Determinants of active pulmonary tuberculosis and implications of a novel mining risk factor for TB control: An unmatched case-control study in Guji Zone, Oromia Region, Ethiopia
Abera Siyum, Anteneh Fikrie Tekola, Gemechis Tuke, Kidist Bobosha, Berhanu SeyoumBackground
Tuberculosis (TB) remains a major global health challenge, especially in low-income countries like Ethiopia. Despite ongoing control efforts, TB remains prevalent, highlighting the need for more in-depth research. Guji Zone of Oromia Region is among high TB burden zones in Ethiopia with a new case detection rate of 279/100,000 population in 2016 Ethiopian Fiscal Year (EFY).
Objectives
This study was aimed to identify the determinants of active PTB, with particular emphasis on the impact of mining, as well as other occupational and structural factors.
Design
A facility-based unmatched case-control study was conducted from August 1 to December 30, 2024 .
Methods
The study was conducted among randomly selected 735 (cases 245 and controls 490) patients in Guji zone from August 2024 to December 2024. A pretested and structured face-to-face interviewer administered questionnaire and chart review were used to collect the data. Data was entered into Epi Data version 4.6.0 and exported to SPSS version 25.0 for analysis. Bi-variable and multi variable binary logistic regression model were used to identify the determinants of active PTB. Adjusted odds ratio with 95% Confidence level and p-value of <0.05 were used to declare statistically significant associations.
Results
A total of 735 study participants comprising 245 cases and 490 controls aged 15 years and above were included, with an overall response rate of 99.6%. Being HIV-positive (AOR = 3.47, 95% CI: 1.95–6.11), cigarette smoking (AOR = 2.84, 95% CI: 1.78–4.51), having a body mass index (BMI) of below 18.5 (AOR = 2.55, 95% CI: 1.24–5.24), daily laborer (AOR = 2.31, 95% CI: 1.30–4.09), having a history of contact with a known TB patient (AOR = 2.92, 95% CI: 1.95–4.36), limited access to health facilities (AOR = 1.76, 95% CI: 1.15–2.71), and poor knowledge of TB (AOR = 2.27, 95% CI: 1.47–3.51) were significantly associated with active PTB. A key novel finding of this analysis is the prominent association between mining occupations and active PTB, with miners exhibiting over three times the odds of developing the disease compared to non-miners (AOR = 3.51, 95% CI: 1.89–6.50).
Conclusion
Our study identified a set of determinants for active PTB, including HIV infection, low BMI, cigarette smoking, mining and daily laborer occupations, poor TB knowledge, history of contact with known TB patient, and limited access to healthcare. Crucially, this study uncovers a novel occupational hazard: mining occupation was independently associated with active PTB. Mitigating this burden requires integrating occupational health interventions, specifically targeted screening and safety protocols within mining communities, into broader TB control strategies.