Network transitions in the cryptocurrency market: The impact of regional conflicts

BackgroundProlonged political conflict in the Eastern Mediterranean Region has led to widespread instability, with mental health concerns extending outside directly affected populations.AimThis study investigates the psychological impact of regional conflict on non-displaced civilians in Egypt, a conflict-neighboring country.MethodsA cross-sectional study was carried out involving 394 Egyptian adults utilizing validated Arabic versions of the PHQ-9 (depression), GAD-7 (anxiety), PSS-10 (perceived stress), and BRCS (resilient coping). Participants also responded to a single-item measure evaluating the extent to which political conflict interrupted their daily functioning. Data was analyzed using descriptive statistics and comparisons across conflict-impact categories.ResultsRespondents reporting greater functional disruption from regional conflict displayed significantly higher depression, anxiety, and stress scores (p < 0.01; η² = 0.13–0.17) and lower resilient coping (p < 0.05; η² = 0.02). The highest burden appeared among participants aged 18–25 and those reporting “extreme difficulty.” Females and frequent social media users exhibited greater psychological distress. Non-overlapping 95% CIs supported the robustness and clinical relevance of group differences.ConclusionsThe findings highlight civilians’ psychological vulnerability in politically unstable yet non-war contexts. Indirect conflict exposure, through media, cultural ties, or regional proximity, adversely affects mental health, underscoring the need for targeted screening and resilience-building programs, particularly for youth and digitally active groups.

Purpose – This article aim For explore idea integrative regarding defense strategy Indonesian hybrid with combine approach conventional, asymmetric, and multidimensional in face complexity conflict in the ASEAN region. Design/ methodology / approach – Research This use systematic literature review (SLR) method on work Suhirwan and Wahyudin (2023), and literature international related defense, regional security, and warfare asymmetrical. This article analyzed 25 sources covering​ books, journals national reputable, and publications international in 2022–2025 period. Findings – The study shows that ASEAN's defense strategy is not can Again only depend on strength conventional, but need framework integrative that includes element diplomacy defense, defense cyber, and the role of actor Civil Defense Model Proposed hybrid​ in article This offer framework adaptive for Indonesia to anticipate threat conventional and non- conventional at a time.Implications practical – This article emphasize that Indonesia needs developing Cyber Forces Independent, strengthening diplomacy defense, as well as build Work The same cross ministries and institutions as part from system defense layered national.​ Originality / Value – Novelty article This lies in the formulation of the Integrative Model Defense Synergistic hybrid​ aspect military regular, defense cyber, counter-terrorism, and diplomacy defense to in One framework strategic. This model give contribution conceptual new for studies defense in ASEAN as well as relevance practical for maker Indonesian policy.

This study analyzes this relationship in the context of international law and security dynamics by focusing on the PYD/YPG, which is supported politically, militarily, and economically by the West under the US umbrella. For this purpose, relevant literature, field data, and intelligence reports available from open sources were utilized. The findings show that Türkiye and EU countries use the organization in line with regional interests. The organization, which has adopted an asymmetric warfare strategy, is waging proxy wars in Syria with the support of the West and acting on its behalf. On the other hand, it easily organizes and continues its activities in the West, especially in Europe. These activities cover a wide range of areas such as lobbying, finance, propaganda, and the recruitment of militants. The Western media, on the other hand, positions the organization as a fighter for freedom and democracy on the grounds of the fight against DAESH and mediates the formation of public opinion in its favor. However, the organization's terrorist acts targeting NATO member Türkiye, its relationship with the PKK, and the mass migrations it causes are ignored. It is understood that the West tries to legitimize the organization to justify its support, which erodes international law and order. While the support provided to the organization deepens regional instability and conflicts, the regional and global security architecture is negatively affected by mass migration, foreign fighters, and cooperation with organized crime networks. Moreover, this relationship causes strategic incompatibilities and trust crises within the Western and NATO alliance, damaging alliance relations and making collaboration difficult.

