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1

Osman, Tarig, Cathrine Victor, Alaa Abdulmoneim, Hala Mohammed, Fatima Abdalla, Asma Ahmed, Eiman Ali, and Wael Mohammed. "Epidemiology of Substance Use among University Students in Sudan." Journal of Addiction 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/2476164.

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Background. Youth populations are vulnerable to substance use particularly in developing countries where circumstances may be favorable for it. There is no published data on substance use among the youth in Sudan other than on tobacco use.Objectives. The aim of this study was to investigate the prevalence, circumstances, and factors associated with substance use.Methods. An institution-based survey was conducted on a sample of 500 students. Data was collected using a questionnaire designed by the WHO for student drug surveys and analyzed using IBM SPSS version 20.Results. The overall prevalence of substance use is 31%. The current prevalence of tobacco, cannabis, alcohol, amphetamines, tranquilizers, inhalants, opiates, cocaine, and heroin use was 13.7%, 4.9%, 2.7%, 2.4%, 3.2%, 1%, 1.2%, 0.7%, and 0.5%, respectively. Curiosity (33.1%) was the main reason for initiation of substance use. The main adverse effects reported were health problems (19.7%) and theft (19.7%). Peers (40.9%) were the prime source of substance use. On multivariate analysis, male sex was the principle predictor for substance use (AOR: 5.55; 95% CI: 3.38, 9.17).Conclusion. Strategies to control substance use should encompass the role of the university and parents in observing and providing education to improve awareness of substances and their consequences.
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Ngondi, Jeremiah, Mark H. Reacher, Fiona E. Matthews, Carol Brayne, Gideon Gatpan, Steven Becknell, Lucia Kur, Jonathan King, Kelly Callahan, and Paul M. Emerson. "Risk factors for trachomatous trichiasis in children: cross-sectional household surveys in Southern Sudan." Transactions of the Royal Society of Tropical Medicine and Hygiene 103, no. 3 (March 2009): 305–14. http://dx.doi.org/10.1016/j.trstmh.2008.08.024.

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Jin, Yan, Young-Ha Lee, Seungman Cha, In-Uk Choi, Hassan Ahmed Hassan Ahmed Ismail, Mousab Siddig Elhag, and Sung-Tae Hong. "Transmission Dynamics of Schistosoma haematobium among School-Aged Children: A Cohort Study on Prevalence, Reinfection and Incidence after Mass Drug Administration in the White Nile State of Sudan." International Journal of Environmental Research and Public Health 18, no. 21 (November 2, 2021): 11537. http://dx.doi.org/10.3390/ijerph182111537.

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The reinfection rate of schistosomiasis after mass drug administration (MDA) has not been documented in Sudan. We aimed to explore the transmission dynamics of urogenital schistosomiasis after MDA, targeting school-aged children in the White Nile State of Sudan, assessing the prevalence, reinfection rate, and incidence. A single dose of praziquantel (40 mg/kg) was administered to 1951 students in five primary schools from January to February 2018 immediately after a baseline survey, and follow-up surveys were performed at 2 weeks and 6 months after treatment. We examined Schistosoma haematobium eggs by centrifugation methods. The overall reinfection rate at 6 months after treatment was 9.8% (95% confidence interval: 0.5–17.4%). By school, the reinfection rate was highest in the Al Hidaib school, whose prevalence was highest at baseline. The reinfection rate was significantly higher in high-infection areas than low-infection areas (p = 0.02). Of the prevalence at 6 months in high-infection areas, 41% of cases were due to reinfection. MDA interventions are decided upon and undertaken at the district level. A more targeted treatment strategy should be developed with a particular focus on tracking high-risk groups, even within a school or a community.
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Elgoraish, Amanda G., Salah Eldin G. Elzaki, Rania TagElsir Ahmed, Arwa Ibrahim Ahmed, Huda A. Fadlalmula, Shymaa Abdalgader Mohamed, Nusiba I. Abdallah, Osman Abdelgadir, Tellal B. Ageep, and Badria B. El-Sayed. "Epidemiology and distribution of Plasmodium vivax malaria in Sudan." Transactions of The Royal Society of Tropical Medicine and Hygiene 113, no. 9 (June 4, 2019): 517–24. http://dx.doi.org/10.1093/trstmh/trz044.

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Abstract Background Plasmodium vivax malaria has been recognised as an important cause of morbidity in several African countries. The prevalence was previously estimated as 2–5% in eastern Sudan. These estimates are observed to be rising and spreading continuously. The present study was undertaken to investigate the situation of distribution and epidemiology of P. vivax malaria in Sudan. Methods Cross-sectional malaria surveys carried out in hospitals and health centres covered 21 sites in 10 states. Data and blood samples were collected from 1226 clinically investigated suspected malaria cases of both genders and all ages. Microscopically detected malaria parasites were confirmed by PCR. Results The overall prevalence of P. vivax among the malaria cases was 26.6%. The prevalence showed significant variations between the states (p<0.001), which could be explained by differences in population movement, the presence of refugees and proximity to endemic neighbouring countries. It also varied significantly with residence status (p<0.001), reflecting the stability of transmission. Conclusion Although malaria in Sudan is still largely attributed to Plasmodium falciparum, P. vivax has been rising with worrying proportions and spreading to new areas. The emergence and marked increase of P. vivax poses new challenges to malaria treatment and control in Sudan.
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Kolaczinski, Jan H., Kara Hanson, Emily Robinson, Diana Picon, Anthony Sabasio, Martin Mpakateni, Mounir Lado, Stephen Moore, Nora Petty, and Simon Brooker. "Integrated Surveys of Neglected Tropical Diseases in Southern Sudan: How Much Do They Cost and Can They Be Refined?" PLoS Neglected Tropical Diseases 4, no. 7 (July 13, 2010): e745. http://dx.doi.org/10.1371/journal.pntd.0000745.

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Odhiambo, Jackline, Caroline Jeffery, Richard Lako, Baburam Devkota, and Joseph J. Valadez. "Measuring health system resilience in a highly fragile nation during protracted conflict: South Sudan 2011–15." Health Policy and Planning 35, no. 3 (December 26, 2019): 313–22. http://dx.doi.org/10.1093/heapol/czz160.

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Abstract Health systems resilience (HSR) is defined as the ability of a health system to continue providing normal services in response to a crisis, making it a critical concept for analysis of health systems in fragile and conflict-affected settings (FCAS). However, no consensus for this definition exists and even less about how to measure HSR. We examine three current HSR definitions (maintaining function, improving function and achieving health system targets) using real-time data from South Sudan to develop a data-driven understanding of resilience. We used 14 maternal, newborn and child health (MNCH) coverage indicators from household surveys in South Sudan collected at independence (2011) and following 2 years of protracted conflict (2015), to construct a resilience index (RI) for 9 of the former 10 states and nationally. We also assessed health system stress using conflict-related indicators and developed a stress index. We cross tabulated the two indices to assess the relationship of resilience and stress. For maintaining function for 80% of MNCH indicators, seven state health systems were resilient, compared with improving function for 50% of the indicators (two states were resilient). Achieving the health system national target of 50% coverage in half of the MNCH indicators displayed no resilience. MNCH coverage levels were low, with state averages ranging between 15% and 44%. Central Equatoria State displayed high resilience and high system stress. Lakes and Northern Bahr el Ghazal displayed high resilience and low stress. Jonglei and Upper Nile States had low resilience and high stress. This study is the first to investigate HSR definitions using a resilience metric and to simultaneously measure health system stress in FCAS. Improving function is the HSR definition detecting the greatest variation in the RI. HSR and health system stress are not consistently negatively associated. HSR is highly complex warranting more in-depth analyses in FCAS.
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Sanders, Angelia M., Zeinab Abdalla, Belgesa E. Elshafie, Andrew W. Nute, Elizabeth F. Long, Nabil Aziz, Paul Weiss, E. Kelly Callahan, and Scott D. Nash. "Prevalence of trachoma within refugee camps serving South Sudanese refugees in White Nile State, Sudan: Results from population-based surveys." PLOS Neglected Tropical Diseases 13, no. 6 (June 13, 2019): e0007491. http://dx.doi.org/10.1371/journal.pntd.0007491.

