Tuberculosis in Sudan: Efficiency of diagnostic techniques commonly used and investigation of some sociodemographic factors which may influence the disease prevalence

Abstract

Introduction: Tuberculosis (TB) is a bacterial disease that can be spread through the air. It usually attacks the lungs, but it can also attack and damage the other parts of the body such as the brain, kidneys, or spine. The disease remains to be a major health problem in countries suffering from poverty and unsettlement like Sudan. Materials and Methods: In this study, sputum samples were collected from 243 patients (186 males and 57 females) being suspected of pulmonary TB. The patients were distributed in TB specialized clinics in different areas of Central (Khartoum), Eastern (Port Sudan), and Western (Al Obeid) parts of Sudan after they have been informed and agreed to participate in the study. Age, sex, and social status including occupation and housing of the patients were recorded. The patients' common complaints were cough, fatigue, chest pain, shortness of breath, loss of weight, and hemoptysis. Samples were collected, treated with 4% NaOH, and examined both microscopically after having them stained with Ziehl-Neelsen (ZN) stain and microbiologically having them cultured on Lowenstein-Jensen (LJ) media. Isolates were further identified using biochemical tests and resistance to anti-TB drugs was determined. 85.2% (207/243) shown acid-fast bacilli in ZN stain whereas 78.6% (191/243) were positive for mycobacteria in culture. 149 (75%) were successfully subcultured in LJ media and confirmed to be Mycobacterium tuberculosis using biochemical tests. Results: Of 149 isolated M. tuberculosis species, 18.1% (27), 32.9% (49), 20.7% (31), and 22.4% (33) were resistant to isoniazid, streptomycin, rifampicin, and ethambutol, respectively. Conclusion: This study highlights the presence of yet-unknown species of mycobacterium causing active infection with TB in patients in Sudan and the presence of a high percentage of drug resistance which knocks in the alarm of having multidrug-resistant TB circulating in Sudan, a country with many suitable predisposing factors for the disease.