{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:19:03Z","timestamp":1787681943992,"version":"build-2784847793"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n Tuberculosis (TB) remains the leading infectious cause of death from a single pathogen, disproportionately affecting low- and middle-income countries. Sudan\u2019s TB burden has been compounded by prolonged armed conflict and deteriorating health infrastructure, yet no published study has assessed TB-related knowledge, attitudes, and self-reported practices (KAP) among Sudanese medical students. This study assessed TB-related KAP among medical students at the University of Khartoum and explored sociodemographic predictors of KAP outcomes.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A cross-sectional survey was conducted at the Faculty of Medicine, University of Khartoum, Sudan (August\u2013October 2024), using a proportionally allocated stratified convenience sample of 311 undergraduate medical students from the third to sixth academic years (response rate 91.5%). A validated, self-administered questionnaire assessed sociodemographic characteristics, TB knowledge (10 items), attitudes (7-item Likert scale), and self-reported preventive practices (5 items). Associations between KAP domains were examined using Pearson correlation, and multiple linear regression identified sociodemographic predictors of each domain, adjusting for sex, age group, and academic year (SPSS version 29).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The mean knowledge score was 6.43\u2009\u00b1\u20092.52 out of 10 (64.3%), indicating moderate overall knowledge. Correct responses were common for TB etiology (94.9%) and airborne transmission (91.3%) but less common for latent TB non-infectiousness (29.3%) and tuberculin skin test (TST) interpretation (49.2%). The mean attitude score was 27.90\u2009\u00b1\u20094.27 out of 35, and the mean self-reported practice score was 19.55\u2009\u00b1\u20093.67 out of 25; only 28.3% reported consistently wearing a face mask when interacting with suspected or confirmed TB patients. Knowledge correlated weakly with attitude scores (r\u2009=\u20090.179, p\u2009=\u20090.001) and was not significantly correlated with practice scores (r\u2009=\u20090.090, p\u2009=\u20090.113); attitude and practice scores were moderately correlated (r\u2009=\u20090.437, p\u2009<\u20090.001). Among the sociodemographic variables assessed, academic year was the strongest predictor of knowledge scores (adjusted R\u00b2\u2009=\u20090.474, p\u2009<\u20090.001), whereas the attitude and practice models explained minimal variance (adjusted R\u00b2\u2009=\u20090.029 and 0.018, respectively); female sex was the only significant predictor of self-reported practice (B\u2009=\u20090.95, 95% CI: 0.09\u20131.80, p\u2009=\u20090.031).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In this single-institution study, medical students at the University of Khartoum demonstrated moderate knowledge of core tuberculosis concepts, with particular strength in disease causation and transmission but important gaps in latent tuberculosis infection and tuberculin skin test interpretation. Knowledge was weakly associated with attitudes and was not associated with self-reported preventive practices, suggesting that factual knowledge alone may not be sufficient to promote corresponding behavior. Given the convenience-sampling design and single-institution setting, these findings should be interpreted as an educational snapshot rather than generalized to all Sudanese medical students; they may nonetheless inform curriculum discussions on reinforcing tuberculosis-related knowledge, attitudes, and preventive practices.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0357003","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T17:27:12Z","timestamp":1787678832000},"page":"e0357003","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tuberculosis-related knowledge, attitudes, and self-reported preventive practices among medical students at the University of Khartoum: A cross-sectional educational survey"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9161-9422","authenticated-orcid":true,"given":"Mohammed","family":"Hamid","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamedelghali","family":"Elshaikh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer Yousif Abdelrahman","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"issue":"3","key":"pone.0357003.ref001","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.ijtb.2020.02.005","article-title":"A systemic review on tuberculosis","volume":"67","author":"A Natarajan","year":"2020","journal-title":"Indian J Tuberc"},{"issue":"1","key":"pone.0357003.ref002","article-title":"Imaging of thoracic tuberculosis: pulmonary and extrapulmonary","volume":"6","author":"N Pattamapaspong","year":"2024","journal-title":"BJR Open"},{"key":"pone.0357003.ref003","unstructured":"World Health Organization. Tuberculosis. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/tuberculosis 2025. Accessed 2025."},{"key":"pone.0357003.ref004","unstructured":"World Health Organization. The End TB Strategy. https:\/\/www.who.int\/publications\/i\/item\/WHO-HTM-TB-2015.19 2015. Accessed 2025."