ABSTRACT The objective of this research article is to provide a comprehensive examination of the internal conflicts in India's Northeast region, particularly in light of the recent outbreak of internal conflict in Manipur. The article adopts a theoretical approach, with a primary emphasis on ethnicity and reconciliation. The origins of ethnic conflict in the region can be traced back to the British colonial period in India. Consequently, this research paper examines the historical trajectory of unrest and conflict in Northeast India. This article endeavors to unravel the intricate drivers behind these protracted conflicts, shedding light on the resultant insurgencies and resistance that have cast a shadow over the northeastern part of India. Employing a primordial theoretical model, the paper analyzes ethnic conflicts, focusing on three states: Assam, Nagaland, and Manipur. Additionally, Lederach's pyramid of peace‐building, serving as a theoretical model, is applied to explore potential reconciliation pathways for the region. In a broader context, this study examines the geopolitical implications arising from ethnic conflicts in Northeast India for South Asia.

Against the backdrop of today’s complex geopolitical realities, the world is experiencing a state of heightened turbulence, which gives rise to new challenges and threats to the international security system. Following the end of the unipolar era, a polycentric world order has emerged, characterized by intensifying competition among multiple centres of political, economic, and strategic influence. This competition increasingly takes on a confrontational nature, marked by hybrid confrontations, economic coercion, information warfare, and localized armed conflicts. There is growing concern about the risk of escalation in regional conflicts – in Eastern Europe, the Middle East, Southeast Asia, and the Indo-Pacific – which could potentially develop into wider global confrontations. At the same time, the spread of authoritarian tendencies, the weakening of international legal institutions, the crisis of multilateral mechanisms for conflict resolution, and the intensifying struggle for resources further deepen global instability. Under current geopolitical turbulence, wartime diplomacy acquires a new functional and legal dimension and becomes a decisive tool for safeguarding national interests and ensuring compliance with international law. Modern wartime diplomacy functions as an adaptive legal-political mechanism operating under heightened security pressures and emergency legal regimes. Its effectiveness increasingly depends on the state’s ability to combine classical diplomatic means with security-oriented, sanctions-based, and institutional instruments of influence. This study examines the international legal foundations of such diplomacy and demonstrates that Ukraine’s wartime practice has catalysed the transformation of external action mechanisms in response to contemporary threats. The research shows that wartime diplomacy operates within a distinct legal framework shaped by the interaction of international humanitarian law, international security law, and the evolving system of European Union (hereinafter – EU) external action. Rooted in the general principles of international law and treaty-based solidarity mechanisms, it performs not only a political but also a juridical function by institutionalising emergency foreign policy decisions. Based on Ukraine’s bilateral and multilateral cooperation formats, it becomes evident that wartime diplomacy delivers not only declarations of support but also tangible legal and political shifts. Existing instruments of cooperation have evolved into long-term and more structured forms of security partnership, approaching the logic of a quasi-alliance. At the same time, new legal avenues of accountability for aggression are emerging, reinforcing Ukraine’s protection in the international arena. As a result, Ukraine is no longer merely a recipient of assistance but an active subject of international law, while the EU increasingly moves from being primarily a “normative power” toward acting as an actor of collective security in the context of armed conflict.

The problem of internal displacement, which was long hidden under the auspices of national sovereignty, has been studied, but due to the aggravation of armed conflicts in various regions of the world, it has not only come out of the shadows, but has also become an acutely relevant serious global problem of today. The interest of the international community in this issue stems both from the growth of its scale and geographical coverage, and from the new awareness of its humanitarian dimension and strategic importance. Quantitatively, the world’s number of internally displaced persons as of the end of 2024 was 73.5 million internally displaced persons (IDPs), which was the highest figure in history. The United Nations Refugee Agency (UNHCR) reported at the end of June 2025 that the number of refugees in the world has also reached a historical maximum – more than 123 million people, with 8.8 million of them being Ukrainians. Qualitatively, these two indicators cannot be compared. Noting not only that refugee movements and internal displacement often have the same causes, but also that they entail comparable hardships for the affected groups and individuals. It has been established that refugees benefit from an internationally guaranteed protection regime, while internally displaced persons theoretically remain under the primary responsibility of their government, but often without any effective protection and discriminated against compared to refugees. As former UN Secretary-General Boutros Boutros-Ghali notes, “it is unacceptable that those who have managed to cross a border benefit from the norms of international law, while sometimes only a few hundred meters away those who have not been able to leave their country remain without protection.” It has been proven based on the results of the study that international law currently does not provide for a universal legal definition of an internally displaced person. The 1998 UN Guidelines on Displacement refer to this category of persons or groups of persons who have been forcibly displaced or obliged to leave their homes or places of habitual residence, in particular as a result of or in order to escape the consequences of armed conflict, situations of violence, human rights violations, natural or man-made disasters, but have not crossed the borders of their own state.