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Holding, Shannon, Ilin Sadeghi, Trevor White, Anna Murray, James Ray, Ayse Asatekin, and Daniele Lantagne. "Acceptability, effectiveness, and fouling of PointOne membrane filters distributed in South Sudan." Journal of Water, Sanitation and Hygiene for Development 9, no. 2 (February 18, 2019): 247–57. http://dx.doi.org/10.2166/washdev.2019.040.

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Abstract The Sawyer PointOne™ household hollow fiber membrane filter (PointOne) efficaciously removes microbiological indicators in the laboratory, and is increasingly considered for emergency response. To our knowledge, PointOne effectiveness in emergencies had not been evaluated. In South Sudan, 773 PointOnes were distributed. For 13 months after distribution, household surveys were completed quarterly, water quality testing was conducted monthly, and post-mortem analysis was completed at study midline to assess acceptability, effectiveness, and membrane fouling, respectively. Recipients found PointOnes acceptable, with high rates of demonstrated correct use (97–100%) and correct backflushing (96–100%). PointOnes effectively reduced thermotolerant coliforms for four months. When surface water use increased, effectiveness dropped, with 38% of filtrate samples contaminated. After backflushing filters with 0.2% chlorine solution, effectiveness improved; however, 5–38% of PointOne filtrate samples remained contaminated over subsequent months. Irreversible fouling was documented during post-mortem analysis. These results highlight that while PointOnes can improve household water quality within an emergency, PointOnes can foul within 4–6 months of use, depending on influent water quality. It is recommended that future PointOne distributions include continuous monitoring and an appropriate cleaning regime, based on influent water quality, to ensure continued performance. Further research on source water quality impacts on PointOne performance is recommended.
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Sanders, Angelia M., Maha Adam, Nabil Aziz, E. Kelly Callahan, and Belgesa E. Elshafie. "Piloting a trachomatous trichiasis patient case-searching approach in two localities of Sudan." Transactions of The Royal Society of Tropical Medicine and Hygiene 114, no. 8 (April 20, 2020): 561–65. http://dx.doi.org/10.1093/trstmh/traa022.

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Abstract Background Approximately 1.9 million people have become blind or visually impaired from trachoma, the leading cause of infectious blindness. Trachoma prevalence surveys conducted in Sudan have shown that thousands of Sudanese suffer from the advanced stages of the disease, trachomatous trichiasis (TT), and warrant sight-saving surgery. Sudan’s National Trachoma Control Program (NTCP) provides free TT surgery; however, given that many TT patients live in remote areas with limited access to health services, identifying patients and providing eye care services has proved challenging. For this reason, the Sudan NTCP piloted a systematic TT case-finding approach to identify patients. Methods In Gedarif state, 11 villages in Baladyat el Gedarif locality and 21 villages in West Galabat locality were included in a TT case-searching activity from September to November 2018. TT case finders were selected from the villages where the activity took place and were trained by ophthalmic medical assistants to identify possible patients. Results Of 66 626 villagers examined, 491 were identified as having TT by TT case finders. Of those, 369 were confirmed as true cases by the TT surgeons, a 75.2% (369/491) success rate. Conclusions The TT case-finding approach provides an example of an effective method for identifying TT patients and should be expanded to other parts of the country known to be endemic for trachoma.
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Bakhiet, Amani M. A., Mohamed H. Abdelraheem, Amani Kheir, Samia Omer, Linda Gismelseed, Abdel-Muhsin A. Abdel-Muhsin, Ahmed Naiem, et al. "Evolution of Plasmodium falciparum drug resistance genes following artemisinin combination therapy in Sudan." Transactions of The Royal Society of Tropical Medicine and Hygiene 113, no. 11 (August 1, 2019): 693–700. http://dx.doi.org/10.1093/trstmh/trz059.

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Abstract Background Malaria control efforts in Sudan rely heavily on case management. In 2004, health authorities adopted artemisinin-based combination therapies (ACTs) for the treatment of uncomplicated malaria. However, some recent surveys have reported ACT failure and a prevalent irrational malaria treatment practice. Here we examine whether the widespread use of ACT and failure to adhere to national guidelines have led to the evolution of drug resistance genes. Methods We genotyped known drug resistance markers (Pfcrt, Pfmdr-1, Pfdhfr, Pfdhps, Pfk13 propeller) and their flanking microsatellites among Plasmodium falciparum isolates obtained between 2009 and 2016 in different geographical regions in Sudan. Data were then compared with published findings pre-ACT (1992–2003). Results A high prevalence of Pfcrt76T, Pfmdr-1-86Y, Pfdhfr51I, Pfdhfr108N, Pfdhps37G was observed in all regions, while no Pfk13 mutations were detected. Compared with pre-ACT data, Pfcrt-76T and Pfmdr-1-86Y have decayed, while Pfdhfr-51I, Pfdhfr-108N and Pfdhps-437G strengthened. Haplotypes Pfcrt-CVIET, Pfmdr-1-NFSND/YFSND, Pfdhfr-ICNI and Pfdhps-SGKAA predominated in all sites. Microsatellites flanking drug resistance genes showed lower diversity than neutral ones, signifying high ACT pressure/selection. Conclusions Evaluation of P. falciparum drug resistance genes in Sudan matches the drug deployment pattern. Regular monitoring of these genes, coupled with clinical response, should be considered to combat the spread of ACT resistance.
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Elmagzoub, Wisal A., Nabawia M. Adam, Sanaa M. Idris, Mohamed E. Mukhtar, Sanaa A. Abdelaziz, Julius B. Okuni, Lonzy Ojok, et al. "Seroprevalence of Mycobacterium avium subsp. paratuberculosis in Dairy Cattle in Khartoum State, Sudan." Veterinary Sciences 7, no. 4 (December 21, 2020): 209. http://dx.doi.org/10.3390/vetsci7040209.

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Paratuberculosis, caused by Mycobacterium avium subspecies paratuberculosis (MAP), is a chronic wasting disease mainly of domestic and wild ruminants. It occurs worldwide, causing significant economic losses through decreased productivity, low fertility, increased cull rates and mortality. It is listed by the OIE (World Organization for Animal Health) as a disease of concern to trade in animals. Prevalence of this disease can be studied by detecting anti-MAP antibodies by Enzyme linked immunosorbent Assay (ELISA). The aim of this study was to investigate the current prevalence of MAP infection in cattle in Khartoum State. The overall apparent prevalence of MAP infection was found to be 6.3% and 18.9% at animal and herd levels, respectively. All seropositive animals were cross-bred females of good body condition; most of them (>90%) were >3 years old and >50% were from medium-sized herds in Omdurman. No significant association (p > 0.05) was found between seropositivity and animal herd size. The prevalence of MAP infection in Khartoum State is still low to medium compared to other parts of the world, but it is comparable to those reported from other African countries. Further studies with the view of designing nationwide surveys in domestic ruminants and camels in other states of the country are needed for establishing control programmes.
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Sanders, Angelia M., Zeinab Abdalla, Belgesa E. Elshafie, Mazin Elsanosi, Andrew W. Nute, Nabil Aziz, E. Kelly Callahan, and Scott D. Nash. "Progress toward Elimination of Trachoma as a Public Health Problem in Seven Localities in the Republic of Sudan: Results from Population-Based Surveys." American Journal of Tropical Medicine and Hygiene 101, no. 6 (December 4, 2019): 1296–302. http://dx.doi.org/10.4269/ajtmh.19-0530.

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Macleod, Colin K., Kamal Hashim Binnawi, Balgesa Elkheir Elshafie, Husam Eldin Sadig, Awad Hassan, Naomi Cocks, Rebecca Willis, Brian Chu, and Anthony W. Solomon. "Unimproved water sources and open defecation are associated with active trachoma in children in internally displaced persons camps in the Darfur States of Sudan." Transactions of The Royal Society of Tropical Medicine and Hygiene 113, no. 10 (July 26, 2019): 599–609. http://dx.doi.org/10.1093/trstmh/trz042.

