GeneXpert-Detected Mycobacterium tuberculosis in Sudan: Insights into Rifampicin Resistance

Abstract Background : This study aimed to determine the prevalence of Tuberculosis (TB) and Rifampicin-resistant Tuberculosis (RR-TB) among Sudanese patients tested using the GeneXpert method. Methods: Data were extracted from the medical records of presumptive tuberculosis patients who attended the hospital from February to October 2025. Sputum samples from presumptive Tuberculosis patients were analyzed using the GeneXpert MTB/RIF assay to detect Mycobacterium tuberculosis and Rifampicin resistance. Results : A total of 153 sputum samples were analyzed. There were male (71.9%) and female (28.1%) participants. The majority of participants (41.8%) were aged 40-64 years, followed by those aged 25-39 years (33.3%). Younger participants aged 15-24years represented (12.4%). At the same time, only a small fraction were children aged 1-14 years (2%). Mycobacterium tuberculosis was detected in 29 cases (19.0%), and 81% were negative. Among the positive cases, moderate bacillary levels were most common (48.3%). Rifampicin resistance was detected in only one case (0.7%), with one additional inconclusive result; the remaining positive cases were sensitive (18.3%). A small number 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) and gender (p=0.228). In contrast, previous TB Infection(p<0.001), and HIV Status (p=0.018) showed a strong association with TB detection. No significant association between age, gender, previous TB infection, and rifampicin resistance (p>0.05) Conclusions: The findings reveal a high prevalence of tuberculosis and significant recurrence among presumptive cases, suggesting gaps in the treatment cascade. The low rate of rifampicin resistance is a cautiously optimistic, yet preliminary, finding, highlighting the need for strengthened surveillance and continuity of care in Sudan's conflict-affected setting.