Horn of Africa still faces serious regional conflicts, and needs a detailed historical analysis regarding the Cold War era. Historical research shows that despite the era of détente, new Soviet geopolitical successes were demonstrated. This study examines reasons for Siad Barre's destabilizing efforts to liberate all Somalis, and establish "Greater Somalia". It also tries to find answer how the Soviet Union, which had favoured Somalia previously, switched to the new socialist government in Ethiopia, and why Washington became an ally of Somalia. Due to the massive large-scale military operation aided by the Soviet Union and Cuba, the Somali army was totally defeated. Subsequently, the attack has worsened the country's foreign relations with other states, the Organization of African Unity (OAU) has remained divided in the case. In the present study the author attempts to capture the main points of Ogaden conflict by exploring different aspects of foreign interventions in Cold War geopolitical playground, how these factors have led to the fall of déténte politics. Keywords: Horn of Africa, Ethiopia, Greater Somalia, détente, Cold War history

World War II profoundly reshaped Asia’s political and cultural landscape. With the decline of European colonial empires and the defeat of Japanese militarism, national liberation movements surged across Asia. As nations fought for political sovereignty, they also faced the task of reestablishing their cultural identity. This paper argues that the Cairo Declaration, as a pivotal international legal document during WWII, not only provided the legal foundation for establishing the postwar political order in Asia but also established regional cultural norms centered on anti-fascism, territorial sovereignty, and respect for cultural diversity. However, this order suffered severe shocks under the Cold War framework, with frequent regional conflicts and bloc confrontation eroding national sovereignty and cultural independence. Against this backdrop, this paper proposes a return to the normative core of the Cairo Declaration to construct an Asian cultural security framework comprising three key elements: respecting sovereign equality and cultural self-determination to rebuild the cornerstone of Asian cultural order; synergistically constructing a post-fascist settlement alongside an Asian human rights system; and transitioning from adversarial narratives to shared values, thereby laying a profound foundation for civilizational dialog that supports regional sustainable development.

The evolution of the ASEAN Political Security Community (APSC) represents both the achievements and limitations of Southeast Asia’s efforts to build a stable and cooperative regional order. The ASPC plays a key role through initiatives to promote dialogue, prevent regional conflicts and strengthen mutual security cooperation. Structural challenges, including unresolved territorial disputes, the rise of China, adherence to the principle of non-intervention, and the growing influence of populism and nationalism, are among the key challenges that the APSC needs to address. These challenges suggest that ASEAN’s normative and institutional frameworks are facing security and governance issues. Therefore, this paper aims to analyze the research landscape on leadership and regionalism in Southeast Asia, with a specific focus on the evolution of the APSC. Scopus-AI analytics were used in the analysis process. Using a comprehensive search string across political, economic and security dimensions, this study draws insights from five Scopus-AI analytics features (summary, extended summary, concept map, topic experts and emerging themes) to map the thematic evolution of the APSC. The findings reveal consistent themes such as the enduring US–China rivalry and ASEAN’s institutional adaptation, rising themes including populism and nationalism, and novel themes such as the role of higher education leadership in fostering regional resilience. Moreover, topic experts highlight the importance of network governance, communicative practices through joint communiqués, and the blue economy as cross-sectoral dimensions influencing security cooperation. Theoretically, the study contributes to debates on regionalism and security community theory by reaffirming ASEAN as an incomplete but evolving security community. Practically, the results highlight the need for institutional reforms, capacity building, and people-centered approaches to enhance ASEAN’s centrality in regional affairs. By synthesizing thematic insights and expert perspectives, this study underscores that the future of the APSC depends on ASEAN’s ability to reconcile sovereignty-centered practices with the demands of deeper integration and collective resilience.

This article aims to enhance our understanding of social assistance providers as important sites of potential human trafficking identification, prevention, and disruption, particularly in countries newly experiencing the phenomenon of mass incoming migration. We do so by examining the experiences of Romanian NGOs and other voluntary actors in Romania providing assistance to migrants traveling from Ukraine during the early months of the Russian invasion. Drawing upon data from semistructured qualitative interviews and site visits with over 20 distinct civil society initiatives in summer 2022, we identify five themes that enhance our understanding of system capacities to address human trafficking in countries unaccustomed to migration, and discuss the implications for criminal justice. The article has implications for countries encountering migration due to regional conflicts, but also for migration related to natural disasters, climate change, and other causes.

