Abstract:
Background: Tuberculosis is one of the most common infectious diseases in the globe that
results in poor health and is one of the main causes of death. Prior to the COVID-19 pandemic
in 2019, tuberculosis was the leading infectious disease-related cause of death. The prevalence
pulmonary tuberculosis and rifampicin resistance, and associated factors with pulmonary
tuberculosis among presumptive in the population of Somaliland has not been reported recently
in the literature.
Objectives: The aim of this study was to assess the prevalence of tuberculosis and rifampicin
resistance, and associated factors with pulmonary tuberculosis among presumptive tuberculosis
patients visiting TB clinics in Somaliland from April 10 to September 15, 2025.
Methodology: An institutional based cross-sectional study was conducted at two regional
hospitals of Somaliland with sample size of 408. Sociodemographic characteristics, clinical
data and other factors associated with Tuberculosis was collected using a structured
questionnaire. Five milliliters (mL) of spot sputum specimen were collected in a 50 mL falcon
tube and tested by gene X-pert mycobacterium tuberculosis and rifampicin resistant assay. The
data were collected by kobo toolbox software and exported to Statistical Package of Social
science version 23.0 for analysis. Adjusted odds ratios and their 95% confidence intervals
were used as indicators of the strength of association at P valve less than 0.05.
Result: The overall prevalence of Pulmonary tuberculosis and Rifampicin-resistant
pulmonary TB was 13.7% (95% CI= 10.5-17.5) and 1.7% (95% CI= 0.7-3.5), respectively.
Contact with tuberculosis patients (AOR = 3.74; 95% CI: 1.56–5.98), a history of previous
tuberculosis (AOR = 2.48; 95% CI: 1.31–6.48), the presence of chronic diseases (AOR =
5.63; 95% CI: 3.02, 10.21), and shisha smoking (AOR = 6.41; 95% CI: 2.54–11.92) were
significantly associated with acquiring pulmonary tuberculosis.
Conclusions: In this study, the overall prevalence of pulmonary tuberculosis (PTB) was
approximately one in seven cases, while rifampicin-resistant tuberculosis (RR-TB) was
identified in about one in sixty cases. Factors that significantly increased the risk of
developing PTB included contact with known TB patients, a previous history of tuberculosis,
the presence of chronic comorbidities, and shisha smoking. Efforts should focus on routine
screening of high risk patients, including individuals with chronic diseases, a history of
previous tuberculosis, and shisha smokers.
