat (AOR = 2.27; 95% CI, 1.27-4.19), who were prisoned over a year (AOR = 1.81, 95%CI, 1.04-3.18) and who were in overcrowded pens (AOR = 1.91, 95% CI, 1.002-3.65) were at higher risk of LTBI. The prevalence of LTBI in prisoners in West Wollega Zone of western Ethiopia was high and could serve as sources of infection to the public. Hence optimum handling of prisoners, and regular follow up and treatment of TB cases in prisons were recommended to minimize the burden of TB in the Zone.

The emergence of COVID-19 overwhelmed tuberculosis (TB) prevention and control, resulting in a decrease in TB detection rate and an increase in TB deaths. Furthermore, the temporary immunosuppressive effects, lung inflammation, and the corticosteroids used to treat COVID-19, may play a direct role in immunosuppression, leading to reactivation of either previous infection or latent TB or the development of new TB. Thus, the aim of this study was to review TB incidence in individuals who recovered from COVID-19. We conducted a systematic search of available databases for previously published studies that reported TB in COVID-19 survivors. The PRISMA checklist was used to guide the review, and the JBI checklist was used to evaluate the study's quality. The descriptive data were summarized. Data were extracted from 21 studies conducted in 13 countries having 33 cases. The median age was 44 years (range; 13.5-80), and more than half (18, 54.5%) were males. Twelve patients immigrated from TB endemic settings. All 17 patients assessed for HIV were seronegative, and all 11 patients assessed for BCG vaccination status were vaccinated. The majority (20, 69%) of patients had some type of comorbidity with diabetes (12/29) and hypertension (9/29) being the most common. Four patients (30.77%) had a history of TB. Corticosteroids were used to treat COVID-19 in 62.5% (10) of individuals. Dexamethasone, remdesivir, azithromycin, hydroxychloroquine, and enoxaparin were the most commonly used drugs to treat COVID-19. The most common TB symptoms were fever, cough, weight loss, dyspnea, and fatigue. Twenty, eleven, and two patients developed pulmonary, extrapulmonary, and disseminated/miliary TB respectively. It may take up to seven months after COVID-19 recovery to develop tuberculosis. Data on the final treatment outcome was found for 24 patients, and five patients died during the anti-TB treatment period. Tuberculosis after recovering from COVID-19 is becoming more common, potentially leading to a TB outbreak in the post-COVID-19 era. The immunosuppressive nature of the disease and its treatment modalities may contribute to post COVID-19 TB. Thus, we recommend a further study with a large sample size. Furthermore, we recommend feasibility studies to assess and treat latent TB in COVID-19 patients residing in TB endemic counties since treatment of latent TB is done only in TB non-endemic countries.

Bovine tuberculosis (bTB) is endemic and of zoonotic importance in Ethiopia. Despite this, there is limited recent information on the prevalence of bTB in cattle slaughtered at abattoirs. This study aimed to estimate the prevalence of bTB in cattle slaughtered at Addis Ababa municipality abattoir based on tuberculous lesions and region of difference (RD4) deletion typing and to assess the current practice and the awareness of occupational workers to zoonoses. A total of 502 cattle slaughtered at the municipality abattoir (260 in the day shift and 242 in the night shift) were included in this cross-sectional study. Data collection and laboratory investigations included postmortem examination, culture and bacteriological examination, molecular characterization of positive isolates using region of difference (RD4) deletion typing and spoligotyping. Knowledge of zoonotic infection risk and practices was investigated through a questionnaire administered to 58 abattoir workers and 58 butchers. Based on postmortem examination, bTB suspected lesion was identified in 4.58% of cattle and it was significantly associated with, the age, breed and body condition of the animals. The detection of tuberculosis lesions during the night shift of the slaughter program was 1.54 times that of the day shift which is not statistically significant but warrants future study with a larger sample size. The gross lesions were predominately found in the lung and associated lymph nodes (65.5%). Of the 23 bTB suspected tuberculous lesions cultured, 11 (47.83%) tissue samples were culture-positive, and four isolates were RD4-positive, identifying M. bovis. Spoligotyping patterns were also effectively detected in four isolates. The observed spoligotype patterns were two SB1477 strains, and SB1176 and SB0133 strains. In the questionnaire survey, 79.31% of abattoir workers were aware of bTB, however, 93.10% of butchers did not know of bTB and understood less about preventing cross-infection. Bovine tuberculosis is evident in cattle reaching the abattoir in Addis Ababa with nearly similar gross lesion pathology-based prevalence of bTB to prior findings reported from the same abattoir a decade ago. This suggests that despite efforts to control the disease in cattle, the prevalence remains largely unchanged. Although statistically non-significant, the trend showing higher odds of detecting tuberculous lesions during the night suggests a need for improved meat inspections during the night shift and the need for larger future studies.

