Pulmonary Tuberculosis Among Homeless People Living in Selected Towns in Wolaita Zone, Southern Ethiopia

Abstract Background: Tuberculosis (TB) is known to be a disease associated with underprivileged social conditions such as poverty, malnutrition, and overcrowding. Homeless individuals are at a higher risk of contracting TB due to factors such as drug and alcohol abuse, smoking, and hunger. Recognizing this risk, the World Health Organization recommends TB screening in these vulnerable populations. As a result, this study aims to evaluate the prevalence of TB and its associated factors among homeless people living in Wolaita Zone Towns. Method: A cross-sectional study was conducted on 352 homeless individuals with presumed TB from May 1 to July 30, 2023. Data was collected using pre-tested structured questionnaires. The symptom was assessed using WHO guidelines. Sputum samples were screened for TB using GeneXpert MTB/RIF assay technique, with confirmation via the Lowenstein-Jensen(LJ) culture method. The data was analyzed using statistical software packages (SPSS) version 26. Logistic regression analysis was used to identify factors associated with TB and a P-value of less than 0.05 at a 95% confidence interval was considered statistically significant. Results: The prevalence of bacteriological confirmed TB among homeless individuals was 7.7% [95% CI: 4.8– 10.5] and RR-TB was not detected. Multivariate logistic regression analysis revealed that smoking cigarettes[AOR =7.673, 95% CI: 1.622,36.303], smoking benzene[AOR =8.348, 95% CI: 2.061,33.813], chewing tobacco [AOR =4.138, 95% CI: 1.249,13.709], duration of being homeless[AOR =6.749, 95% CI: 1.914, 23.797], taking any medication currently [AOR =4.686, 95% CI:1.216,18.064], BMI [AOR =5.328, 95% CI: 1.663,17.070] and having HIV infection [AOR =5.234, 95% CI: 1.558, 17.585] were significantly associated with the prevalence of PTB in homeless peoples. Conclusions: This study indicates a higher prevalence of PTB in homeless individuals compared to the general population. It is strongly recommended to implement targeted TB preventive and control measures and actively monitor for the diseases within those vulnerable population.