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Free Content Tuberculosis control in Sudan against seemingly insurmountable odds

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SETTING: Sudan, Africa's largest and one of its poorest countries, in which civil disturbance, resource limitation and communications difficulties are substantial impediments to delivery of health services.

OBJECTIVES: To 1) illustrate the burden of tuberculosis; 2) review measures taken to control the disease; 3) outline the introduction of the DOTS strategy; and 4) demonstrate the trend in the output of the DOTS strategy.

METHODS: Published information on general health, tuberculosis and health structure provide the setting. Routine reports illustrate the trend in case notification in Sudan, and outcome of treatment by period of enrolment on treatment (cohort).

RESULTS: Since 1992, sputum smear microscopy centres have been established in existing health facilities (179 of a total 290 targeted centres). By the end of the second quarter of 1998, 82860 cases of tuberculosis had been reported, of whom 52% were sputum smear-positive cases. Of these, 89% 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 the second quarter of 1997; the proportion of notified cases for whom treatment results were available increased from 16% in 1994 to 63% in 1996. Of these, 72% were successfully treated, increasing from 62% in 1994 to 73% in 1996.

CONCLUSIONS: Despite seemingly 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 diagnostic examinations and improvements in treatment outcome. Further improvement is necessary, but appears feasible.
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Keywords: Sudan; tuberculosis control

Document Type: Regular Paper

Affiliations: 1: Sudan National Tuberculosis Programme, Sudan 2: Department of Medicine, University of Khartoum, Sudan 3: International Union Against Tuberculosis and Lung Disease, Paris, France 4: University of Oslo, Oslo, Norway

Publication date: July 1, 2000

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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