This study analyzed the collective identity construction of Pitu Ulunna Salu (PUS) in strengthening peacebuilding efforts in Mamasa, West Sulawesi. The reconstruction of PUS became a peace mission doctrine that reshaped public perceptions of brotherhood and harmony after the regional expansion conflicts, which had triggered ethnic and religious disintegration. The research employed a qualitative case study design, collecting data through in-depth interviews and secondary sources. The findings showed that the reconstruction of PUS cultural identity, as part of the historical alliance of traditional institutions served as a catalyst for reconciliation and conflict mitigation in Mamasa. The community’s adherence to traditional values and communal leadership was instrumental in maintaining social harmony, while youth were playing a pivotal role in the ongoing transformation of conflict. This study introduced a conceptual model of Cultural Identity-Based Peacebuilding, which integrated three key elements: traditional authority, collective memory, and youth participation. The model explained how indigenous identity reconstruction functioned not only as cultural preservation but also as a strategic sociopolitical mechanism for sustainable peace. The novelty of this research lay in framing local identity as an active agent in transforming post conflict societies rather than as a passive cultural symbol. A deeper understanding of PUS identity formation enabled the effective application of regional identity in peace processes, enhancing the sustainability of reconciliation. This study provided an empirical and theoretical contribution by bridging indigenous knowledge and contemporary peace studies, offering a replicable model for other multicultural post-conflict contexts. Keywords: Conflict Reconciliation, Pitu Ulunna Salu, Social Construction, Peacebuilding

Thermostable vaccine delivery represents a transformative step toward equitable and climate-resilient immunization systems. Unlike conventional vaccines requiring strict cold-chain storage at 2-8 °C, thermostable formulations retain efficacy at elevated ambient temperatures (up to 40-45 °C), enabling deployment in low-resource, remote, and climate-vulnerable regions. Recent advances in excipients, nanoencapsulation, stabilization matrices such as polymers, metal-organic frameworks (MOFs), liposomes, and drying techniques like lyophilization and spray drying have significantly enhanced heat tolerance and shelf life stability. Existing reviews primarily emphasize material innovations and biophysical stabilization strategies, often highlighting case studies and high-throughput screening approaches. However, critical gaps remain regarding systems-level integration of thermostable vaccine platforms. Few studies explore the convergence of digital formulation design, AI-driven development pipelines, geospatial modeling, lifecycle engineering, and carbon-neutral delivery strategies. Similarly, the integration of smart logistics, real-time monitoring, blockchain-based vaccine authentication, and the policy-technology interface required for deployment in conflict zones, postdisaster areas, and regions severely affected by climate change remains underrepresented. Addressing these gaps is essential to move beyond cold-chain elimination toward climate-smart and sustainable vaccine systems capable of meeting the health needs of underserved populations and addressing emerging global immunization challenges.

The aim of this paper is to examine the role of great power leaders in managing regional conflicts, with a Comparative study of Asian ideological styles versus the Western approaches. It is disputable fact that the Great Leader’s ideologies can shape the policies of a county. This means that, national, regional and international policies can be influenced by the actions of the ruling leaders through their ideological beliefs, strategic dreams, diplomatic strategies, and their perceptions which considerably impact disputes dynamics and resolves. Asian leaders are primarily focus on non-interference, harmony, and long-term stability. They often use diplomatic means for conflict resolutions and employ the methods which rooted from their national and historical background, while Western leaders are habitually prioritize their ideologies through concentrating on implementation of international law, the issue of sovereignty, democratic diplomacy, and stressing institutions such as the United Nations (NATO) to address regional and international disputes. The analysis of this paper reveals that, presence of differences in their ideologies has an impacts on how conflict are started, increased, escalated and or resolved, in a particular region which result in security dilemma. The paper also reveals that, some conflicts and disputes are the results of aggressive leaders in a particular region that often driven by their own political interests, and political survival. Indeed, understanding these contrasting leadership methods among leaders is very important for building national, regional and global order, because it will provide the general framework in formulating effective strategies through rules and regulations within nations, which ultimately shape the elected leader to bind with those rules. The paper gives analysis on recent chaotic cases of Sudan, Russia vs Ukraine war and Israel-Gaza war, and provide empirical evidence that illustrate the implications of these leadership differences in contemporary geopolitical settings.

