Management of Tuberculosis at El-Obeid Teaching Hospital During the Sudanese Armed Conflict: A Single-Center Descriptive Study

Background: Tuberculosis (TB) is a major global health issue, particularly in countries with armed conflict, a poor health-care system, and low-income populations. The purpose of this study was to describe the characteristics, diagnostic approaches, and reported barriers to healthcare access among TB patients managed at El-Obeid Teaching Hospital during three years of the armed conflict (2023 to 2026) in the war zone. Methodology: Between April 2023 and April 2026, a descriptive, prospective hospital-based study was conducted in El-Obeid, the capital of North Kordofan State, Sudan. The study included all patients diagnosed with TB in El-Obeid Teaching Hospital during the period from April 15, 2023, to April 15, 2026. Results: This study investigated 2193 TB patients, with 70% male patients and 30% female patients. The population was split 52% urban and 48% rural. Approximately 63% of patients began anti-TB medication later, within two to six months. Delays in treatment were caused by security concerns (42%), financial constraints (32%), a lack of healthcare resources (22%), and missed diagnoses (3%). The majority of patients reported a "new episode," followed by re-registered and multi-drug-resistant TB (MDR-TB) cases (90.6%, 8.8%, and 0.6%, respectively). Of the 13 MDR cases, 46% were new episodes, 38% were MDR, and 16% were reregistered. In 194 reregistered cases, 56% were recurring, while 44% were defaulters. Conclusion: The incidence rates of TB are increasing with the extent of war duration, particularly among men. Coinfection with HIV was significantly rising among women.