Common comorbidities among tuberculosis patients in Western Sudan during the Sudan armed conflict

Abstract

Background: Tuberculosis continues to be the primary cause of death from infectious diseases globally. In low- and middle-income countries, TB significantly contributes to morbidity and mortality, particularly among patients with comorbidities such as HIV infection, diabetes mellitus, smoking, depression, chronic obstructive pulmonary disease, and pulmonary TB. HIV co-infection elevates the risk of progression to developed tuberculosis (TB) disease. This study evaluated comorbidity in tuberculosis among patients attending El-Obeid Teaching Hospital during the armed conflict from 2023 to 2024. Methodology: This descriptive retrospective study took place in the respiratory department of El-Obeid Teaching Hospital in North Kordofan State, Sudan. The study examined 751 patients diagnosed with tuberculosis, alongside detailed coverage files from the early years of the Sudan war. We collected the data in August 2024. We developed a thorough data collection sheet and methodically organized all pertinent data. Results: Of the 751 patients, 692 received a tuberculosis (TB) diagnosis without any comorbidities, making up 92% of the cohort. The remaining 59 patients, accounting for 8%, had TB with comorbidities: 40% with diabetes mellitus (DM), 29% with HIV, 15% with hypertension (HIN), and 7%, 6%, and 3% with chronic kidney disease (CKD), bronchial asthma, and cardiac disease, respectively. The majority of patients were over 60 years old, comprising 37% of the cohort. The majority of the patients were unemployed, and their tuberculosis treatment outcomes were complete. Conclusion: Tuberculosis (TB) with comorbidity is more prevalent in diabetic patients than in those with HIV. We recommend regular screening for chronic comorbid diseases to improve treatment outcomes and minimize complications. Additionally, promoting outpatient care is essential for improving TB management, and further surveillance is necessary to fully understand the extent of the issue.