This article analyses the EU’s engagement in conflict resolution and peacebuilding in its Eastern Neighbourhood, which is undergoing political transformation. The article highlights that, initially focusing on diplomatic efforts and development assistance, the EU has gradually deepened its engagement in response to the increasing complexity of regional conflicts. In the Eastern Partnership countries, the EU has deployed a range of instruments, from political dialogue and economic sanctions to financial assistance and civilian missions, aimed at stabilising the region and promoting long-term peace. The effectiveness of such EU strategies varies in a number of ways, reflecting the diverse political landscapes and challenges faced by each EaP country. This article analyses three separate case studies to examine the EU’s conflict resolution and peacebuilding strategies. Each of these studies provides a nuanced understanding of EU conflict resolution and peacebuilding strategies in different geopolitical and conflict contexts. In this regard, Georgia’s significant involvement in European integration processes is highlighted, which underscores Georgia’s strategic importance for the EU in promoting democratic governance and regional stability. The article also examines the role of the EU in Georgia’s political and security sector reforms and conflict prevention. The article also examines the geopolitical dimensions of the Nagorno-Karabakh conflict in the context of Armenia’s European integration processes and Armenia’s membership in the Eurasian Economic Union. The article analyzes the role of the EU in Ukraine, in particular, after the annexation of Crimea and Russia’s invasion in 2022, which shows a significant shift towards a more proactive and interventionist stance. A comparative analysis of the Ukrainian case provides an opportunity to gain insight into the EU’s strategies to stabilize the Eastern Partnership region, support state-building, and overcome the broader geopolitical consequences of the conflict.

In recent decades, India’s financial markets have undergone remarkable change, marked by growing foreign participation, rapid technological advancement, and increasing integration with the global economy. At the same time, shifting power equations, regional conflicts, and trade disputes have made the geopolitical environment more uncertain, creating new challenges for India’s financial sector. This study explores how such geopolitical developments influence key segments of the Indian financial system—equity, bond, foreign exchange, and banking markets—over the period January 2012 to April 2024, a timeframe that includes major events such as the Russia–Ukraine war and U.S.–China trade tensions.&amp;nbsp;Adopting a quantitative approach, the analysis uses the Quantile Vector Autoregression (QVAR) framework to trace how shocks from global geopolitical risk spread across financial markets under low, medium, and high-risk conditions. The Geopolitical Risk Index (GPRI) proposed by Caldara and Iacoviello (2024) serves as the primary measure of geopolitical uncertainty, while relevant financial data are drawn from sources such as NSE, RBI, and Bloomberg. The findings indicate that the effect of geopolitical risk is uneven across markets and more pronounced during periods of heightened tension. The study also points to the underlying resilience of Indian markets, supported by sound regulation, economic diversification, and institutional strength, while stressing the importance of continued policy vigilance to manage risk and sustain financial stability.

BackgroundSocioeconomic status (SES) is correlated with gunshot violence. This study examined the associations between SES and the severity of gunshot injuries in Israel.MethodsThe Israel National Trauma Registry was reviewed for all violence-related gunshot wound patients who were admitted to all public hospitals in Israel from 2019 to 2022. Self-inflicted injuries were excluded. This time frame preceded the regional military conflict that began in October 2023 and did not include any military-related activity. The registry records patient demographics including ethnicity. Severity was assessed on the Injury Severity Score (ISS), and SES was categorized into 10 clusters based on the patients’ home addresses using the Israel Central Bureau of Statistics index.ResultsA total of 1,848 patients who sustained a gunshot injury were extracted from the database for the period in question, and their SES was identified. Patients from lower SES areas (1–5) were typically young (mean age 30.87 vs. 31.33 in the higher SES group; p = 0.4059) and were almost all from the Arab sector (94.53% vs. 46.94% in the higher SES group; p < 0.0001). Males were injured more frequently, regardless of SES (1825 vs. 82 females). While most patients came from lower SES backgrounds (92% SES levels 1–5), severe injuries were more prevalent in those with higher SES levels (6–10), and had higher ISS scores (p < 0.0001), more admissions to the intensive care unit (p = 0.04), injuries to internal organs (p = 0.0026), and referrals to rehabilitation facilities (p = 0.04). No differences were found for mode of transport to the hospital or likelihood to undergo surgery as a function of SES.ConclusionsThe rate of gunshot-related injuries in Israel is significantly affected by socioeconomic status and ethnicity. The lower SES cohorts, with an ethnic majority of Arabs, experienced more frequent gunshot injuries, but these tended to be less severe. This discrepancy suggests a potential difference in the underlying injury mechanism between social and ethnic groups. Local authorities as well as community leaders would benefit from a clearer understanding of these differences in injury mechanisms, which can contribute to better management of this growing societal issue.

