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

= 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.