Cross-sectional study toward optimizing the national screening strategy for tuberculosis infection in Lebanon

Tuberculosis infection (TBI) remains a public health concern. This study aimed to assess the prevalence of TBI among selected at-risk populations in the Beirut and Mount Lebanon governorates, the regions bearing the highest TB burden in Lebanon, and to evaluate factors associated with positive TST and QFT results. A cross-sectional study was conducted from September 2019 to June 2023 among healthcare workers, TB contacts, migrants, and prisoners. Participants underwent Tuberculin Skin Testing (TST) and/or QuantiFERON-TB Gold Plus (QFT) testing. Logistic regression analyses were used to identify factors associated with positive test results. A total of 860 participants were screened, with migrants and TB contacts showing the highest TBI prevalence. Overall TST and QFT positivity were 24.9% and 20.9%, respectively. Agreement between TST and QFT differed by population group, with notable discrepancies among migrants and prisoners. Kappa agreement ranged from fair (κ = 0.33, contacts) to moderate (κ = 0.60, migrants) across groups. Multivariate analysis identified key risk factors for positive TST and QFT results, including TB contact and migrant status (aOR up to 5.9 and 1.8, respectively). This study highlights the need for tailored TBI screening strategies in Lebanon, depending on the population group. The findings may inform optimization of screening approaches and support the National TB Programme’s efforts toward TB prevention and elimination. As the study relied on targeted convenience sampling in two governorates, these estimates should be interpreted as indicative of the sampled groups rather than as nationally representative prevalence figures.