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Abstract Purpose To estimate the proportion of children with trachomatous inflammation—follicular (TF) and adults with trachomatous trichiasis (TT) in internally displaced persons (IDP) camps in the Darfur States of Sudan and to evaluate associated risk factors. Methods IDP camps were identified from government census data. We conducted a subanalysis of data collected in these camps during 2014–2015 as part of surveys covering 37 districts of the Darfur States within the Global Trachoma Mapping Project. A random-effects hierarchical model was used to evaluate factors associated with TF in children or TT in adults. Results Thirty-six IDP camps were represented in the survey data, in which 1926 children aged 1–9 y were examined, of whom 38 (8%) had TF. Poor sanitation, younger age and living in a household that purchased water from a vendor were associated with TF in children aged 1–9 y. Of 2139 individuals examined aged ≥15 y, 16 (0.7%) had TT. TT was strongly independently associated with being older and living alone. Conclusion Trachoma is found at low levels in these camps, but still at levels where intervention is needed. Disease elimination in conflict-related settings presents a unique challenge for the trachoma community, and may require an innovative approach. Understanding how best to undertake trachoma elimination interventions in these areas should be prioritized.
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Ahmed, Ayman, Mustafa Abubakr, Hamza Sami, Isam Mahdi, Nouh S. Mohamed, and Jakob Zinsstag. "The First Molecular Detection of Aedes albopictus in Sudan Associates with Increased Outbreaks of Chikungunya and Dengue." International Journal of Molecular Sciences 23, no. 19 (October 5, 2022): 11802. http://dx.doi.org/10.3390/ijms231911802.

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As part of our surveys of the invasive malaria vector Anopheles stephensi in four Sudanese states, including North and South Kordofan, Sennar, and White Nile, we collected 166 larvae. Our morphological identification confirmed that 30% of the collected mosquito samples were Anopheles species, namely An. gambiae s.l. and An. stephensi, while the 117 Aedes specimens were Ae. luteocephalus (39%), Ae. aegypti (32%), Ae. vexans (9%), Ae. vittatus (9%), Ae. africanus (6%), Ae. metalicus (3%), and Ae. albopictus (3%). Considering the serious threat of Ae. albopictus emergence for the public health in the area and our limited resources, we prioritized Ae. albopictus samples for further genomic analysis. We extracted the DNA from the three specimens and subsequently sequenced the cytochrome oxidase 1 (CO1) gene and confirmed their identity as Aedes albopictus and their potential origin by phylogenetic and haplotype analyses. Aedes albopictus, originating from Southeast Asia, is an invasive key vector of chikungunya and dengue. This is the first report and molecular characterization of Ae. albopictus from Sudan. Our sequences cluster with populations from the Central African Republic and La Réunion. Worryingly, this finding associates with a major increase in chikungunya and dengue outbreaks in rural areas of the study region and might be linked to the mosquito’s spread across the region. The emergence of Ae. albopictus in Sudan is of serious public health concern and urges for the improvement of the vector surveillance and control system through the implementation of an integrated molecular xenosurveillance. The threat of major arboviral diseases in the region underlines the need for the institutionalization of the One Health strategy for the prevention and control of future pandemics.
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Valadez, Joseph James, Sima Berendes, Jackline Odhiambo, William Vargas, Baburam Devkota, Richard Lako, and Caroline Jeffery. "Is development aid to strengthen health systems during protracted conflict a useful investment? The case of South Sudan, 2011–2015." BMJ Global Health 5, no. 4 (April 2020): e002093. http://dx.doi.org/10.1136/bmjgh-2019-002093.

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IntroductionIs achievement of Sustainable Development Goal (SDG) 16 (building peaceful societies) a precondition for achieving SDG 3 (health and well-being in all societies, including conflict-affected countries)? Do health system investments in conflict-affected countries waste resources or benefit the public’s health? To answer these questions, we examine the maternal, newborn, child and reproductive health (MNCRH) service provision during protracted conflicts and economic shocks in the Republic of South Sudan between 2011 (at independence) and 2015.MethodsWe conducted two national cross-sectional probability surveys in 10 states (2011) and nine states (2015). Trained state-level health workers collected data from households randomly selected using probability proportional to size sampling of villages in each county. County data were weighted by their population sizes to measure state and national MNCRH services coverage. A two-sample, two-sided Z-test of proportions tested for changes in national health service coverage between 2011 (n=11 800) and 2015 (n=10 792).ResultsTwenty-two of 27 national indicator estimates (81.5%) of MNCRH service coverage improved significantly. Examples: malaria prophylaxis in pregnancy increased by 8.6% (p<0.001) to 33.1% (397/1199 mothers, 95% CI ±2.9%), institutional deliveries by 10.5% (p<0.001) to 20% (230/1199 mothers, ±2.6%) and measles vaccination coverage in children aged 12–23 months by 11.2% (p<0.001) to 49.7% (529/1064 children, ±2.3%). The largest increase (17.7%, p<0.001) occurred for mothers treating diarrhoea in children aged 0–59 months with oral rehydration salts to 51.4% (635/1235 children, ±2.9%). Antenatal and postnatal care, and contraceptive prevalence did not change significantly. Child vitamin A supplementation decreased. Despite significant increases, coverage remained low (median of all indicators = 31.3%, SD = 19.7) . Coverage varied considerably by state (mean SD for all indicators and states=11.1%).ConclusionHealth system strengthening is not a uniform process and not necessarily deterred by conflict. Despite the conflict, health system investments were not wasted; health service coverage increased.
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Fatih, Chellai. "Determinants of Under-Five Child Mortality in Arab Countries. Are the Effects Homogeneous Across Birth Order and Among Countries?" European Review Of Applied Sociology 14, no. 23 (December 1, 2021): 34–49. http://dx.doi.org/10.2478/eras-2021-0009.

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Abstract Under-five-child mortality remains a major challenge for governments in the Arab world to achieve Sustainable Development Goals. Thus, further studies are needed to analyze the determinants of child mortality. The Multiple Indicators Cluster Surveys (MICS) datasets of six Arab countries (Algeria, Egypt, Iraq, Mauritania, Sudan, and Tunisia) have been used, which are consisting of 249.000 children nested within 54.644 mothers. The study was designed in a women-parity-covered one to six birth order. Binary multivariable logistic models were used to estimate the risk ratios of death by adjusting for child sex, birth outcome (twin vs. singleton), mother’s education level, maternal age, previous birth interval, place of residence (rural vs. urban), and the family wealth index. The findings revealed that the under-five child mortality rates were 87, 70,66,35,36, and 21 per 1000 live births in Sudan, Mauritania, Egypt, Iraq, Algeria, and Tunisia, respectively). First-born infants in these six countries have a higher risk of mortality during their five years of life. Second, third-and fourth-born infants were at a decreased risk of death compared to first-born infants in all countries; in contrast, fifth-and-sixth-born infants were at an increased risk in all countries except Sudan and Mauritania. Twin children have a higher risk of death than singletons in all countries and across all birth orders. Children of mothers with higher educational levels living in urban areas are at lower risk of death than their peers across all birth orders. Regarding policy implications, decision-makers can target three main axes: first, enhancing women’s educational levels; second, increasing birth intervals (birth spacing policies); and third, improving living standards and healthcare strategies, especially in rural areas to improve child and mother health.
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Gerken, Keli N., A. Desirée LaBeaud, Henshaw Mandi, Maïna L’Azou Jackson, J. Gabrielle Breugelmans, and Charles H. King. "Paving the way for human vaccination against Rift Valley fever virus: A systematic literature review of RVFV epidemiology from 1999 to 2021." PLOS Neglected Tropical Diseases 16, no. 1 (January 24, 2022): e0009852. http://dx.doi.org/10.1371/journal.pntd.0009852.