},{"key":"pone.0357003.ref005","volume-title":"Global Tuberculosis Report 2024","author":"World Health Organization","year":"2024"},{"issue":"1","key":"pone.0357003.ref006","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1186\/s12889-023-15213-w","article-title":"The social determinants of national tuberculosis incidence rates in 116 countries: a longitudinal ecological study between 2005\u20132015","volume":"23","author":"FA K\u00f6ltringer","year":"2023","journal-title":"BMC Public Health"},{"issue":"5","key":"pone.0357003.ref007","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(18)30195-5","article-title":"The impact of social protection and poverty elimination on global tuberculosis incidence: a statistical modelling analysis of Sustainable Development Goal 1","volume":"6","author":"DJ Carter","year":"2018","journal-title":"Lancet Glob Health"},{"issue":"4","key":"pone.0357003.ref008","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/S1473-3099(15)00434-X","article-title":"Fighting poverty to prevent tuberculosis","volume":"16","author":"MJ Saunders","year":"2016","journal-title":"Lancet Infect Dis"},{"key":"pone.0357003.ref009","unstructured":"Sudan Health Cluster. Sudan Health Cluster Annual Report 2021. 2022. https:\/\/reliefweb.int\/report\/sudan\/sudan-health-cluster-annual-report-2021"},{"issue":"4","key":"pone.0357003.ref010","article-title":"Impact of the 2023 armed conflict on Sudan\u2019s healthcare system","volume":"2","author":"A Khogali","year":"2023","journal-title":"Public Health Chall"},{"issue":"1","key":"pone.0357003.ref011","article-title":"Burden of Tuberculosis in Western Sudan During the Sudan Armed Conflict","volume":"17","author":"AK Mohammed","year":"2025","journal-title":"Cureus"},{"key":"pone.0357003.ref012","doi-asserted-by":"crossref","first-page":"1014666","DOI":"10.1155\/2023\/1014666","article-title":"Tuberculosis knowledge, attitudes, and practice in middle- and low-income countries: a systematic review","volume":"2023","author":"OM Craciun","year":"2023","journal-title":"Journal of Tropical 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in a rural community in Vietnam","volume":"90","author":"NP Hoa","year":"2009","journal-title":"Health Policy"},{"issue":"1","key":"pone.0357003.ref022","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0210913","article-title":"Tuberculosis knowledge, attitude and practice among healthcare workers during the 2016 Hajj","volume":"14","author":"B Alotaibi","year":"2019","journal-title":"PLoS One"},{"issue":"1","key":"pone.0357003.ref023","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1186\/s12889-020-08788-1","article-title":"Tuberculosis knowledge and attitude among non-health science university students needs attention: a cross-sectional study in three Ethiopian universities","volume":"20","author":"A Mekonnen","year":"2020","journal-title":"BMC Public Health"},{"key":"pone.0357003.ref024","article-title":"Knowledge, attitude and practice regarding tuberculosis among nursing students in a coastal district of Karnataka","author":"HS Kamath","year":"2024","journal-title":"Indian J Tuberc"},{"issue":"3","key":"pone.0357003.ref025","first-page":"520","article-title":"Determinants of the knowledge of and attitude towards tuberculosis in Nigeria","volume":"32","author":"KE Agho","year":"2014","journal-title":"J Health Popul Nutr"},{"issue":"3","key":"pone.0357003.ref026","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1258\/0049475054620770","article-title":"Medical interns knowledge of TB in Pakistan","volume":"35","author":"JA Khan","year":"2005","journal-title":"Trop Doct"},{"key":"pone.0357003.ref027","article-title":"Drug-Resistant Tuberculosis Stigma Among HealthCare Workers Toward the Development of a Stigma-Reduction Strategy: A Scoping Review","volume":"138","author":"LL Aranas","year":"2023","journal-title":"Public Health Rep"},{"key":"pone.0357003.ref028","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.ijid.2016.10.011","article-title":"Tuberculosis stigma as a social determinant of health: a systematic mapping review of research in low incidence countries","volume":"56","author":"GM Craig","year":"2017","journal-title":"Int J Infect Dis"},{"issue":"1","key":"pone.0357003.ref029","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1186\/s12889-024-20868-0","article-title":"A systematic review exploring the role of tuberculosis stigma on test and treatment uptake for tuberculosis infection","volume":"25","author":"A K\u0131l\u0131\u00e7","year":"2025","journal-title":"BMC Public Health"},{"key":"pone.0357003.ref030","doi-asserted-by":"crossref","first-page":"1478251","DOI":"10.3389\/fpubh.2025.1478251","article-title":"An analysis of knowledge, attitudes, practice and influencing factors for tuberculosis prevention and control among Hainan University students","volume":"13","author":"H Xie","year":"2025","journal-title":"Front Public Health"},{"issue":"1","key":"pone.0357003.ref031","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1186\/s12889-018-5636-x","article-title":"Knowledge and determinants regarding tuberculosis among medical students in Hunan, China: a cross-sectional study","volume":"18","author":"Y Ou","year":"2018","journal-title":"BMC Public Health"},{"issue":"1","key":"pone.0357003.ref032","doi-asserted-by":"crossref","DOI":"10.22582\/am.v11i1.31","article-title":"How much can a KAP survey tell us about people\u2019s knowledge, attitudes and practices? 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