Background Globally, pre-and post-migration TB screening are integral to controlling TB among migrants. Annually, approximately 300,000 Ethiopians migrate to the Middle East in search of job opportunities. But prior to their trip the migrants are randomly distributed by Wafid to 12 authorized clinics in Addis Ababa, for pre-migration medical screening for communicable diseases including Tuberculosis (TB), which is one of the main concerns and screened using chest X-ray (CXR). Based on the screening results, the job seekers are classified as Fit or Unfit to travel to the Middle East. This study aimed to estimate the prevalence of presumptive TB among Ethiopian Migrant Workers upon screening and identify the possible associated risk factors. Method A retrospective cross-sectional study was conducted using data between June,2023 and June, 2025 collected from three clinics utilizing Sefed Software Systems database. Ethiopian Migrant Domestic Workers (MDWs) are randomly placed for pre-migration screening to these health facilities by the Ministry of Labor and Skills. The prevalence of presumptive TB was estimated using STATA software version 14. Logistic regression model was applied to determine associations between X-ray TB diagnosis and with socio-demographic and clinical variables. Results Among 233,941 individuals screened during the study period, 10, 342 (4.42%) were deemed Unfit to travel due to abnormal CXR findings. Significant associations were observed between TB-suspects based on X-rays and several variables. Using multivariable logistic regression analysis, religion (OR = 1.24; 95% CI: 1.19–1.28); marital status (OR = 0.88; 95% CI: 0.84–0.93), age (OR = 3.35; 95% CI: 2.70–4.15), hepatitis B (OR = 1.71; 95% CI: 1.48–1.97), syphilis (VDRL) (OR = 1.97; 95% CI: 1.63–2.37) and pregnancy (OR = 1.56, 95% CI = 1.34–1.81) showed statistically significant association with potential TB status with P  < 0.05. HIV status showed marginal association (OR = 1.40; 95% CI: 0.91–2.14). Conclusion This study revealed a relatively high prevalence of presumptive TB among Ethiopian (MDWs) seeking jobs in the Middle East. The X-ray results may not be confirmatory diagnosis for TB. Therefore, further investigation is required using other confirmatory methods such as Gene Xpert or TB culture. Linking medically unfit individuals to TB care is crucial to mitigate transmission risks based on the WHO recommendations.

There was a 'missing millions' gap between the incidence of tuberculosis (TB) cases and the notified cases. In many TB high-burden countries, only about 25% of household contacts (HHCs) completing household TB evaluation and 20-89% of eligible contacts did not adhere to TB screening. The study was conducted to assess the yield of door-to-door TB household contact investigation among household contact of bacteriologically confirmed pulmonary TB cases in central Ethiopia. This cross-sectional study was carried out in selected health facilities of central Ethiopia from January 1, 2023 to December 3, 2023.All sequential voluntary bacteriologically confirmed TB patients and their HHCs without discrimination by age were included in the study. Xpert Ultra assay and TB culture were used to investigate active TB from sputum sample. Spearman's correlation analysis was used to determine the correlation between the index case cycle threshold value and the corresponding HHCs. Multivariable logistic regression analysis was done to investigate the associated risk factors for active TB in HHCs. Among 967 HHCs claimed by 303 index cases (259 drug susceptible TB (DS-TB) and 44 multi-drug resistance TB (MDR/RR-TB)), 902(93.07%) HHCs had received baseline symptom-based TB evaluation. Presumptive TB was identified in 20.17% (182) of the evaluated HHCs and 13(1.44%) were diagnosed with active TB. Eleven HHCs (7.24%; 95% CI: 3.85-12.9%) from DS-TB index case contacts and 2 (6.67%; 95% CI: 1.16-23.51) from MDR/RR-TB indexes HHCs were found to be MTB detected Rifampicin resistance not detected cases. The Xpert ultra assay results revealed an 84.62% (95% CI: 57.77-95.68) Rifampicin drug resistance concordance between the index case and the corresponding HHC. Active TB was significantly associated with night sweating and sharing a bed with the index patient, P-value < 0.05. Home-to-home TB contact screening have high active TB yield and implementable in both rural and urban areas of the nation only by mentoring and motivating the health extension workers. Proximity to bacteriologically confirmed TB patient for long time exposes household contacts for active TB. Scheduling convenient times and last-mile service delivery to contacts is very important to address the missed active TB cases in the community.

