In transition: current health challenges and priorities in Sudan
Tóm tắt
A recent symposium and workshop in Khartoum, the capital of the Republic of Sudan, brought together broad expertise from three universities to address the current burden of communicable and non-communicable diseases facing the Sudanese healthcare system. These meetings identified common challenges that impact the burden of diseases in the country, most notably gaps in data and infrastructure which are essential to inform and deliver effective interventions. Non-communicable diseases, including obesity, type 2 diabetes, renal disease and cancer are increasing dramatically, contributing to multimorbidity. At the same time, progress against communicable diseases has been slow, and the burden of chronic and endemic infections remains considerable, with parasitic diseases (such as malaria, leishmaniasis and schistosomiasis) causing substantial morbidity and mortality. Antimicrobial resistance has become a major threat throughout the healthcare system, with an emerging impact on maternal, neonatal and paediatric populations. Meanwhile, malnutrition, micronutrient deficiency and poor perinatal outcomes remain common and contribute to a lifelong burden of disease. These challenges echo the United Nations (UN) sustainable development goals and concentrating on them in a unified strategy will be necessary to address the national burden of disease. At a time when the country is going through societal and political transition, we draw focus on the country and the need for resolution of its healthcare needs.
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Tài liệu tham khảo
Cockett R . Darfur and the failure and division of an African state. Sudan: Yale University Press, 2016.
United Nations . Sudan country profile. Available: https://www.imuna.org/resources/country-profiles/sudan [Accessed Jul 25 2019].
Kloos, 2002, The paleoepidemiology of schistosomiasis in ancient Egypt, Human Ecology, 9, 14
WHO/UNICEF Joint Monitoring Programme . Progress on drinking water, sanitation and hygiene 2017 World Health Organisation; 2017.
Berger S . Infectious diseases of Sudan and South Sudan. Gideon informatics, 2017
Bürgmann H , Frigon D , H Gaze W , et al . Water and sanitation: an essential battlefront in the war on antimicrobial resistance. FEMS Microbiol Ecol 2018;94.doi:10.1093/femsec/fiy101
Yassin, 2014, Quality aspects of manually transported drinking water in the Outskirts of Khartoum state, Univ Khartoum Eng J, 4, 58
United Nations Global Analysis and Assessment of Sanitation and Drinking Water(GLAAS) 2015. Available: https://www.who.int/water_sanitation_health/publications/glaas_strategy.pdf?ua=1 [Accessed Jul 25 2019].
Cha, 2017, Nationwide cross-sectional survey of schistosomiasis and soil-transmitted helminthiasis in Sudan: study protocol, BMC Public Health, 17, 1, 10.1186/s12889-017-4719-4
Lee, 2015, Reduction of urogenital schistosomiasis with an integrated control project in Sudan, PLoS Negl Trop Dis, 9, 10.1371/journal.pntd.0003423
Grimes JET , Croll D , Harrison WE , et al . The roles of water, sanitation and hygiene in reducing schistosomiasis: a review. Parasit Vectors 2015;8.doi:10.1186/s13071-015-0766-9
Gizaw, 2017, Impact of climate change and El Niño episodes on droughts in sub-Saharan Africa, Clim Dyn, 49, 665, 10.1007/s00382-016-3366-2
Food and Agricultiure Organization of the United Nations . Early warning early action report on food security and agriculture. Rome; 2018.
Selby, 2014, Beyond scarcity: rethinking water, climate change and conflict in the Sudans, Global Environmental Change, 29, 360, 10.1016/j.gloenvcha.2014.01.008
Mudawi, 2008, Epidemiology of viral hepatitis in Sudan, Clin Exp Gastroenterol, 1, 9, 10.2147/CEG.S3887
World Health Organisation . Who world malaria report 2018. Geneva World Health Organisation; 2018.
Sudan federal Ministry of health. annual health statistics reports (2014). Malaria indicator survey 2012-2013 in the Republic of Sudan. Available: http://ghdx.healthdata.org/record/sudan-national-malaria-indicator-survey-2012 2013 [Accessed Jul 25 2019].
Suliman, 2016, Molecular Evidence of High Proportion of Plasmodium vivax Malaria Infection in White Nile Area in Sudan, J Parasitol Res, 2016, 1, 10.1155/2016/2892371
Hashim, 2017, Pattern of malaria in hospitalized children in Khartoum state, Sudan J Paediatr, 17, 35, 10.24911/SJP.2017.2.4
Phillips MA , Burrows JN , Manyando C , et al . Malaria. Nat Rev Dis Primers 2017;3.doi:10.1038/nrdp.2017.50
Howes, 2012, G6Pd deficiency prevalence and estimates of affected populations in malaria endemic countries: a geostatistical model-based MAP, PLoS Med, 9, 10.1371/journal.pmed.1001339
John, 2016, Primaquine plus artemisinin combination therapy for reduction of malaria transmission: promise and risk, BMC Med, 14, 4, 10.1186/s12916-016-0611-9
Adeel, 2015, When history was made in Khartoum civil Hospital: first introduction of chemotherapy for schistosomiasis, Sudan J Paediatr, 15, 80
Cha S , Elhag MS , Lee YH , et al . Epidemiological findings and policy implications from the nationwide schistosomiasis and intestinal helminthiasis survey in Sudan (March 2019). Available: https://ssrn.com/abstract=3310618 [Accessed Jul 25 2019].