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Background Rift Valley fever virus (RVFV) is a lethal threat to humans and livestock in many parts of Africa, the Arabian Peninsula, and the Indian Ocean. This systematic review’s objective was to consolidate understanding of RVFV epidemiology during 1999–2021 and highlight knowledge gaps relevant to plans for human vaccine trials. Methodology/Principal findings The review is registered with PROSPERO (CRD42020221622). Reports of RVFV infection or exposure among humans, animals, and/or vectors in Africa, the Arabian Peninsula, and the Indian Ocean during the period January 1999 to June 2021 were eligible for inclusion. Online databases were searched for publications, and supplemental materials were recovered from official reports and research colleagues. Exposures were classified into five groups: 1) acute human RVF cases, 2) acute animal cases, 3) human RVFV sero-surveys, 4) animal sero-surveys, and 5) arthropod infections. Human risk factors, circulating RVFV lineages, and surveillance methods were also tabulated. In meta-analysis of risks, summary odds ratios were computed using random-effects modeling. 1104 unique human or animal RVFV transmission events were reported in 39 countries during 1999–2021. Outbreaks among humans or animals occurred at rates of 5.8/year and 12.4/year, respectively, with Mauritania, Madagascar, Kenya, South Africa, and Sudan having the most human outbreak years. Men had greater odds of RVFV infection than women, and animal contact, butchering, milking, and handling aborted material were significantly associated with greater odds of exposure. Animal infection risk was linked to location, proximity to water, and exposure to other herds or wildlife. RVFV was detected in a variety of mosquito vectors during interepidemic periods, confirming ongoing transmission. Conclusions/Significance With broad variability in surveillance, case finding, survey design, and RVFV case confirmation, combined with uncertainty about populations-at-risk, there were inconsistent results from location to location. However, it was evident that RVFV transmission is expanding its range and frequency. Gaps assessment indicated the need to harmonize human and animal surveillance and improve diagnostics and genotyping. Given the frequency of RVFV outbreaks, human vaccination has strong potential to mitigate the impact of this now widely endemic disease.
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Nasser, Sara, Jonathan Berek, Andreas Ullrich, Livia Giordano, and Jalid Sehouli. "A report on the Marrakech International Women’s Cancer Days: dialogs and implications." International Journal of Gynecologic Cancer 29, no. 2 (December 21, 2018): 417–21. http://dx.doi.org/10.1136/ijgc-2018-000059.

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The MarrakechInternational Women’s Cancer Days showcased a first-time international meeting of healthcare professionals worldwide to discuss, over the course of 3 days, aspects of public health, prevention, and treatment of gynecological cancers in the Arabic region. The focus was particularly on promoting globally sustainable research initiatives. The event was a joint initiative organized by the Gynecological Cancer Intergroup and the Pan-Arabian Research Society of Gynecological Oncology. The first conference day focused on the early diagnosis and screening of cervical cancer and the required action to establish equity within screening programs and improve cancer control strategies in the Euro-Mediterranean region. The second day highlighted current screening, diagnosis, and treatment strategies for ovarian cancer in the Arabic region, with particular discussion on the incidence of germline mutations in Arabic women with ovarian cancer. Centers from the Arabic region such as Jordan, Tunesia, Sudan, and Morocco presented their own data on ovarian cancer patients and local clinical practice, and barriers to treatment. It was highlighted that more support is required in surgical training and medical therapies. On the third day , the focus was on cervical cancer therapies and treatment. Interesting surveys on patient awareness of screening programs and cervical cancer were presented from various centers including Lebanon, Sudan, and the UAE. The conference ended with emphasis on patient education, and quality of life. The meeting provided a first-time platform for sustainable worldwide dialog and exchange on all aspects of gynecological cancers focusing on the Arabic woman and the particular barriers, unchartered territories, and challenges this patient population presents to the global healthcare community.
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Borras-Bermejo, Blanca, Isabella Panunzi, Catherine Bachy, and Julita Gil-Cuesta. "Missed opportunities for vaccination (MOV) in children up to 5 years old in 19 Médecins Sans Frontières-supported health facilities: a cross-sectional survey in six low-resource countries." BMJ Open 12, no. 7 (July 2022): e059900. http://dx.doi.org/10.1136/bmjopen-2021-059900.

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ObjectiveTo describe missed opportunities for vaccination (MOV) among children visiting Médecins Sans Frontières (MSF)-supported facilities, their related factors, and to identify reasons for non-vaccination.DesignCross-sectional surveys conducted between 2011 and 2015.Setting and participantsChildren up to 59 months of age visiting 19 MSF-supported facilities (15 primary healthcare centres and four hospitals) in Afghanistan, Democratic Republic of the Congo, Mauritania, Niger, Pakistan and South Sudan. Only children whose caregivers presented their vaccination card were included.Outcome measuresWe describe MOV prevalence and reasons for no vaccination. We also assess the association of MOV with age, type of facility and reason for visit.ResultsAmong 5055 children’s caregivers interviewed, 2738 presented a vaccination card of whom 62.8% were eligible for vaccination, and of those, 64.6% had an MOV. Presence of MOV was more likely in children visiting a hospital or a health facility for a reason other than vaccination. MOV occurrence was significantly higher among children aged 12–23 months (84.4%) and 24–59 months (88.3%) compared with children below 12 months (56.2%, p≤0.001). Main reasons reported by caregivers for MOV were lack of vaccines (40.3%), reason unknown (31.2%) and not being informed (17.6%).ConclusionsAvoiding MOV should remain a priority in low-resource settings, in line with the new ‘Immunization Agenda 2030’. Children beyond their second year of life are particularly vulnerable for MOV. We strongly recommend assessment of eligibility for vaccination as routine healthcare practice regardless of the reason for the visit by screening vaccination card. Strengthening implementation of ‘Second year of life’ visits and catch-up activities are proposed strategies to reduce MOV.
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Dusabimana, Alfred, Joseph Nelson Siewe Fodjo, Michel Mandro Ndahura, Bruno P. Mmbando, Stephen Raimon Jada, Annelies Boven, Eric De Smet, et al. "Surveillance for Onchocerciasis-Associated Epilepsy and OV16 IgG4 Testing of Children 6–10 Years Old Should Be Used to Identify Areas Where Onchocerciasis Elimination Programs Need Strengthening." Pathogens 11, no. 3 (February 23, 2022): 281. http://dx.doi.org/10.3390/pathogens11030281.

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To eliminate onchocerciasis-associated morbidity, it is important to identify areas where there is still high ongoing Onchocerca volvulus transmission. Between 2015 and 2021, door-to-door surveys were conducted in onchocerciasis-endemic villages in Cameroon, the Democratic Republic of Congo (DRC), Nigeria, South Sudan, and Tanzania to determine epilepsy prevalence and incidence, type of epilepsy and ivermectin therapeutic coverage. Moreover, children aged between six and 10 years were tested for anti-Onchocerca antibodies using the Ov16 IgG4 rapid diagnostic test (RDT). A mixed-effect binary logistic regression analysis was used to assess significantly associated variables of Ov16 antibody seroprevalence. A high prevalence and incidence of epilepsy was found to be associated with a high Ov16 antibody seroprevalence among 6–10-year-old children, except in the Logo health zone, DRC. The low Ov16 antibody seroprevalence among young children in the Logo health zone, despite a high prevalence of epilepsy, may be explained by a recent decrease in O. volvulus transmission because of a decline in the Simulium vector population as a result of deforestation. In the Central African Republic, a new focus of O. volvulus transmission was detected based on the high Ov16 IgG4 seropositivity among children and the detecting of nodding syndrome cases, a phenotypic form of onchocerciasis-associated epilepsy (OAE). In conclusion, Ov16 IgG4 RDT testing of 6–10-year-old children is a cheap and rapid method to determine the level of ongoing O. volvulus transmission and to assess, together with surveillance for OAE, the performance of onchocerciasis elimination programs.
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Ackah, Martin, David Owiredu, Mohammed Gazali Salifu, and Cynthia Osei Yeboah. "Estimated prevalence and gender disparity of physical activity among 64,127 in-school adolescents (aged 12–17 years): A multi-country analysis of Global School-based Health Surveys from 23 African countries." PLOS Global Public Health 2, no. 10 (October 21, 2022): e0001016. http://dx.doi.org/10.1371/journal.pgph.0001016.