This study examines the economic and geopolitical ramifications of the 2024 Israel-Iran escalation, demonstrating how even limited Middle Eastern confrontations can trigger disproportionate global disruptions. Using the crisis as a case study, it explores how hybrid warfare destabilises energy markets, strains diplomatic alignments, and exposes structural vulnerabilities in adjacent regions. The analysis highlights South Asia and East Africa, heavily reliant on Persian Gulf energy and remittances, where rising shipping costs have fuelled inflation, widened trade deficits, and undermined consumer confidence. In the Gulf, home to 20 million South Asian workers, minor escalations have jeopardised labour markets, remittance flows, and investment confidence. Within MENA, Lebanon faces deepening economic collapse, Israel confronts fiscal overextension, and Gulf states recalibrate diplomacy under rising threats. The paper argues that regional conflicts in energy corridors generate global consequences, highlighting the urgency of proactive multilateral strategies in de-escalation, maritime security, and financial resilience to mitigate cascading instability.

The author examines how states combine the protection of national interests with social welfare provision, which is especially important given the rapid changes in the global political and legal environment. The paper analyzes the transformation of foreign policy under the influence of international law. It shows how international norms influence state strategies and how states form new approaches to international law. Special attention is paid to the European Union’s foreign policy. It's implemented through the Common Foreign and Security Policy (CFSP), which covers political and security issues, as well as through economic diplomacy, the responsibility of the European Commission. The author reveals the main challenges and prospects of this policy in the face of new threats, dependence on energy sources, and regional conflicts. The article also examines international legal issues, particularly those related to territorial integrity, sovereignty, sanctions policy, and human rights. This allows understanding better how a new international relations system is being formed and what role socially oriented states play. A new model of global leadership is studied using the example of China’s foreign policy under Xi Jinping’s leadership. The “One Belt, One Road” initiative is presented not only as an infrastructure project but also as a means for developing international cooperation. The enlargement of the European Union is considered a strategic stage of European integration. The author interprets the new stages of accession of candidate countries as an investment in the continent’s security, stability and economic growth. The modern doctrine of US foreign policy is also considered.

BackgroundMultidrug-resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) represents a major public health threat and a significant obstacle to global TB control. Analysing trends and forecasting future patterns is critical for effective resource planning. However, the application of predictive modelling for MDR/RR-TB has not been widely explored in Ethiopia.ObjectiveThis study aimed to analyse the temporal trends and develop a forecasting model for MDR/RR-TB cases recorded at treatment initiation centres in Northeast Ethiopia between 2015 and 2023.MethodsA retrospective study of all MDR/RR-TB cases diagnosed from January 2015 to December 2023 in Northeast Ethiopia was conducted using data retrieved from six treatment initiation centers (TIC) registries. Data were collected via Kobo Toolbox and analysed with SPSS v27 for descriptive statistics. Seasonal ARIMA models were developed in R to assess trends and generate forecasts, with model selection based on AIC, BIC, and residual diagnostics. Data quality was ensured through verification and consistency checks.ResultsFrom an initial 409 identified individuals, 372 were included in the final analysis after excluding transferred cases. Annual case counts demonstrated instability, with a notable rise between 2017 and 2019 (up to 63.6%) and a distinct decline during 2020–2021, followed by a sharp increase in early 2022. A clear seasonal pattern was observed, with case troughs occurring in August and peaks during the dry season (Bega), followed by a decline in December.ConclusionMDR/RR-TB case trends in Northeast Ethiopia exhibited significant fluctuations over the study period. The pronounced decline in 2020–2021 was likely attributable to service disruptions from the COVID-19 pandemic and regional conflict, while the subsequent surge may reflect a recovery of case detection efforts and the conflict’s impact on transmission. TB control programs should prioritize high-risk seasonal periods and ensure resilient systems for timely diagnosis and treatment access amidst external shocks.