Human risk factors associated with the presence of antibodies against Mycobacterium tuberculosis complex in captive Asian elephants from Chitwan valley, Nepal.

Tuberculosis (TB) caused by Mycobacterium tuberculosis complex (MTC) is a growing public health concern for elephants and humans in Nepal. We tested 99 captive Asian elephants (Elephas maximus) in Chitwan valley for MTC antibodies and interviewed 223 mahouts to explore associations between human risk factors, husbandry practices, interspecies interactions, and MTC seropositivity. Using univariable analysis and multivariable logistic regression, we found a 20.2% seroprevalence (95% CI: 13-29%). No socio-demographic mahout factors were linked to elephant seropositivity. Significant risk factors included government/NTNC ownership (OR = 7.74; 95% CI: 2.8-21.44), hand-feeding (P = 0.006), lack of personal protective equipment (PPE; OR = 0.25 for use; 95% CI: 0.08-0.81), pit-based waste disposal (OR = 4.11; 95% CI: 1.7-9.94), livestock proximity (OR = 3.94; 95% CI: 1.62-9.57), and mahouts collecting dead animals for consumption (OR = 3.29; 95% CI: 1.1-9.8). Wild elephant interactions were protective (OR = 0.36; 95% CI: 0.15-0.86), suggesting lower MTC prevalence in wild populations, though captive-to-wild transmission remains a concern. These findings underscore the need for a One Health approach, integrating enhanced biosecurity, PPE promotion, improved waste management, livestock TB control, and community education to mitigate zoonotic TB risks and protect elephant welfare, mahout health, and conservation efforts in Chitwan.