PREVALENCE & RIFAMPICIN RESISTANCE OF PULMONARY TUBERCULOSIS AND ITS ASSOCIATED FACTORS WITH PULMONARY TUBERCULOSIS AMONG PRESUMPTIVE TB PATIENTS IN SOMALILAND

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.