• MEH Mohamed Department of Public and Tropical Health, University of Medical Sciences and Technology, Sudan
  • ME Hamad Department of Veterinary Medicine, United Arab Emirates University, UAE
  • AA Daffalla College of Graduate studies & Scientific research, Nile University, Sudan
  • MM Mukhtar Institute of Endemic Diseases, University of Khartoum, Sudan



Tuberculosis, Multidrug resistance, Directly Observed Treatment Strategy, Treatment outcome


Scarce information is available regarding the incidence, prevalence, diagnosis, and management outcomes of Multi Drug Resistant-Tuberculosis (MDR-TB) in Sudan.. This study aimed to assess MDR-TB diagnosis, management, treatment outcomes and predictors of treatment in Abu-Anga TB Reference Hospital in Sudan between the period 2015 - 2021. A retrospective facility-based study was conducted on the records of 60 patients with MDR-TB. Twenty three patients with complete file records were enrolled in the study. Data collected from the hospital registry of the 23 MDR-TB case files was analyzed using (SPSS. Ver 24). Descriptive analysis was also used for counts percentages. Results of the study participants showed that among the 23 patients, multiple drug resistance type had the highest percentage (39.1%), Rifampicin resistance was (21.7%), poly-drug resistance represented (26%) with the Pre-XDR percentage (8.7%) and XDR types being at the lowest percentages (4.3%). The outcome of the treatment indicated that 10 patients (43.4%) were cured, 6 patients (26%) were lost to follow up, 4 patients (17.4 %) failed treatment, and 3 (13%) patients died. The findings of this study indicated that good outcome predictors were the adoption of Directly Observed Treatment Strategy, hospitalization treatment model, and in-patient treatment with family support. Poor treatment outcomes were significantly related to rural residency, HIV (human immunodeficiency virus) co-infection, and treatment relapse. It is recommended to increase patient awareness among those living in rural areas to available treatment regimens and improve disease perception to increase treatment compliance and adherence. The study findings highlighted the importance of training of health providers on the proper recording and maintenance of all MDR-TB case files.


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Author Biographies

ME Hamad, Department of Veterinary Medicine, United Arab Emirates University, UAE

Associate Professor - Department of Veterinary Medicine, United Arab Emirates University, UAE

AA Daffalla, College of Graduate studies & Scientific research, Nile University, Sudan

Dean, College of Graduate Studies & Scientific Research, Nile university, Sudan

MM Mukhtar, Institute of Endemic Diseases, University of Khartoum, Sudan

Professor -Institute of Endemic Diseases, University of Khartoum, Sudan


Adam, M. A. M., Ali, H. M. H., & Khalil, E. A. G. (2017). Initial second-line drug resistance of Mycobacterium tuberculosis isolates from Sudanese retreatment-patients. Journal of clinical tuberculosis and other mycobacterial diseases, 9, 21–23.

Adkinson, N. F., Bennett, J .E., Douglas, R .G., & Mandell, G. L. (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases (7th ed.). Philadelphia, PA: Churchill Livingstone/Elsevier. p. Chapter 250. ISBN 978-0-443-06839-3.

Ali, M. H., Alrasheedy, A. A., Hassali, M. A., Kibuule, D., & Godman, B. (2019). Predictors of multidrug-resistant tuberculosis (MDR-TB) in Sudan. Antibiotics (Basel, Switzerland), 8(3), 90.

Ali, M. H., Alrasheedy, A. A., Kibuule, D., Godman, B., Hassali, M. A., & Ali, H. M. H. (2019). Assessment of multidrug-resistant tuberculosis (MDR-TB) treatment outcomes in Sudan; findings and implications. Expert review of anti-infective therapy, 17(11), 927–937.

Basit, A., Ahmad, N., Khan, A. H., Javaid, A., Syed Sulaiman, S. A., Afridi, … Ahmad, I. (2014). Predictors of two months culture conversion in multidrug-resistant tuberculosis: findings from a retrospective cohort study. PloS one, 9(4), e93206.

Boyd, A. T., Lodiongo, D. K., Benson, J. M., Aragaw, S., Pasquale, M. S., Ayalneh, H., … Bunga, S. (2021). Implementation of tuberculosis preventive treatment among people living with HIV, South Sudan. Bulletin of the World Health Organization, 99(1), 34–40. Retrieved from

Broekmans, J . F. (2007). Reichman and Hershfield’s tuberculosis: a comprehensive, international approach, third edition, parts A and B. Bulletin of the World Health Organization, 85(5), 418.

Cameron, A., Ewen, M., Ross-Degnan, D., Ball, D., & Laing, R. (2009). Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis. Lancet (London, England), 373(9659), 240–249.

Chakaya, J, Khan, M, Ntoumi, F, Aklillu, E, Fatima, R, Mwaba, … Zumla A. (2021). Global Tuberculosis Report 2020 - Reflections on the Global TB burden, treatment and prevention efforts. Int J Infect Dis. official publication of the International Society for Infectious Diseases, 113 Suppl 1(Suppl 1):S7-S12.

Companion Handbook to the WHO Guidelines for the Programmatic Management of Drug-Resistant Tuberculosis. Geneva: World Health Organization; 2014.

Gadallah, M. A., Mokhtar, A., Rady, M., El-Moghazy, E., Fawzy, M., & Kandil, S. K. (2016). Prognostic factors of treatment among patients with multidrug-resistant tuberculosis in Egypt. Journal of the Formosan Medical Association = Taiwan yi zhi, 115(11), 997–1003.

