Objective: Rifampicin-resistant tuberculosis (RR-TB) is an emerging challenge for tuberculosis (TB) control programs globally. Updated knowledge of the increase in RR-TB is critical to allocate resources, address prevention, and control. This study aimed to assess the prevalence and risk factors of RR amongst suspected pulmonary TB patients attending the Kumba District Hospital in the Southwest region of Cameroon.

Patients and Methods: A cross-sectional study including 153 suspected TB participants was conducted between April 12 and June 30, 2022. Data on socio-demographics and risk factors were collected using a semi-structured questionnaire. Microscopy using the Ziehl-Neelsen staining technique and GeneXpert MTB/RIF Ultra was used to detect TB disease and RR.

Results: Of the 153 participants included in the study, 32 (20.9%) and 37 (24.18%) were positive for Acid Fast Bacilli (AFB) using microscopy and M. tuberculosis using GeneXpert MTB/RIF Ultra, respectively [86.49% sensitivity and 100% specificity]. RR was detected in 3/153 (1.96%) patients. RR-TB was significantly associated with a history of contact with a TB patient (p = 0.038), previously diagnosed TB patients (p = 0.045; OR = 14.67; 95% CI: 1.27 – 170.05), as well as family size (p = 0.002).

Conclusions: Despite the low prevalence of RR-TB in the study area, systematic monitoring of TB contacts is advocated to prevent the dissemination of drug resistance to rifampicin. Upgrading diagnostic performance is necessary to avoid missing cases in the region, as well as the country, which remains largely reliant on sputum smear microscopy.