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The Africa sub-region currently lacks quantitative normative data to illustrate the extent of burden and gender inequities of physical activity level in order to inform policy and education, towards meeting the WHO’s 2030 physical activity milestone. The study aimed to provide insights on the current prevalence of sufficient physical activity and gender disparity, using a nationally representative data from the Global School-based student Health Survey (GSHS) from 23 African countries. The study used the multi-country GSHS data from 23 African countries (2003–2017). Sufficient physical activity was measured through self-administered questionnaire. The prevalence of sufficient physical activity among in-school adolescents in each country was estimated by proportion with corresponding 95% confidence intervals. Meta-analysis with random effect was employed to pool the prevalence of physical activity level in the 23 African countries. Additionally, sub-group, sensitivity, and meta-regression analyses were performed. The study included 23 African countries representing 64,127 in-school adolescents aged 12–17 years. Overall, only 20% [95% CI: 18%-22%] of adolescents in Africa engaged in sufficient physical activity. With respect to sex, only 25% [95% CI: 22%-28%] of males and 16% [95% CI: 14%-18%] of females met the WHO recommendation of sufficient physical activity. Sufficient physical activity ranged from 11.6% [9.2%-14.5%] in Sudan to 38.3% [CI:30.2%-47.1%] in Benin. Sufficient physical activity in boys ranged from 7.5% [95% CI: 6.2%-9.0%] in Zambia to 29.2% [95% CI: 22.5%-36.8%] in Benin, and ranged from 2.5% [95% CI: 1.6%-4.0%] in Senegal to 12.2% [95% CI:10.6%-14.1%] in Tanzania for girls. Only 20% of in-school adolescents met the WHO’s recommended physical activity level. Generally, adolescent girls in Africa are less active than adolescent boys. Addressing the rising burden of insufficient physical activity in adolescents and narrowing the gender gap could ultimately increase the overall physical activity engagement and achieve the WHO’s global physical activity target by 2030.
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Marques, Adilson, Duarte Henriques-Neto, Miguel Peralta, João Martins, Yolanda Demetriou, Dorothea M. I. Schönbach, and Margarida Gaspar de Matos. "Prevalence of Physical Activity among Adolescents from 105 Low, Middle, and High-Income Countries." International Journal of Environmental Research and Public Health 17, no. 9 (April 30, 2020): 3145. http://dx.doi.org/10.3390/ijerph17093145.

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Introduction: Physical activity (PA) is a beneficial health behaviour, however most adolescents worldwide are physically inactive. Updated information on the prevalence and trends of PA is important to inform national and international authorities and support countries’ public health policies and actions. This study aimed to present the worldwide, regional, and national prevalence of PA participation according to its frequency in adolescents. Methods: This study is based on cross-sectional surveys of adolescents’ populations from several countries and all regions worldwide. The sample comprised 520,533 adolescents (251,788 boys; 268,745 girls), from 105 countries and regions. Results: Most adolescents engaged in PA up to 3 days/week (57.1%; 95% CI: 56.9; 57.2). The prevalence of engaging in PA every day decreases over the age from 28.2% at age of 11–12 years (95% CI: 27.4; 29.0) to 21.2% at age of 16–17 years (95% CI: 20.3; 22.0) among boys; and from 19.4% (95% CI: 18.5; 20.2) to 11.1% (95% CI: 10.1; 12.0) among girls. For boys and girls who engaged in PA 5-6 days/week, the prevalence increases from countries with the lowest human development index to countries with the highest. Cambodia (7.3%, 95% CI: 3.8; 10.8), Philippines (7.7%, 95% CI: 5.6; 9.7), Sudan (8.8%, 95% CI: 4.7; 12.9), Timor-Leste (8.9%, 95% CI: 5.5; 12.3), and Afghanistan (10.1%, 95% CI: 6.1; 14.1) were the countries with the lowest prevalence of sufficient PA. Conclusions: National, regional, and worldwide data on the prevalence of physical activity in adolescents highlights the importance of improving the global levels of PA, especially in girls. Identifying the factors causing the age-related decrease in physical activity levels will permit public health entities to define priority actions and policies against physical inactivity.
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Elmusharaf, K., A. Abbas, A. Ibrahim, S. Elsayed, and L. Badraldin. "Reproductive health in rural Sudan: a population based survey." Contraception 80, no. 2 (August 2009): 225–26. http://dx.doi.org/10.1016/j.contraception.2009.05.118.

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Elduma, Adel Hussein. "Female Genital Mutilation in Sudan." Open Access Macedonian Journal of Medical Sciences 6, no. 2 (February 14, 2018): 430–34. http://dx.doi.org/10.3889/oamjms.2018.099.

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BACKGROUND: Female genital mutilation or female circumcision (FGM) is a serious health problem in Sudan. This procedure is harmful to women and causes many complications during pregnancy and childbirth.OBJECTIVE: This study aims to determine the female genital mutilation (FGM) and its associated factors in Sudan.SUBJECTS AND METHODS: Data from Sudan Multiple Indicator Cluster Survey (MICS - UNICEF) was used in this research. The survey was carried out in 2014 and included women aged between 14 – 49 years. A logistic regression model was used to find an association between dependent and independent variables.RESULT: Total numbers of 21947 women were included in the survey and out of the 6249 (28.5 %) from urban and 15698 (71.5%) from rural areas. The prevalence of female circumcision was 89%. Women who had circumcised daughters were 32.1 %. The highest prevalence of FGM was reported from South Kordofan state with 7.8%, and lowest was in Red Sea state (7.6%). A significant association was observed between circumcised women and their marital status, daughter circumcision, and the level of education.CONCLUSION: The practice of female genital mutilation is spread all over the country. Poor women with low level of education are at high risk for this phenomenon. More efforts have to be provided to end this dangerous practice.
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LaVange, Lisa M., Sally C. Steams, Jennifer E. Lafata, Gary G. Koch, and Babubhai V. Shah. "Innovative strategies using SUDAAN for analysis of health surveys with complex samples." Statistical Methods in Medical Research 5, no. 3 (September 1996): 311–29. http://dx.doi.org/10.1177/096228029600500306.

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Roth, Eric A., and K. Balan Kurup. "Child mortality levels and survival patterns from Southern Sudan." Journal of Biosocial Science 22, no. 3 (July 1990): 365–72. http://dx.doi.org/10.1017/s0021932000018721.

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SummaryData from a 1985 survey in two major population centres in Southern Sudan, Juba and Wau, were analysed in order to assess childhood mortality levels and the effect of UNICEF's health care programme. There are continuing high levels of childhood mortality. Logistic regression analysis shows significant positive associations between child survival and immunization, oral rehydration therapy and maternal education.
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Khalifa, Mona A. "Determinants of birth intervals in Sudan." Journal of Biosocial Science 21, no. 3 (July 1989): 301–20. http://dx.doi.org/10.1017/s0021932000018009.

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SummaryUsing individual birth history data from the Sudan Fertility Survey, 1979, parity-related differences in fertility are demonstrated, as well as differences between socioeconomic groups. Rural women, women with no education and those married to uneducated husbands show rapid parity progression and its cumulative effects on fertility which are consistent over all birth intervals. Urban women, women with some education and those married to educated husbands, however, go rapidly through their second and third birth intervals and then more slowly at higher parities. A limitation of the study was the inability to control fully for the effects of breast-feeding and contraception.There is evidence for a reduction in high parity births,' starting in the 1970s.
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Adams, Ali, Francis Ojemu, Okechi Ogueji, and Leonie Tax. "Violence Against Health Care in Nigeria and South Sudan: Frontline Health Worker Perspectives on Threats and Solutions." Prehospital and Disaster Medicine 37, S2 (November 2022): s55. http://dx.doi.org/10.1017/s1049023x22001546.

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Background/Introduction:Health staff in South Sudan and Nigeria face extreme risks while providing services: in 2021, at least 18 health care workers were killed in South Sudan and Nigeria, while 32 were kidnapped. Reporting of such incidents takes place via the WHO coordinated SS. However, such event reporting is not designed to capture “lower scale” security incidents, nor does it capture possible solutions. As such, the IRC in coordination with the Health Cluster and national organizations are conducting a survey to complement the existing analysis with insights of frontline health care workers, to support program design, funding requests, and advocacy activities. Research questions include: What are the most common incidents of violence against health care workers?What has been the impact of these incidents on staff well-being, on the health system/sector, and on access to health care for the wider community?What are the priorities in preventing such incidents and reducing their impact?Objectives:To identify incidents of violence against health care as experienced by health care staff in 2022.To identify health workers perspective on causes, impact, and what works in terms of prevention and response.Method/Description:A self-administered, online survey targeting all health staff working for the humanitarian community in South Sudan and Northeastern Nigeria.Results/Outcomes:This study is on-going with results expected by early September.Conclusion:This study is on-going with results expected by early September.
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Abusalih, Howeida, and Zeinab Abu Sabeib. "Update of the nutritional situation in the Republic of Sudan." North African Journal of Food and Nutrition Research 4, no. 9 (November 15, 2020): S17—S24. http://dx.doi.org/10.51745/najfnr.4.9.s17-s24.

