Background: Sudan is a Sub-Saharan African country with a high prevalence rate of Tuberculosis. Natural Resistant Associated Macrophage Protein 1 (NRAMP1) plays a potential role in the development of immunity against TB, and it has a critical role in disease resistance. The aim of the study was to evaluate the association of NRAMP1 polymorphism at intron4 (INT4) region with susceptibility to TB infection. Methods: Demographic, clinical and microbiological data were collected from 150 participants and investigated using designed questionnaire. The genotyping of NRAMP1-INT4 polymorphism was performed in 60 TB-infected patients and 50 healthy control using Polymerase chain reaction and restriction fragment-length polymorphism method (PCR-RFLP). Results: Among cases (60%) were males, only (3.3%) were vaccinated. The most reported risk factors were tobacco smoking (17%), diabetes (10%), alcohol consumption (2%) and corticosteroid therapy intakes (1%). Pulmonary TB was detected in 67% of the patients, 24% had pulmonary/MDR and 9% had extrapulmonary TB. The frequency of wild G allele was significantly higher in cases compared with healthy control subjects (P-value <0.0001). Also, a significant association was observed between the heterozygosity for NRAMP1-INT4 variant and resistance to TB infection (P-value 0.001, OR= 4.83, 95%CI 1.96~11.88). Homozygotes mutant INT4 (C/C) genotype was not detected in both cases and controls. Conclusions: the NRAMP1-INT4 polymorphism may serve as marker of unidentified genetic factors that may play a critical role in host immunity to TB in the Sudanese population. Further studies with large sample size are recommended to determine population-specific genetic associations with TB susceptibility in order to guide TB therapy and prophylaxis in a population-specific manner. Keywords: M. tuberculosis, MDR, NRAMP1, SNP, Sudan.

In addition to excessive burden of non-communicable diseases, natural and manmade disasters and internal conflicts, Sudan is predominantly susceptible to communicable diseases such as Malaria, Tuberculosis, and Pneumonia, which bring about a burden of infectious diseases and demand for high quality health care. According to the WHO as well as the Sudan Health Observatory, Pneumonia is one of the leading causes of death in Sudan. This study therefore aimed to determine pneumonia infection prevalence among Sudanese as well as its related risk factors. A systematic review of the literature was conducted in the 1st of December 2020. The review was regulated in accordance with PRISMA. After abstract and full text screening only seventeen articles met our inclusion criteria and passed the quality assessment procedure. Seven included studies determined prevalence of pneumonia; the overall pooled prevalence was around 30%. Furthermore, twelve research articles investigated risk factors related to pneumonia among Sudanese population. Further research with larger sample sizes targeting risk factors of pneumonia among Sudanese population is needed to be conducted. Keywords Africa, Developing countries, Risk, STIs, sub-Saharan Africa