Tuberculosis control in Sudan against seemingly insurmountable odds.


Research type: Research Paper

Authors: El Sony, A.I .Baraka, O..Enarson, D.A..Bjune, G..

Abstract: Sudan, Africa's largest and one of its poorest countries, in which civil disturbance, resource limitation and communication difficulties are substanial impediments to delivery of health services. The objectives are to illustrate the burden of tuberculosis; review measures taken to control the disease; out-line the introducation of the DOTS strategy; and demonstrate the trend in the output of the DOTS strategy. The methods are used : published information on general health, tuberculosis and health structure provide the setting; and routine reports illustrate the trend in case notification in Sudan, and outcome of treatment by period of enrolment on treatment (cohort). Since 1992, sputum smear microscopy centres have been established in existing health facilities (179 of a total 290 targeted centres), by the of the second quarter of 1998,82860 cases of ruberculosis had been reported, of whom 52 percent were sputum smear-positive cases. Of these, 89 percent had no history of previous treatment for as much as one month. The treatment outcomes for 11000 new smear-positive cases were reported by the end of second quarter of 1997; the proportion of notified cases for whom treatment results were availthese, 72 percent were successfully treated, increasinf from 62 percent in 1994 to 73 percent in 1996. Despite semmingly overwhelming odds, the DOTS strategy has been successfully commenced and is in the process of expansion throughout the country, with monitoring of the quality of daignostic examinations and improvements in treatment outcome. Further improvement is necessary, but appears feasible. (27 ref.) .