GeneXpert-detected Mycobacterium tuberculosis in Sudan: insights into rifampicin resistance

This study aimed to determine the prevalence of Tuberculosis (TB) and rifampicin-resistant Tuberculosis (RR-TB) among Sudanese patients tested using the GeneXpert assay. Data were extracted from medical records of presumptive tuberculosis patients attending the hospital between February and October 2025. Sputum samples were analyzed using the GeneXpert MTB/RIF assay to detect Mycobacterium tuberculosis and rifampicin resistance. A total of 153 sputum samples were analyzed. male participants comprised 71.0%, and female participants 28.1%. The majority (41.8%) were aged 40–64 years, followed by 25–39 years (33.3%), 15–24 years (12.4%), and children aged 1–14 years (2%). M. tuberculosis was detected in 29 cases (19.0%), with 81% tested negative. Among positive cases, medium bacillary levels were most common (48.3%). Rifampicin resistance was detected in one case (0.7%), with one additional inconclusive result; the remaining positive cases were rifampicin sensitive (18.3%). A small proportion of participants reported previous TB Infection (4.6%) or HIV Infection (1.3%). Chi-square analysis revealed no statistically significant relationship between age (p = 0.454) or gender (p = 0.228) and TB infection. In contrast, previous TB Infection(p < 0.001), and HIV Status (p = 0.018) were strongly associated with TB detection. No significant association was observed between age, gender, previous TB infection, and rifampicin resistance (p > 0.05). The findings suggest a high prevalence of tuberculosis and notable recurrence among presumptive cases, suggesting deficiencies in the treatment cascade. The low rate of rifampicin resistance is a cautiously optimistic, preliminary finding, highlighting the need for strengthened surveillance and continuity of care in Sudan’s conflict-affected setting.