Global tuberculosis report 2022. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO. ISBN 978-92-4-006172-9 (electronic version).

Guidelines for the Programmatic Management of Drug-Resistant Tuberculosis: 2011 Update. (2011). World Health Organization. Retrieved from

Hassanain, S. A., Edwards, J. K., Venables, E., Ali, E., Adam, K., Hussien, H., & Elsony, A. (2018). Conflict and tuberculosis in Sudan: a 10-year review of the National Tuberculosis Programme, 2004-2014. Conflict and health, 12, 18.

Hajissa, K., Marzan, M., Idriss, M. I., & Islam, M. A. (2021). Prevalence of Drug-resistant Tuberculosis in Sudan: A Systematic Review and Meta-Analysis. Antibiotics (Basel, Switzerland), 10(8), 932.

Jeon, D.,S., Shin, D.,O., Park, S.,K. Seo, J. E., Seo, H. S., Cho, Y. S., … Shim, T. S. (2011). Treatment outcome and mortality among patients with multidrug-resistant tuberculosis in tuberculosis hospitals of the public sector. J Korean Med Sci, 26(1):33–41. Retrieved from

Kimbrough, W., Saliba, V., Dahab, M., Haskew, C., & Checchi, F. (2012). The burden of tuberculosis in crisis-affected populations: a systematic review. The Lancet. Infectious diseases, 12(12), 950–965.

Korenromp, E. L., Glaziou, P., Fitzpatrick, C., Floyd, K., Hosseini, M., Raviglione, M., Atun, R., & Williams, B. (2012). Implementing the global plan to stop TB, 2011-2015--optimizing allocations and the Global Fund's contribution: a scenario projections study. PloS one, 7(6), e38816.

Kurbatova, E. V., Cegielski, J. P., Lienhardt, C., Akksilp, R., Bayona, J., Becerra, M. C., … Zignol, M. (2015). Sputum culture conversion as a prognostic marker for end-of-treatment outcome in patients with multidrug-resistant tuberculosis: a secondary analysis of data from two observational cohort studies. The Lancet. Respiratory medicine, 3(3), 201–209.

Liddle, K. F., Elema, R., Thi, S. S., Greig, J., & Venis, S. (2013). TB treatment in a chronic complex emergency: treatment outcomes and experiences in Somalia. Transactions of the Royal Society of Tropical Medicine and Hygiene, 107(11), 690–698.

Liu, Q., Lu, P., Martinez, L., Yang, H., Lu, W., Ding, X., & Zhu, L. (2018). Factors affecting time to sputum culture conversion and treatment outcome of patients with multidrug-resistant tuberculosis in China. BMC infectious diseases,18(1),114.

Melese, A. & Zeleke, B. (2018). Factors associated with poor treatment outcome of tuberculosis in Debre Tabor, northwest Ethiopia. BMC Res Notes,11(1):25.

Mohammed, S., Nagla, S., Morten, S., Asma, E., & Arja, A. (2015). Illness perceptions and quality of life among tuberculosis patients in Gezira, Sudan. African health sciences, 15(2), 385–393.

Nagaraja, C., Shashibhushan, B. L., Asif, M., Manjunath, P. H., & Sagar, C. (2012). Pattern of drug-resistance and treatment outcome in multidrug-resistant pulmonary tuberculosis. The Indian journal of chest diseases & allied sciences, 54(1), 23–26. Retrieved from

Narasimhan, P., Wood, J., Macintyre, C.R., & Mathai, D. (2013). "Risk factors for tuberculosis". Pulmonary Medicine. 2013: 828939. PMID: 23476764 PMCID: PMC3583136.

Sharaf Eldin, G. S., Fadl-Elmula, I., Ali, M. S., Ali, A. B., Salih, A. L., Mallard, K., Bottomley, C., & McNerney, R. (2011). Tuberculosis in Sudan: a study of Mycobacterium tuberculosis strain genotype and susceptibility to anti-tuberculosis drugs. BMC infectious diseases, 11, 219.

Sudan National TB Management Guideline 2018. Retrieved from: URL:

The role of BCG vaccine in the prevention and control of tuberculosis in the United States. A joint statement by the Advisory Council for the Elimination of Tuberculosis and the Advisory Committee on Immunization Practices. (1996). MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports, 45(RR-4), 1–18. Retrieved from

WHO consolidated guidelines on tuberculosis. Module 4: treatment - drug resistant tuberculosis management, 2022 update (2022).

World Health Organization. (‎2010)‎. Multidrug and extensively drug-resistant TB (‎M/XDR-TB)‎: 2010 global report on surveillance and response. World Health Organization.

World Health Organization. (‎2011)‎. Global tuberculosis control: WHO report 2011. World Health Organization.

World Health Organization Global tuberculosis report 2016. Available from URL:

World Health Organization Global tuberculosis report 2017. Available from URL:

World Health Organization Global tuberculosis report (full). 2019. Available from: URL:




How to Cite

Mohamed, M., Hamad, M., Daffalla, A., & Mukhtar, M. (2023). ASSESSMENT OF THE STATUS OF TUBERCULOSIS MULTIDRUG-RESISTANCE (MDR-TB) IN ABU-ANGA TB REFERENCE HOSPITAL, SUDAN 2015 - 2021. Proceedings of the Global Public Health Conference, 6(1), 67–79.