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Background: Sudan is situated in the northeastern part of Africa. The population of the country is approximately 43 million, spread over 1.88 million square kilometers. Although Sudan has great resources, most of the population suffers from poverty and food deficiency because of the conflicts in the different parts of the country .The suffering was augmented by climatic drought and floods which resulted in food insecurity. The population’s internal displacement is disadvantageous regarding access to health services and is consequently more vulnerable to diseases and malnutrition. In Sudan, thirty-three percent of the population suffered from food deprivation according to the national survey of 2010. The prevalence of undernourishment was 31% and 34 % percent for urban and rural populations respectively. Furthermore, based on WHO epidemiologic criteria, the prevalence of stunting and wasting are classified as profound, 38.2%, for stunting which is more than the average of the developing countries( 25%), wasting defined as low weight for height also has a higher prevalence in under-five in Sudan comparing it to the developing countries' average which is 16.8% and 8.9% respectively. Although recent national survey data are lacking, it is evident that micronutrient deficiencies are a major public health concern from the sporadic studies’ findings. Notwithstanding these challenges, the government and the Federal Ministry of Health, move along to make progress towards nutrition and food security, some supplementation campaigns have been conducted but coverage of the population is still low. Sudan is one of the 61 countries that leading a global movement to end up malnutrition in all its forms. Keywords: Sudan, deficiencies, food, micronutrient, mortality, insecurity.
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Abusalih, Howeida, and Zeinab Abu Sabeib. "Update of the nutritional situation in the Republic of Sudan." Special Issue July-December 2020 04, no. 09 (November 15, 2020): S17—S24. http://dx.doi.org/10.51745/najfnr.4.09.s17-s24.

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Background: Sudan is situated in the northeastern part of Africa. The population of the country is approximately 43 million, spread over 1.88 million square kilometers. Although Sudan has great resources, most of the population suffers from poverty and food deficiency because of the conflicts in the different parts of the country .The suffering was augmented by climatic drought and floods which resulted in food insecurity. The population’s internal displacement is disadvantageous regarding access to health services and is consequently more vulnerable to diseases and malnutrition. In Sudan, thirty-three percent of the population suffered from food deprivation according to the national survey of 2010. The prevalence of undernourishment was 31% and 34 % percent for urban and rural populations respectively. Furthermore, based on WHO epidemiologic criteria, the prevalence of stunting and wasting are classified as profound, 38.2%, for stunting which is more than the average of the developing countries( 25%), wasting defined as low weight for height also has a higher prevalence in under-five in Sudan comparing it to the developing countries' average which is 16.8% and 8.9% respectively. Although recent national survey data are lacking, it is evident that micronutrient deficiencies are a major public health concern from the sporadic studies’ findings. Notwithstanding these challenges, the government and the Federal Ministry of Health, move along to make progress towards nutrition and food security, some supplementation campaigns have been conducted but coverage of the population is still low. Sudan is one of the 61 countries that leading a global movement to end up malnutrition in all its forms. Keywords: Sudan, deficiencies, food, micronutrient, mortality, insecurity.
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RM, Hajhamed. "Knowledge, attitude and practice toward COVID-19, 2020 in Kassala, Sudan." International Journal of Clinical Case Reports and Reviews 6, no. 1 (January 4, 2021): 01–05. http://dx.doi.org/10.31579/2690-4861/095.

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Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus. The behavior of the general public will probably have an important bearing on the course of the coronavirus disease 2019 (COVID-19) epidemic. Human behavior is influenced by people's knowledge and perceptions. This study was done to assess the knowledge, attitude and practice of the people in the state of Kassala. A cross-sectional descriptive survey of 210 Sudanese residents from the state of kassala was conducted between March –May 2020. 210 questionnaires where distributed, Data collected were analyzed using descriptive statistics, analysis for frequencies and chi-square was obtained using R Language Version R i386 4.0.2. 96.2 % of our respondents heard about corona (p-value < 2.2e-16), while the main source of information was through the radio 34.3 %( p-value = 5.515e-15). 83.3 % of the respondents think they are at risk of exposure to COVID -19, 97.6% think that it’s important to take measures to prevent corona virus in the community. Most of our respondents (94.35) think that corona causes stigma to the affected people. 61.9% of our participants think the virus is very dangerous. In the effort to prevent the spread of the disease, 28.6% the respondents stopped greeting people while 28 % of them did not take any measures to stop it. There is poor knowledge, attitude and practice to wards corona in the state of kassala. The ministry of health needs to intensify the effort to provide knowledge through radio, as it was the most commonly used media in our community.
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Elamin, Obbey A. "Effect of Improving Housing Conditions on Early Childhood Health in Rural Sudan." Journal of Sustainable Development 9, no. 4 (July 30, 2016): 96. http://dx.doi.org/10.5539/jsd.v9n4p96.

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Improving housing sector in rural areas is important to improve health status of under-five children. Propensity score matching using nonparametric kernel estimates is used to examine the effect of improving rural structure of houses in rural Sudan and provide them with services like access to clean piped water, sanitation on improving under-five children health. The prevalence of diarrhoea and cough in rural Sudan are used as measures of health outcome and data from the Sudan Household Health Survey in 2010 is used. Our results show that providing houses with piped water can reduce prevalence of diarrhoea and cough by 22 and 24 percentage points, respectively. Gas cooking fuel reduces the prevalence rates by 26 and 29 percentage points, respectively. Construction materials of walls have strong impact on reducing the prevalence of both illnesses. We recommend that the quality of piped water should be observed and maintained in good standard to ensure that clean water is supplies to the household sector. Developing the housing sector in the rural has many advantages in improving early childhood health in Sudan and it should be one of the priorities of the government.
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Tongun, Justin Bruno, Mohamedi Boy Sebit, Grace Ndeezi, David Mukunya, Thorkild Tylleskar, and James K. Tumwine. "Prevalence and determinants of pre-lacteal feeding in South Sudan: a community-based survey." Global Health Action 11, no. 1 (January 2018): 1523304. http://dx.doi.org/10.1080/16549716.2018.1523304.

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Chaney, Elizabeth H., J. Don Chaney, Min Qi Wang, and James M. Eddy. "Lifestyle Behaviors and Mental Health of American Adults." Psychological Reports 100, no. 1 (February 2007): 294–302. http://dx.doi.org/10.2466/pr0.100.1.294-302.

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The purpose of this study was to test the hypothesis that individuals reporting healthy lifestyle behaviors would also report better self-rated mental health. Logistic regression analyses were conducted utilizing SUDAAN on the Behavioral Risk Factor Surveillance Survey data set. This descriptive analysis suggests that persons reporting poor mental health were more likely to report unhealthy lifestyle behaviors. This set of findings encourages careful design of experimental studies of empirically based associations of mental health and life style, using psychometrically sound measures. Then public health programs focused on change of health-related behaviors might be more suitably devised.
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Ibrahim-Khalil, S., M. Elhag, E. Ali, F. Mahgoub, S. Hakiem, N. Omer, S. Shafie, and E. Mahgoub. "An epidemiological survey of rheumatic fever and rheumatic heart disease in Sahafa Town, Sudan." Journal of Epidemiology & Community Health 46, no. 5 (October 1, 1992): 477–79. http://dx.doi.org/10.1136/jech.46.5.477.

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36

Tayeb, Sally El, Safa Abdalla, Odd Mørkve, Ivar Heuch, and Graziella Van den Bergh. "Injuries in Khartoum state, the Sudan: a household survey of incidence and risk factors." International Journal of Injury Control and Safety Promotion 21, no. 2 (May 8, 2013): 144–53. http://dx.doi.org/10.1080/17457300.2013.792283.

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Adam, Mosab, Hongwei Shen, Khalid-A. Enan, Hao Wang, Azza B. Musa Musa, Abdel R. El Hussein, Isam M. Khidir, and Xuejun Ma. "Molecular survey of certain protozoan agents that cause diarrhea in children in Sudan." F1000Research 11 (November 29, 2022): 1401. http://dx.doi.org/10.12688/f1000research.123652.1.