World Health Organization . Neglected tropical diseases. cutaneous leishmaniasis in Sudan. Available: http://www.emro.who.int/neglected-tropical-diseases/countries/cl-sudan.html [Accessed Jul 25 2019].
Mahamoud, 2018, Identification of an area predominantly endemic for childhood and adolescent visceral leishmaniasis in central Sudan, Acta Trop, 178, 142, 10.1016/j.actatropica.2017.11.010
Marlais, 2018, Visceral leishmaniasis IgG1 rapid monitoring of cure vs. relapse, and potential for diagnosis of post kala-azar dermal leishmaniasis, Front Cell Infect Microbiol, 8, 1, 10.3389/fcimb.2018.00427
Abass, 2017, Bacterial resistance to antibiotics: current situation in Sudan, J Adv Microbiol, 6, 1, 10.9734/JAMB/2017/36715
Mustafa I . The patterns of medicines use in Sudan: a cross sectional study at National health insurance fund setting, 2012. Available: http://apps.who.int/medicinedocs/documents/s20953en/s20953en.pdf [Accessed Jul 25 2019].
Ibrahim, 2012, Increased multi-drug resistant Escherichia coli from hospitals in Khartoum state, Sudan, Afr Health Sci, 12, 368
Kheder, 2013, Physicians' knowledge and perception of antimicrobial resistance: a survey in Khartoum state hospital settings, Br J Pharm Res, 3, 347, 10.9734/BJPR/2013/2117
Elbur, 2013, An audit of prophylactic surgical antibiotic use in a Sudanese teaching hospital, Int J Clin Pharm, 35, 149, 10.1007/s11096-012-9719-y
Elbur, 2013, Prophylactic antibiotics and wound infection, J Clin Diagn Res, 7, 2747
Ahmed, 2013, Puerperal sepsis in a rural hospital in Sudan, Mater Sociomed, 25, 10.5455/msm.2013.25.19-22
Mohammed, 2011, Maternal mortality in Kassala State - Eastern Sudan: community-based study using Reproductive age mortality survey (RAMOS), BMC Pregnancy Childbirth, 11, 10.1186/1471-2393-11-102
Essack, 2017, Antimicrobial resistance in the who African region: current status and roadmap for action, J Public Health, 39, 8
United Nations World Population Prospects , 2017. Available: https://population.un.org/wpp/[Accessed Jul 25 2019].
Elmadhoun, 2016, Prevalence of diabetes mellitus and its risk factors in urban communities of North Sudan: population-based study, J Diabetes, 8, 839, 10.1111/1753-0407.12364
El-Sayed, 2018, Sugar intake in Sudanese individuals was associated with some features of the metabolic syndrome: population based study, Diabetes Metab Syndr, 12, 245, 10.1016/j.dsx.2017.09.001
Ali YA , Almobarak AO , Awadalla H , et al . Obesity among Sudanese adults with diabetes: a population-based survey. Ann Transl Med 2017;5.doi:10.21037/atm.2017.05.11
Khalil, 2017, Low levels of physical activity in Sudanese individuals with some features of metabolic syndrome: population based study, Diabetes Metab Syndr, 11 Suppl 2, S551, 10.1016/j.dsx.2017.04.003
Awadalla, 2017, Diabetes complications in Sudanese individuals with type 2 diabetes: overlooked problems in sub-Saharan Africa?, Diabetes Metab Syndr, 11 Suppl 2, S1047, 10.1016/j.dsx.2017.07.039
Saeed, 2016, A five-year survey of cancer prevalence in Sudan, Anticancer Res, 36, 279
Saeed, 2014, Cancer incidence in Khartoum, Sudan: first results from the cancer registry, 2009-2010, Cancer Med, 3, 1075, 10.1002/cam4.254
Muddathir, 2013, Frequency of Bcr-Abl fusion transcripts in Sudanese patients with chronic myeloid leukemia using real-time reverse transcription-polymerase chain reaction, Saudi Med J, 34, 29
Kassebaum, 2017, Child and adolescent health from 1990 to 2015: findings from the global burden of diseases, injuries, and risk factors 2015 study, JAMA Pediatr, 171, 573, 10.1001/jamapediatrics.2017.0250
Bashir, 2013, Neonatal mortality in Sudan: analysis of the Sudan household survey, 2010, BMC Public Health, 13, 10.1186/1471-2458-13-287
Federal Ministry of Health, Ministry of Health, Government of South Sudan, Central Bureau of Statistics Southern Sudan Commission of Census S & E . Sudan household health survey 2nd round 2010 summary report July; 2010.
Mahfouz, 2012, Iodized salt consumption in Sudan: present status and future directions, J Health Popul Nutr, 30, 431
Hussein, 2012, Iodine status and fish intake of Sudanese schoolchildren living in the red sea and white Nile regions, Public Health Nutr, 15, 2265, 10.1017/S1368980012000833
Crawford, 2014, Nutritional armor in evolution: docosahexaenoic acid as a determinant of neural, evolution and hominid brain development, Mil Med, 179, 61, 10.7205/MILMED-D-14-00246