To date, isoniazid mono-resistant tuberculosis (TB) is becoming an emerging global public health problem. It is associated with poor treatment outcome. Different studies have assessed the treatment outcome of isoniazid mono-resistant TB cases, however, the findings are inconsistent and there is limited global comprehensive report. Thus, this study aimed to assess the poor treatment outcome and its associated risk factors among patients with isoniazid mono-resistant TB. Studies that reported the treatment outcomes and associated factors among isoniazid mono-resistant TB were searched from electronic databases and other sources. We used Joana Briggs Institute critical appraisal tool to assess the study's quality. We assessed publication bias through visual inspection of the funnel plot and confirmed by Egger's regression test. We used STATA version 17 for statistical analysis. Among 347 studies identified from the whole search, data were extracted from 25 studies reported from 47 countries. The pooled successful and poor treatment outcomes were 78% (95%CI; 74%-83%) and 22% (95%CI; 17%-26%), respectively. Specifically, complete, cure, treatment failure, mortality, loss to follow-up and relapse rates were 34%(95%CI; 17%-52%), 62% (95%CI; 50%-73%), 5% (95%CI; 3%-7%), 6% (95%CI; 4%-8%), 12% (95%CI; 8%-17%), and 1.7% (95%CI; 0.4%-3.1%), respectively. Higher prevalence of pooled poor treatment outcome was found in the South East Asian Region (estimate; 40%, 95%C; 34%-45%), and African Region (estimate; 33%, 95%CI; 24%-42%). Previous TB treatment (OR; 1.74, 95%CI; 1.15-2.33), having cancer (OR; 3.53, 95%CI; 1.43-5.62), and being initially smear positive (OR; 1.26, 95%CI; 1.08-1.43) were associated with poor treatment outcome. While those patients who took rifampicin in the continuation phase (OR; 0.22, 95%CI; 0.04-0.41), had extrapulmonary TB (OR; 0.70, 95%CI; 0.55-0.85), and took second-line injectable drugs (OR; 0.54, 95%CI; 0.33-0.75) had reduced risk of poor treatment outcome. Isoniazid mono-resistant TB patients had high poor treatment outcome. Thus, determination of isoniazid resistance pattern for all bacteriologically confirmed TB cases is critical for successful treatment outcome. PROSPERO registration number: CRD42022372367.

