Prevalence and determinants of tuberculosis and COVID-19 among patients with presumptive tuberculosis in a Nigerian tertiary hospital

Tuberculosis (TB) remains a major public health challenge in Nigeria, while the overlap between TB and coronavirus disease 2019 (COVID-19) in symptomatic patients has been less clearly described in routine clinical settings. This study assessed the prevalence and determinants of TB and COVID-19 among presumptive TB patients in a tertiary hospital in Port Harcourt, Nigeria. This hospital-based cross-sectional study, conducted between April and August 2024, involved 242 presumptive TB patients attending Rivers State University Teaching Hospital, Port Harcourt recruited using consecutive sampling. Sociodemographic characteristics, medical-related, and behavioural/environmental data were collected using a structured interviewer-administered questionnaire, while TB and COVID-19 were assessed using Xpert Mycobacterium tuberculosis /rifampicin (Xpert MTB/RIF) assay and STANDARD Q COVID-19 Ag Test, respectively. Statistical analysis involved descriptive statistics, chi-square tests, and multivariable logistic regression analyses using GraphPad Prism 9, with statistical significance set at p ≤ 0.05. TB was detected in 21.9% of participants; however, no participant tested positive for COVID-19, yielding a COVID-19 prevalence of 0.0%, and no case of TB/COVID-19 co-infection was identified. None of the sociodemographic characteristics examined was significantly associated with TB prevalence ( p > 0.05). However, contact with someone with prolonged coughing (aOR: 5.41, 95% CI: 2.55–11.70; p < 0.0001) and HIV-positive status (aOR: 3.02, 95% CI: 1.08–8.37; p = 0.0334) were significant determinants of TB infection. In addition, current smoking (aOR: 5.18, 95% CI: 1.74–15.70; p = 0.0031) and living in a densely populated area with limited ventilation (aOR: 2.82, 95% CI: 1.29–6.12; p = 0.0086) independently predicted TB infection. TB remains a considerable burden among presumptive TB patients in this setting, whereas no COVID-19 or TB/COVID-19 co-infection was detected during the study period. TB risk was driven mainly by exposure-related, behavioural, clinical, and environmental factors rather than sociodemographic characteristics. Strengthening routine TB screening, contact investigation, bidirectional TB/HIV services, smoking-cessation support, and interventions addressing overcrowded, poorly ventilated living conditions may improve TB control in similar high-burden settings.