Tuberculosis-related knowledge, attitudes, and self-reported preventive practices among medical students at the University of Khartoum: A cross-sectional educational survey

BACKGROUND: Tuberculosis (TB) remains the leading infectious cause of death from a single pathogen, disproportionately affecting low- and middle-income countries. Sudan's TB burden has been compounded by prolonged armed conflict and deteriorating health infrastructure, yet no published study has assessed TB-related knowledge, attitudes, and self-reported practices (KAP) among Sudanese medical students. This study assessed TB-related KAP among medical students at the University of Khartoum and explored sociodemographic predictors of KAP outcomes. METHODS: A cross-sectional survey was conducted at the Faculty of Medicine, University of Khartoum, Sudan (August-October 2024), using a proportionally allocated stratified convenience sample of 311 undergraduate medical students from the third to sixth academic years (response rate 91.5%). A validated, self-administered questionnaire assessed sociodemographic characteristics, TB knowledge (10 items), attitudes (7-item Likert scale), and self-reported preventive practices (5 items). Associations between KAP domains were examined using Pearson correlation, and multiple linear regression identified sociodemographic predictors of each domain, adjusting for sex, age group, and academic year (SPSS version 29). RESULTS: The mean knowledge score was 6.43 ± 2.52 out of 10 (64.3%), indicating moderate overall knowledge. Correct responses were common for TB etiology (94.9%) and airborne transmission (91.3%) but less common for latent TB non-infectiousness (29.3%) and tuberculin skin test (TST) interpretation (49.2%). The mean attitude score was 27.90 ± 4.27 out of 35, and the mean self-reported practice score was 19.55 ± 3.67 out of 25; only 28.3% reported consistently wearing a face mask when interacting with suspected or confirmed TB patients. Knowledge correlated weakly with attitude scores (r = 0.179, p = 0.001) and was not significantly correlated with practice scores (r = 0.090, p = 0.113); attitude and practice scores were moderately correlated (r = 0.437, p < 0.001). Among the sociodemographic variables assessed, academic year was the strongest predictor of knowledge scores (adjusted R² = 0.474, p < 0.001), whereas the attitude and practice models explained minimal variance (adjusted R² = 0.029 and 0.018, respectively); female sex was the only significant predictor of self-reported practice (B = 0.95, 95% CI: 0.09-1.80, p = 0.031). CONCLUSIONS: In this single-institution study, medical students at the University of Khartoum demonstrated moderate knowledge of core tuberculosis concepts, with particular strength in disease causation and transmission but important gaps in latent tuberculosis infection and tuberculin skin test interpretation. Knowledge was weakly associated with attitudes and was not associated with self-reported preventive practices, suggesting that factual knowledge alone may not be sufficient to promote corresponding behavior. Given the convenience-sampling design and single-institution setting, these findings should be interpreted as an educational snapshot rather than generalized to all Sudanese medical students; they may nonetheless inform curriculum discussions on reinforcing tuberculosis-related knowledge, attitudes, and preventive practices.