Background There is a gap between tuberculosis (TB) infection and the onset of clinical TB disease, which makes identifying TB transmission dynamics a prominent challenge. Different reports were made on the concordance of drug-resistance profiles between the household contact and the purported index case. This study investigated the drug-resistance pattern concordance of the index-household contact pair in central Ethiopia. Method A laboratory-based cross-sectional study was conducted on Mycobacterium tuberculosis isolates identified from bacteriologically confirmed pulmonary TB patients and their household contacts (HHCs) in central Ethiopia from January to December 2023. Sputum specimens were collected from index cases and presumptive HHCs and examined using the Xpert Ultra assay, Xpert XDR assay, and Mycobacterium tuberculosis culture. Descriptive statistics were used to summarize the data. Result Among 902 TB symptoms screened HHCs of 303 index cases, 20.17% (182/902) had Presumptive TB, and 7.14% (13/182) developed active tuberculosis. In index cases, 23.52% (64 /272) showed resistance to at least one of the five first-line anti-TB drugs. The prevalence of mono-resistant to STR, INH, RIF, and PZA was: 2.20% (6 /272), 2.20% (6/272), 6.25% (17/272), and 1.47% (4/272), respectively. Any first-line anti-TB drug resistance was higher among relapse cases than new cases, at 41.67% (10/24) and 21.77% (54/248), respectively. Among the RR/MDR-TB cases tested with the Xpert MTB/XDR assay, 56.81% (25/44) cases showed resistance to INH. Among these 25 INH resistance samples, 5 had no melting point on the wild ahpc gene as well as on the ahpc gene mutant. In HHCs with positive cultures, 23.07% (3/13) displayed resistance to any first-line anti-TB medication. Only 69.23% (9/13) of HHCs had isolates that aligned with the pDST pattern of the index case for all five first-line anti-TB drugs. Conclusion Nearly one-third of the household contacts have discordant drug-resistance profiles from the index patients. This study offers compelling proof that it is not advisable to treat close contacts without DST results based on the DST results of the supposed source case. The low drug resistance rate to new oral second-line drugs in this study did not guarantee the absence of resistance to each drug.

Rapid and sensitive Tuberculosis (TB) diagnosis closer to patients is a key global TB control priority. Truenat assays (MTB, MTB Plus, and MTB-RIF Dx) are new TB molecular diagnostic tools for the detection of TB and Rifampicin (RIF)-resistance from sputum samples. The diagnostic accuracy of the assays is needed prior to implementation in clinical use in Ethiopia. This study aimed to determine the sensitivity and specificity of Truenat assays; and aimed to compare the assays to the Xpert MTB/RIF assay. A prospective evaluation study was conducted among 200 presumptive TB patients in microscopy centers in Addis Ababa, Ethiopia from May 2019 to December 2020. Culture (Solid and Liquid methods) and phenotypic (liquid method) drug susceptibility testing (DST) were used as a reference standard. Of 200 adult participants, culture confirmed TB cases were 25 (12.5%), and only one isolate was resistant to RIF by phenotypic DST. The sensitivity of Truenat MTB was 88.0% [95% CI 70.1, 95.8], while 91.7 [95% CI 74.2, 97.7] for Truenat MTB Plus at the microscopy centers. The specificity of Truenat MTB was 97.2% [95% CI 93.1, 98.9], while for Truenat MTB Plus was 97.2% [95% CI 93.0, 99.0]. The sensitivity of Truenat MTB was 90.5% while for MTB Plus, 100% compared to the Xpert MTB/RIF assay. Truenat assays were found to have high diagnostic accuracy. The assays have the potential to be used as a point of care (POC) TB diagnostic tests.

Background The genotyping of the M. tuberculosis complex has significantly enhanced the comprehension of transmission dynamics and is employed to substantiate transmission dynamics among epidemiologically interconnected cases. This investigation sought to examine genomic diversity, transmission dynamics, and mutations conferring drug resistance in epidemiologically linked pulmonary tuberculosis cases and their household contacts in central Ethiopia. Methods A total of 50 genomes were considered for WGS analysis using the TB- profiler pipeline for drug resistance and genotypic analysis (SNP distance cut-off 12). Results By analyzing the successful WGS data from 48 isolates, we identified that the majority were classified under lineages L4 (Euro-American, 33/48; 68.75%) and L3 (Delhi-CAS, 12/48; 25.0%). The Euro-American sub-lineage (L.4.2.2) was the most common (16/48; 33.33%). The incidence of tuberculosis due to M. bovis was 4.17% (2/48). Approximately one-fifth of the 48 isolates were determined to be at least MDR TB (10/48; 20.83%). The cluster analysis uncovered 4 clusters, resulting in an overall clustering rate of 17.02% (8 /47). Out of the four clusters, three were from the same household, while one cluster was from non-index household contacts. Out of the 10 index-HHC pairs that had valid WGS analysis, three exhibited genomes that were exactly matched. Conclusion People living in regions with a significant prevalence of tuberculosis face the danger of acquiring the disease from external sources. Genomic sequencing provides valuable information about the epidemiological trends of tuberculosis, which helps in developing improved strategies for high-risk groups susceptible to unnoticed TB transmission.