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Introduction Diarrhea is a significant health problem in third world countries; identification of causative agents of diarrhea is essential to apply measures to prevent and control this disease. In addition, scant data are available regarding childhood diarrhea in Sudan. Our research aimed to determine the incidence of specific protozoan pathogens (Entameobia histolytica, Cryptosporidium spp., and Gardia lambelia) among the young (aged less than five years) in Khartoum, Sudan. Methods We conducted a parasitological cross-sectional survey, and stool samples from 437 patients were examined for E. histolytica, C. parvum, and G. lambelia using a multiplex real-time PCR method. Results Of the 437 stool samples tested, infection with intestinal parasite was found in 155 (35.5%) cases, and co-infection was identified in 16 (3.7%) cases. G. lambelia (18.8%) and C. parvum (15.8 %) were the most frequently identified parasites, followed by E. histolytica (0.5%). The highest and lowest rates of parasitic infections were seen in the less than two years age group (32.7%), and in the 2–4-year-old group (2.7%), the male children showed higher rates of infections (23.7%) compared to females (11.7%). The incidence of protozoan infection was higher (37.7%) in the rainy season (August to December) (32.7%) in contrast with that (2.7%) in the dry season (April to June). Discussion Our present study demonstrated the high prevalence of G. lambelia and C. parvum in children with diarrhea in Khartoum State and the multiplex real-time technique's usefulness in disclosing pathogenic protozoal agents. Our result highlighted the necessity of developing intervention measurement and control strategies to deal with childhood parasitic diarrhea in this region.
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Mugo, Ngatho Samuel, Kingsley E. Agho, Anthony B. Zwi, Eliaba Yona Damundu, and Michael J. Dibley. "Determinants of neonatal, infant and under-five mortality in a war-affected country: analysis of the 2010 Household Health Survey in South Sudan." BMJ Global Health 3, no. 1 (February 2018): e000510. http://dx.doi.org/10.1136/bmjgh-2017-000510.

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BackgroundUnder-five children born in a fragile and war-affected setting of South Sudan are faced with a high risk of death as reflecting in high under-five mortality. In South Sudan health inequities and inequitable condition of daily living play a significant role in childhood mortality. This study examines factors associated with under-five mortality in South Sudan.MethodsThe study population includes 8125 singleton, live birth, under-five children born in South Sudan within 5 years prior to the 2010 South Sudan Household Survey. Factors associated with neonatal, infant and under-five deaths were examined using generalised linear latent and mixed models with the logit link and binomial family that adjusted for cluster and survey weights.ResultsThe multivariate analysis showed that mothers who reported a previous death of a child reported significantly higher risk of neonatal (adjusted OR (AOR)=3.74, 95% confidence interval (CI 2.88 to 4.87), P<0.001), infant (AOR=3.19, 95% CI (2.62 to 3.88), P<0.001) and under-five deaths (AOR=3.07, 95% CI (2.58 to 3.64), P<0.001). Other associated factors included urban dwellers (AOR=1.37, 95% CI (1.01 to 1.87), P=0.045) for neonatal, (AOR=1.35, 95% CI (1.08 to 1.69), P=0.009) for infants and (AOR=1.39, 95% CI (1.13 to 1.71), P=0.002) for under-five death. Unimproved sources of drinking water were significantly associated with neonatal mortality (AOR=1.91, 95% CI (1.11 to 3.31), P=0.02).ConclusionsThis study suggested that the condition and circumstances in which the child is born into, and lives with, play a role in under-five mortality, such as higher mortality among children born to teenage mothers. Ensuring equitable healthcare service delivery to all disadvantaged populations of children in both urban and rural areas is essential but remains a challenge, while violence continues in South Sudan.
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El Tayeb, Sally, Safa Abdalla, Ivar Heuch, and Graziella Van den Bergh. "Socioeconomic and disability consequences of injuries in the Sudan: a community-based survey in Khartoum State." Injury Prevention 21, e1 (November 13, 2013): e56-e62. http://dx.doi.org/10.1136/injuryprev-2013-040818.

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Hassan, Rowa, Kebede Deribe, Ahmed Hassan Fahal, Melanie Newport, and Sahar Bakhiet. "Clinical epidemiological characteristics of mycetoma in Eastern Sennar locality, Sennar State, Sudan." PLOS Neglected Tropical Diseases 15, no. 12 (December 13, 2021): e0009847. http://dx.doi.org/10.1371/journal.pntd.0009847.

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Mycetoma epidemiological features remain uncharacterised. Few studies have been conducted in a community-based setting to explore the epidemiological features and risk factors for mycetoma in Sudan. To bridge this gap, this study was conducted in Eastern Sennar Locality, Sennar State, Sudan, to report the clinical, epidemiological characteristics of mycetoma patients and the disease burden in the state. We used cluster sampling; sixty villages were randomly selected across the locality’s five administrative units, and a household-to-household survey was conducted. We collected data using pre-designed questionnaires at the community, household, and individual levels. We performed descriptive analyses of the data and produced prevalence maps using ArcGIS 10.5 ([ESRI] Inc., Redlands CA, USA). A total of 41,176 individuals were surveyed, and 359 mycetoma patients were identified. The overall prevalence of mycetoma was 0.87% (95%CI = 0.78–0.97%), the prevalence among males was 0.83% (95%CI = 0.71–0.96%), and females 0.92% (95% CI = 0.79–1.06%). Individuals in the age group 31–45 years had the highest prevalence among the different age groups (1.52%, 95% CI = 1.23–1.86%). The prevalence map showed patients clustered within the central and north-eastern part of the locality, while villages in the south-western part had few or no cases. In conclusion, this clinical epidemiological study is pioneering and shows that mycetoma is prevalent in certain parts of Sudan. This data obtained will support the design of measures to reduce the disease burden in the state. The survey procedures and protocols can be adopted for further studies in Sudan and beyond.
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Ahmed, Hussain Gadelkarim. "Awareness Survey on Knowledge of Microbial Infectious Causes of Cancer in Northern State of Sudan." Asian Pacific Journal of Cancer Prevention 13, no. 11 (November 30, 2012): 5497–500. http://dx.doi.org/10.7314/apjcp.2012.13.11.5497.

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Abdalla, Salma M., Esra AA Mahgoub, Jihad Abdelgadir, Nahla Elhassan, and Zulfa Omer. "Operationalization of patients’ rights in Sudan: Quantifying nurses’ knowledge." Nursing Ethics 26, no. 7-8 (October 15, 2018): 2239–46. http://dx.doi.org/10.1177/0969733018787224.

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Background: Promoting patients’ rights is essential for defining the standards of clinical services within a country. Given their responsibilities, nurses can be the primary target for research to investigate the issue of patients’ rights within a healthcare system. As such, assessing the knowledge of nurses about patients’ rights is an essential step toward improving the quality of healthcare in limited resource settings like Sudan. Objectives: We aimed to assess the level of knowledge about patients’ rights among the nursing staff at Friendship Teaching Hospital in Sudan. Methods: This hospital-based cross-sectional study was carried out at the Friendship Teaching Hospital in Sudan. We surveyed the totality of nurses (95) at the hospital using an amended survey. The data were analyzed in SPSS software using descriptive and inferential statistics. Ethical consideration: The study was approved by the Research Unit of Khartoum Ministry of Health and the Hospital administration. All respondents gave verbal consent prior to participating in the study. Results: Only 48.4% of the participants knew about the existence of the Sudanese Charter of patients’ rights. Nonetheless, our analysis found that 65.8% of nurses had acceptable level of knowledge (scored more than 75% of the total knowledge score) of patients’ rights, and none of the participant scored less than 50% of the total knowledge score. Finally, we found no statistical association between the knowledge score and demographic data, educational level, whether the participant knows about the existence of the Charter or not and a number of other factors. Conclusion: Nurses’ lack of knowledge about the existence of the Sudanese Charter of patients’ rights adopted in 2009 rights confirms the need for further efforts by Ministry of Health to promote the document. Furthermore, further research is needed to investigate the disconnect between nurses’ lack of knowledge about the existence of the charter and their awareness of the rights within the charter as well as the actual implementation of rights.
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Hounsome, Natalia, Rowa Hassan, Sahar Mubarak Bakhiet, Kebede Deribe, Stephen Bremner, Ahmed Hassan Fahal, and Melanie J. Newport. "Role of socioeconomic factors in developing mycetoma: Results from a household survey in Sennar State, Sudan." PLOS Neglected Tropical Diseases 16, no. 10 (October 17, 2022): e0010817. http://dx.doi.org/10.1371/journal.pntd.0010817.

