Burden of pulmonary tuberculosis among Ethiopians seeking jobs in the Middle East: a retrospective study

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.