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Background Mycetoma is a chronic, progressively destructive disease of subcutaneous tissues and bones caused by certain species of bacteria or fungi. We conducted a cross-sectional community-based study alongside mapping of mycetoma in five administrative units with high mycetoma endemicity in the Eastern Sennar Locality, Sennar State, Sudan. Methods A household survey was administered which included questions about the household members, household characteristics, economic activity and history of mycetoma. A clinical examination was conducted on all members of the household. If mycetoma was suspected, an individual questionnaire was completed collecting demographic, clinical and epidemiological data as well as information on the use of health care and associated costs. Geographical coordinates and photos of the lesions were taken, and the affected persons were referred to the medical centre for confirmation of the diagnosis and treatment. We compared the characteristics of households with confirmed cases of mycetoma with those without confirmed cases, and individuals with confirmed mycetoma with those in whom mycetoma was not confirmed. Results In total 7,798 households in 60 villages were surveyed; 515 suspected cases were identified and 359 cases of mycetoma were confirmed. Approximately 15% of households with mycetoma had more than one household member affected by this disease. Households with mycetoma were worse off with respect to water supply, toilet facilities, electricity and electrical appliances compared to the survey households. Only 23% of study participants with mycetoma had sought professional help. Of these, 77% of patients travelled an average of six hours to visit a medical facility. More than half of patients had to pay towards their treatment. The estimated average cost of treatment was 26,957 Sudanese pounds per year (566 US dollars, exchange rate 2018). Conclusions Results of this survey suggest that agricultural practices and reduced access to sanitation and clean water can be risk factors in developing mycetoma. Poor access to health care and substantial financial costs were barriers to seeking treatment for mycetoma.
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44

Elhadi, Yasir Ahmed Mohammed, Abdelmuniem Ahmed, Elhadi B. Salih, Osman S. Abdelhamed, Mohamed Hayder Hamid Ahmed, and Noha Ahmed El Dabbah. "A cross-sectional survey of burnout in a sample of resident physicians in Sudan." PLOS ONE 17, no. 3 (March 4, 2022): e0265098. http://dx.doi.org/10.1371/journal.pone.0265098.

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Background Resident physicians in Sudan face a variety of physical and psychological stressors. Nevertheless, the prevalence of burnout syndrome among this critical population remains unknown. The purpose of this study was to estimate the prevalence rate of burnout and its associated factors in a sample of resident physicians in Sudan. Methods A cross-sectional design was used to assess the burnout syndrome among resident physicians at the teaching hospitals of Wad-Medani in Gezira state, east-central Sudan. Three hundred resident physicians at the dermatology, general surgery, pediatrics, obstetrics and gynecology, psychiatry, ear, nose and throat (ENT), oncology, urology, and internal medicine departments, were approached and invited to participate in the study. The Arabic version of the Maslach Burnout Inventory was distributed to respondents from July to October 2021. Results From the 300 resident physicians, 208 (69.3%) responded. The average age of the study population was 29.99 ± 3.01 years, with more than half were females (56.7%), single (59.6%), and with more than three years of residency experience (50.5%). In total, 86.1% met the criteria for burnout in at least one dimension and 13.9% in all three dimensions. On the dimension of emotional exhaustion (EE), 70.7% reported high levels of burnout. While, 44.2% reported high levels of depersonalization (DP), and 73.1% experienced a sense of decreased professional accomplishment (PA). There were significant differences in burnout, EE, and DP levels among different specialties, with the pediatrics-specialty trainees reported higher levels. Burnout syndrome was associated with the working hours per single duty; participants who reported working for more than 24 hours had experienced higher levels of burnout, EE, and DP. Conclusion Large-scale studies are required to assess the determinants of burnout syndrome among resident physicians in Sudan. In addition, Stakeholders should urgently implement effective remedies to protect the mental health of resident physicians.
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Zijlstra, E. E., M. Siddig Ali, A. M. El-Hassan, Isam A. El-Toum, Maria Satti, H. W. Ghalib, and P. A. Kager. "Direct agglutination test for diagnosis and sero-epidemiological survey of kala-azar in the Sudan." Transactions of the Royal Society of Tropical Medicine and Hygiene 85, no. 4 (July 1991): 474–76. http://dx.doi.org/10.1016/0035-9203(91)90224-m.

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46

Elzein, E. M. E. Abu. "Recovery of bluetongue virus serogroup from sera collected for a serological survey from apparently healthy cattle, from the Sudan." Journal of Hygiene 96, no. 3 (June 1986): 529–33. http://dx.doi.org/10.1017/s002217240006633x.

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SUMMARYVirus of the bluetongue (BT) serogroup was recovered from 11% of cattle sera collected from apparently healthy animals in Khartoum Province for the sole purpose of screening for BT antibodies. Since these sera did not contain BT antibodies, the donor cattle could have been scored as BT free in the serological survey.Virus was initially isolated in chicken embryos inoculated intravascularly, and was further adapted to Vero cell cultures. Isolates were identified as belonging to the BT serogroup using the agar gel immunodiffusion (AGID) and complement fixation (CF) tests.The results indicated that cattle in the Sudan could harbour BT virus without showing symptoms of the disease. Such an observation necessitates further work to clarify the role of cattle in the epidemiology of BT in the Sudan.
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47

Mohammed Idris, Fawzia, Mehdi Seraj, and Huseyin Ozdeser. "Assessing the possibility of financing social health insurance from zakat, case of Sudan: ARDL bounds approach." Journal of Islamic Accounting and Business Research 13, no. 2 (October 25, 2021): 264–76. http://dx.doi.org/10.1108/jiabr-06-2021-0158.

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Purpose The purpose of this study is to find funding sources for social health insurance in Sudan to cover vulnerable families. Design/methodology/approach The concept of this paper is to look into the causality relationship between insured and directly paid poor people and their incomes through using the autoregressive distributed lag model (ARDL) and using a survey raw data carried out in 2010 in Sudan. Findings The findings show that insured vulnerable people and income-generating activities have a significant positive relationship. The results, on the other hand, show a marginally negative effect on income for those who have directly paid poor people. Originality/value Previous research on the position of zakat has focused primarily on its role in poverty alleviation and has given little consideration to its role in social security. This study is characterized by improving the possibility of changing the mechanism of distributing zakat funds in favor of health financing to maximize the benefit.
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48

Abdalla, Safa. "Patterns of vulnerability to non-fatal injuries in Sudan: initial evidence from a national cross-sectional survey." Injury Prevention 20, no. 5 (December 10, 2013): 310–16. http://dx.doi.org/10.1136/injuryprev-2013-040884.

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49

Elhadi, Yasir Ahmed Mohammed, Abdelmuniem Ahmed, Ramy Mohamed Ghazy, Elhadi B. Salih, Osman S. Abdelhamed, Ramy Shaaban, Hammad Mohamed Hammad Mohamed, Alanood Elnaeem Mohamed, Noha Ahmed El Dabbah, and Ashraf Ahmed Zaher Zaghloul. "Healthcare Utilization with Drug Acquisition and Expenses at the National Health Insurance Fund in Sudan." Healthcare 10, no. 4 (March 27, 2022): 630. http://dx.doi.org/10.3390/healthcare10040630.

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Background: Understanding the pattern of care use can provide valuable information for reform interventions. This study investigates the pattern of healthcare utilization and its association with drug acquisition patterns and expenses in the National Health Insurance Fund (NHIF) of Al Jazira State in Sudan. Methods: A cross-sectional survey was conducted at NHIF primary healthcare centers of Al Jazirah state in Sudan. Results: A total of 768 beneficiaries were interviewed, of which 63.2% reported using out-of-network physician care, while 36.8% receive care from the NHIF physician network only. More than half (60.8%) of NHIF-interviewed clients reported a heavy burden of medication costs. The pattern of physician utilization was significantly associated with the number and source of regular drugs, the burden of out-of-pocket payment, and monthly out-of-pocket expenditures on medications, (p < 0.001). The regression analysis revealed that gender, marital status, number of chronic diseases, and number of regular drugs were the significant predictors of the pattern of physician care utilization; these factors explained nearly 36% of the variance in respondents’ pattern of physician care utilization. Conclusions: An impressive proportion of out-of-network care was found in Al Jazirah State in Sudan. The NHIF stakeholders should consider medication subsidy as a potential strategy for decreasing patient leakage to out-of-network services.
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Mugo, Ngatho Samuel, Kingsley E. Agho, and Michael J. Dibley. "Risk Factors for Non-use of Skilled Birth Attendants: Analysis of South Sudan Household Survey, 2010." Maternal and Child Health Journal 20, no. 6 (March 9, 2016): 1266–79. http://dx.doi.org/10.1007/s10995-016-1928-x.

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